Is post-operative antibiotic therapy justified for surgical removal of mandibular third molar? A comparative study

Abstract

Surgical removal of impacted mandibular third molar (SRIMTM) is the most common procedure performed in oral and maxillofacial surgery. In the literature, many complications associated with lower third molar removal are described such as pain, swelling, trismus, infection, inflammation, and nerve damage. Antibiotics are routinely used either pre-operatively or post-operatively to reduce the chances of surgical site infection (SSI). However routine use of antibiotics for SRIMTM is still controversial. For antibiotics to be effective in reducing post-operative infective complications, the time of administration is very important. Adequate serum concentration of antibiotic must be achieved prior to the procedure. In a developing country like India, antibiotics are routinely prescribed post-operatively. The current study is designed to evaluate the efficacy of post-operative prophylactic antibiotic in SRIMTM.

Keywords: Impacted mandibular third molar; Post-operative prophylactic antibiotic; Surgical site infection.

Fig. 1

VAS scale to evaluate pain reference values given to patients. A Score 0—no pain, patient feels well. B Score 1—slight pain. If the patient is distracted he/she does not feel pain. C Score 2—mild pain. The patient feels pain even if concentrating on some activity. D Score 3—severe pain. The patient is very disturbed but nevertheless can continue with normal activities. E Score 4—very severe pain. The patient is forced to abandon normal activities. F Score 5—extremely severe pain. The patient must abandon every type of activity and feel the need to lie down

Fig. 2

Vertical and horizontal measurement to determine facial measurement. A Vertical measure corresponds to the measure between the external canthus of the eye and the angle of the mandible. B Horizontal measure corresponds to the measure between the commissure and the ear lobe