Comparison of the effects of administration and non-administration of antibiotics on post-surgical complications of impacted wisdom teeth

Some of the post-operative complications of impacted third molar surgery, one of the most prevalent surgeries in oral field, are known to be infection, erythema, trismus and pain. Antibiotic prescription to prevent post-operative infection under some particular circumstances, is acceptable but under debate considering their disadvantages. In the present study, we examined the infection rate in patients taking no or 2 types of antibiotics distinctively after impacted mandibular third molar surgery.

In this double blind clinical trial, 90 patients within the age range of 18 to 34 were dedicated to 3 groups (group 1: 2 capsules of placebo on surgery day and 1 for 4 days, group 2: Amoxicillin 500 mg every 8 hours for 5 days, group 3: Azithromycin 250 mg, 2 capsules on surgery day and 1 capsule for 4 days). All subjects were treated by a sole surgeon, protocol, surgical technique, and flap type and the same amount of osteotomy. In addition to aforesaid drugs, the patients received chlorhexidine and Gelofen 400 mg. At the day 7 postoperative, cases were examined to evaluate the infection (trismus, erythema and halitosis). Data were analysed using Chi-Square test and the groups were compared by Kruskal-Wallis test.

Three signs of infection (halitosis, erythema and trismus) were compared in patients. Symptoms of halitosis and erythema were more indicated in first group, but the ultimate statistical analyses among the 3 groups from halitosis and erythema viewpoint showed no significant difference (P=0.072, P=0.149). Although, no severe trismus was reported, the most moderate trismus incidence was in group 2 and mild trismus was exhibited in group 1. In group 3, no trismus occurred. On the whole, the trismus frequency among groups was statistically significant (P=0.004).

Comparing infection symptoms of the three study groups emphasized the fact that only trismus rate was statistically significant (P=0.004). On balance, the results of this study indicated that antibiotics did not have significant impact on the reduction of most postoperative complications, especially on infection.