Are systemic antibiotics necessary in the prevention of wound healing complications after intra-alveolar dental extraction?

Int J Oral Maxillofac Surg. 2016 Dec;45(12):1658-1664. doi: 10.1016/j.ijom.2016.08.023. Epub 2016 Oct 13.

Abstract

This double-blind, randomized controlled study was done to assess the necessity of systemic antibiotics in the prevention of wound healing complications after intra-alveolar dental extraction. A consecutive recruitment method was used to allocate participants to two treatment groups. Subjects in group A (antibiotics group, n=75) received amoxicillin and metronidazole for 5 days postoperatively, while those in group B (placebo group, n=75) were given identical-looking placebo drugs in place of the antibiotics. Postoperative socket healing complications, pain, and compliance with postoperative instructions were assessed postoperatively. Healing was uneventful in 129 patients (86%). Twenty-one patients (14%) developed wound healing complications. Dry socket was the most common complication in the antibiotics group (six subjects), while acutely inflamed sockets was the most common in the placebo group (five subjects). Non-adherence to postoperative instructions and postoperative pain were found to be significantly associated with the development of wound healing complications. The prescription of antibiotics after routine intra-alveolar dental extraction in healthy patients may not play any significant role in preventing wound healing complications. However, non-compliance with postoperative instructions might be associated with increased wound healing complications.

Keywords: antibiotics use; intra-alveolar dental extraction.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Amoxicillin / therapeutic use
  • Anti-Bacterial Agents / therapeutic use*
  • Double-Blind Method
  • Dry Socket / etiology
  • Female
  • Humans
  • Male
  • Metronidazole / therapeutic use
  • Middle Aged
  • Patient Compliance
  • Postoperative Complications / etiology
  • Postoperative Complications / prevention & control*
  • Surgical Wound / complications*
  • Tooth Extraction / adverse effects*
  • Wound Healing / drug effects*

Substances

  • Anti-Bacterial Agents
  • Metronidazole
  • Amoxicillin