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Meta-Analysis
. 2021 Feb 24;2(2):CD003811.
doi: 10.1002/14651858.CD003811.pub3.

Antibiotics to prevent complications following tooth extractions

Giovanni Lodi  1 , Lorenzo Azzi  2 , Elena Maria Varoni  3 , Monica Pentenero  4 , Massimo Del Fabbro  1 , Antonio Carrassi  3 , Andrea Sardella  3 , Maddalena Manfredi  5
Affiliations
Meta-Analysis

Antibiotics to prevent complications following tooth extractions

Giovanni Lodi et al. Cochrane Database Syst Rev. .

Abstract

Background: The most frequent indications for tooth extractions, generally performed by general dental practitioners, are dental caries and periodontal infections. Systemic antibiotics may be prescribed to patients undergoing extractions to prevent complications due to infection. This is an update of a review first published in 2012.

Objectives: To determine the effect of systemic antibiotic prophylaxis on the prevention of infectious complications following tooth extractions.

Search methods: Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health Trials Register (to 16 April 2020), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, 2020, Issue 3), MEDLINE Ovid (1946 to 16 April 2020), Embase Ovid (1980 to 16 April 2020), and LILACS (1982 to 16 April 2020). The US National Institutes of Health Trials Registry (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases.

Selection criteria: We included randomised, double-blind, placebo-controlled trials of systemic antibiotic prophylaxis in patients undergoing tooth extraction(s) for any indication.

Data collection and analysis: At least two review authors independently performed data extraction and 'Risk of bias' assessment for the included studies. We contacted trial authors for further details where these were unclear. For dichotomous outcomes, we calculated risk ratios (RR) and 95% confidence intervals (CI) using random-effects models. For continuous outcomes, we used mean differences (MD) with 95% CI using random-effects models. We examined potential sources of heterogeneity. We assessed the certainty of the body of evidence for key outcomes as high, moderate, low, or very low, using the GRADE approach.

Main results: We included 23 trials that randomised approximately 3206 participants (2583 analysed) to prophylactic antibiotics or placebo. Although general dentists perform dental extractions because of severe dental caries or periodontal infection, only one of the trials evaluated the role of antibiotic prophylaxis in groups of patients affected by those clinical conditions. We assessed 16 trials as being at high risk of bias, three at low risk, and four as unclear. Compared to placebo, antibiotics may reduce the risk of postsurgical infectious complications in patients undergoing third molar extractions by approximately 66% (RR 0.34, 95% CI 0.19 to 0.64; 1728 participants; 12 studies; low-certainty evidence), which means that 19 people (95% CI 15 to 34) need to be treated with antibiotics to prevent one infection following extraction of impacted wisdom teeth. Antibiotics may also reduce the risk of dry socket by 34% (RR 0.66, 95% CI 0.45 to 0.97; 1882 participants; 13 studies; low-certainty evidence), which means that 46 people (95% CI 29 to 62) need to take antibiotics to prevent one case of dry socket following extraction of impacted wisdom teeth. The evidence for our other outcomes is uncertain: pain, whether measured dichotomously as presence or absence (RR 0.59, 95% CI 0.31 to 1.12; 675 participants; 3 studies) or continuously using a visual analogue scale (0-to-10-centimetre scale, where 0 is no pain) (MD -0.26, 95% CI -0.59 to 0.07; 422 participants; 4 studies); fever (RR 0.66, 95% CI 0.24 to 1.79; 475 participants; 4 studies); and adverse effects, which were mild and transient (RR 1.46, 95% CI 0.81 to 2.64; 1277 participants; 8 studies) (very low-certainty evidence). We found no clear evidence that the timing of antibiotic administration (preoperative, postoperative, or both) was important. The included studies enrolled a subset of patients undergoing dental extractions, that is healthy people who had surgical extraction of third molars. Consequently, the results of this review may not be generalisable to all people undergoing tooth extractions.

Authors' conclusions: The vast majority (21 out of 23) of the trials included in this review included only healthy patients undergoing extraction of impacted third molars, often performed by oral surgeons. None of the studies evaluated tooth extraction in immunocompromised patients. We found low-certainty evidence that prophylactic antibiotics may reduce the risk of infection and dry socket following third molar extraction when compared to placebo, and very low-certainty evidence of no increase in the risk of adverse effects. On average, treating 19 healthy patients with prophylactic antibiotics may stop one person from getting an infection. It is unclear whether the evidence in this review is generalisable to patients with concomitant illnesses or patients at a higher risk of infection. Due to the increasing prevalence of bacteria that are resistant to antibiotic treatment, clinicians should evaluate if and when to prescribe prophylactic antibiotic therapy before a dental extraction for each patient on the basis of the patient's clinical conditions (healthy or affected by systemic pathology) and level of risk from infective complications. Immunocompromised patients, in particular, need an individualised approach in consultation with their treating medical specialist.

PubMed Disclaimer

Conflict of interest statement

GL: none LA: none EV: none MP: none MDF: none AC: none AS: none MM: none

Figures

1
1
Study flow diagram.
2
2
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
3
3
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
4
4
Funnel plot of comparison: antibiotic versus placebo, outcome: infectious complications.
5
5
Funnel plot of comparison: antibiotic versus placebo, outcome: dry socket.
1.1
1.1. Analysis
Comparison 1: Antibiotic versus placebo, Outcome 1: Postsurgical infectious complications (6th to 7th day)
1.2
1.2. Analysis
Comparison 1: Antibiotic versus placebo, Outcome 2: Pain (dichotomous on 6th to 7th day)
1.3
1.3. Analysis
Comparison 1: Antibiotic versus placebo, Outcome 3: Pain score (VAS 0 to 10 cm where 0 = no pain) 7th day
1.4
1.4. Analysis
Comparison 1: Antibiotic versus placebo, Outcome 4: Fever (6th to 7th day)
1.5
1.5. Analysis
Comparison 1: Antibiotic versus placebo, Outcome 5: Swelling (7th day)
1.6
1.6. Analysis
Comparison 1: Antibiotic versus placebo, Outcome 6: Trismus (7th day)
1.7
1.7. Analysis
Comparison 1: Antibiotic versus placebo, Outcome 7: Dry socket (6th to 7th day)
1.8
1.8. Analysis
Comparison 1: Antibiotic versus placebo, Outcome 8: Adverse events (6th to 7th day)
See this image and copyright information in PMC

Update of

References

References to studies included in this review

Arteagoitia 2005 {published data only}
    1. Arteagoitia I, Diez A, Barbier L, Santamaria G, Santamaria J. Efficacy of amoxicillin/clavulanic acid in preventing infectious and inflammatory complications following impacted mandibular third molar extraction. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology 2005;100(1):e11-8. - PubMed
Arteagoitia 2015 {published data only}
    1. Arteagoitia I, Ramos E, Santamaria G, Barbier L, Alvarez J, Santamaria J. Amoxicillin/clavulanic acid 2000/125 mg to prevent complications due to infection following completely bone-impacted lower third molar removal: a clinical trial. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology 2015;119:8-16. - PubMed
Barclay 1987 {published data only}
    1. Barclay JK. Metronidazole and dry socket: prophylactic use in mandibular third molar removal complicated by non-acute pericoronitis. New Zealand Dental Journal 1987;83:71-5. - PubMed
Bergdahl 2004 {published data only}
    1. Bergdahl M, Hedstrom L. Metronidazole for the prevention of dry socket after removal of partially impacted mandibular third molar: a randomised controlled trial. British Journal of Oral & Maxillofacial Surgery 2004;42(6):555-8. - PubMed
Bezerra 2011 {published and unpublished data}
    1. Bezerra T. Poster Board Number: 16: Prophylaxis versus placebo treatment for infective and inflammatory complications of surgical third molar removal: a split-mouth, double-blind, controlled, clinical trial with amoxicillin (500 mg). Journal of Oral and Maxillofacial Surgery 2010;68(9 (Suppl)):e69. - PubMed
    1. Bezerra TP, Studart-Soares EC, Scaparo HC, Pita-Neto IC, Batista SH, Fonteles CS. Prophylaxis versus placebo treatment for infective and inflammatory complications of surgical third molar removal: a split-mouth, double-blind, controlled, clinical trial with amoxicillin (500 mg). Journal of Oral & Maxillofacial Surgery 2011;69(11):e333-9. - PubMed
Bortoluzzi 2013 {published data only}
    1. Bortoluzzi MC, Capella DL, Barbieri T, Pagliarini M, Cavalieri T, Manfro R. A single dose of amoxicillin and dexamethasone for prevention of postoperative complications in third molar surgery: a randomized, double-blind, placebo controlled clinical trial. Journal of Clinical Medicine Research 2013;5:26-33. - PMC - PubMed
Bystedt 1980 {published data only}
    1. Bystedt H, Nord CE, Nordenram A. Effect of azidocillin, erythromycin, clindamycin and doxycycline on postoperative complications after surgical removal of impacted mandibular third molars. International Journal of Oral Surgery 1980;9(3):157-65. - PubMed
Bystedt 1981 {published data only}
    1. Bystedt H, Konow L, Nord CE. A comparison of the effect of phenoxymethylpenicillin and azidocillin on postoperative complications after surgical removal of impacted mandibular third molars. Swedish Dental Journal 1981;5(5-6):225-34. - PubMed
Gbotolorun 2016 {published data only}
    1. Gbotolorun OM, Dipo-Fagbemi IM, Olojede AO, Ebigwei S, Adetoye JO. Are systemic antibiotics necessary in the prevention of wound healing complications after intra-alveolar dental extraction? International Journal of Oral and Maxillofacial Surgery 2016;45:1658-64. - PubMed
Halpern 2007 {published data only}
    1. Halpern LR, Dodson TB. Does prophylactic administration of systemic antibiotics prevent postoperative inflammatory complications after third molar surgery? Journal of Oral and Maxillofacial Surgery 2007;65(2):177-85. - PubMed
Happonen 1990 {published data only}
    1. Happonen RP, Backstrom AC, Ylipaavalniemi P. Prophylactic use of phenoxymethylpenicillin and tinidazole in mandibular third molar surgery, a comparative placebo controlled clinical trial. British Journal of Oral & Maxillofacial Surgery 1990;28(1):12-5. - PubMed
Kaczmarzyk 2007 {published data only}
    1. Kaczmarzyk T, Wichlinski J, Stypulkowska J, Zaleska M, Panas M, Woron J. Single-dose and multi-dose clindamycin therapy fails to demonstrate efficacy in preventing infectious and inflammatory complications in third molar surgery. International Journal of Oral and Maxillofacial Surgery 2007;36(5):417-22. - PubMed
Kaziro 1984 {published data only}
    1. Kaziro GS, Harris M. A comparative placebo controlled trial between metronidazole and Arnica Montana in preventing post-surgical complications. Journal of Dental Research 1981;60(Special Issue):1176.
    1. Kaziro GS. Metronidazole (Flagyl) and Arnica Montana in the prevention of post-surgical complications, a comparative placebo controlled clinical trial. British Journal of Oral & Maxillofacial Surgery 1984;22(1):42-9. - PubMed
Lacasa 2007 {published data only}
    1. Lacasa JM, Jiménez JA, Ferrás V, Bossom M, Sóla-Morales O, García-Rey C, et al. Prophylaxis versus pre-emptive treatment for infective and inflammatory complications of surgical third molar removal: a randomized, double-blind, placebo-controlled, clinical trial with sustained release amoxicillin/clavulanic acid (1000/62.5 mg). International Journal of Oral and Maxillofacial Surgery 2007;36(4):321-7. - PubMed
Leon Arcila 2001 {published and unpublished data}
    1. Leon Arcila ME, Acosta P, Bravo BE, Mena A, Noguera DP, Zúñiga JR. Antibiotic prophylaxis in third molar surgery [Profilaxis antibiotica en cirugia de terceros molares incluidos]. Revista Estomatologia 2001;9(2):4-13.
López‐Cedrún 2011 {published and unpublished data}
    1. López-Cedrún JL, Pijoan JI, Fernández S, Santamaria J, Hernandez G. Efficacy of amoxicillin treatment in preventing postoperative complications in patients undergoing third molar surgery: a prospective, randomized, double-blind controlled study. Journal of Oral and Maxillofacial Surgery 2011;69:e5-14. - PubMed
MacGregor 1980 {published data only}
    1. MacGregor AJ, Addy A. Value of penicillin in the prevention of pain, swelling and trismus following the removal of ectopic mandibular third molars. International Journal of Oral Surgery 1980;9(3):166-72. - PubMed
    1. MacGregor AJ, Addy AG. The effect of penicillin upon pain, swelling and trismus following the removal of impacted third molars. Journal of Dental Research 1980;59(Special Issue D Part 1):1799 (Abs No 35).
Milani 2015 {published data only}
    1. Milani BA, Bauer HC, Sampaio-Filho H, Horliana AC, Perez FE, Tortamano IP, et al. Antibiotic therapy in fully impacted lower third molar surgery: randomized three-arm, double-blind, controlled trial. Oral and Maxillofacial Surgery 2015;19:341-6. - PubMed
Mitchell 1986 {published data only}
    1. Mitchell DA. A controlled clinical trial of prophylactic tinidazole for chemoprophylaxis in third molar surgery. British Dental Journal 1986;160(8):284-6. - PubMed
Pasupathy 2011 {published data only}
    1. Pasupathy S, Alexander M. Antibiotic prophylaxis in third molar surgery. Journal of Craniofacial Surgery 2011;22:551-3. - PubMed
Ritzau 1992 {published data only}
    1. Ritzau M, Hillerup S, Branebjerg PE, Ersbol BK. Does metronidazole prevent alveolitis sicca dolorosa? A double-blind, placebo-controlled clinical study. International Journal of Oral and Maxillofacial Surgery 1992;21(5):299-302. - PubMed
Sekhar 2001 {published data only}
    1. Sekhar CH, Narayanan V, Baig MF. Role of antimicrobials in third molar surgery: prospective, double blind, randomized, placebo-controlled clinical study. British Journal of Oral & Maxillofacial Surgery 2001;39(2):134-7. - PubMed
Sixou 2012 {published data only}
    1. Sixou M, Burban J, Lakhssassi N, Duran D, De Mello G, Quéro J. Amoxicillin prophylaxis in oral surgery. Revue de Stomatologie et Chirurgie Maxillo-Faciale 2012;113:358-64. - PubMed

References to studies excluded from this review

Abu‐Mowais 1990 {published data only}
    1. Abu-Mowais M, Abdul-Amir R, El-Mostehy MR, Mansour M, Mohalhal I. The clinical safety and efficacy of antibiotic prophylaxis after surgical removal of third molars. Journal of the Kuwait Medical Association 1990;24(1):57-9.
Adde 2012 {published data only}
    1. Adde CA, Soares MS, Romano MM, Carnaval TG, Sampaio RM, Aldarvis FP, et al. Clinical and surgical evaluation of the indication of postoperative antibiotic prescription in third molar surgery. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology 2012;114:S26-31. [DOI: 10.1016/j.tripleo.2011.08.018] - DOI - PubMed
Arora 2014 {published data only}
    1. Arora A, Roychoudhury A, Bhutia O, Pandey S, Singh S, Das BK. Antibiotics in third molar extraction; are they really necessary: a non-inferiority randomized controlled trial. National Journal of Maxillofacial Surgery 2014;5:166-71. [DOI: 10.4103/0975-5950.154821] - DOI - PMC - PubMed
Ataoglu 2008 {published data only}
    1. Ataoğlu H, Oz GY, Candirli C, Kiziloğlu D. Routine antibiotic prophylaxis is not necessary during operations to remove third molars. British Journal of Oral & Maxillofacial Surgery 2008;46(2):133-5. - PubMed
Bargnesi 1985 {published data only}
    1. Bargnesi R, Bondi C, Cavalli A, Vallania G. A clinical double blind study of the usefulness of systemic prophylactic antibiotic therapy in minor oral surgery. Giornale di Stomatologia e di Ortognatodonzia 1985;4(2):29-32. - PubMed
Barone 2017 {published and unpublished data}
    1. Barone A, Marchionni FS, Cinquini C, Cipolli Panattoni A, Toti P, Marconcini S, et al. Antibiotic treatment to prevent postextraction complications: a monocentric, randomized clinical trial. Preliminary outcomes. Minerva Stomatologica 2017;66(4):148-56. - PubMed
    1. Marchionni FS. Antibiotic treatment to prevent postextraction complications: a monocentric, randomized clinical trial. Preliminary outcomes [PhD thesis]. Pisa (Italy): Università di Pisa, 2017. - PubMed
Busa 2014 {published data only}
    1. Busa A, Parrini S, Chisci G, Pozzi T, Burgassi S, Capuano A. Local versus systemic antibiotics effectiveness: a comparative study of postoperative oral disability in lower third molar surgery. Journal of Craniofacial Surgery 2014;25:708-9. [DOI: 10.1097/SCS.0000000000000431] - DOI - PubMed
Curran 1974 {published data only}
    1. Curran JB, Kennett S, Young AR. An assessment of the use of prophylactic antibiotics in third molar surgery. International Journal of Oral Surgery 1974;3(1):1-6. - PubMed
Delilbasi 2004 {published data only}
    1. Delilbasi C, Saracoglu U, Keskin A. Effects of 0.2% chlorhexidine gluconate and amoxicillin plus clavulanic acid on the prevention of alveolar osteitis following mandibular third molar extractions. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, & Endodontology 2002;94(3):301-4. - PubMed
de Moura 2011 {published data only}
    1. Moura WL, Freire SASR, Mendes SM, Olate S. Efficacy of amoxicillin treatment in preventing postoperative complications in patients undergoing third molar surgery: a double blind study [Eficacia del tratamiento con amoxicilina en la prevención de complicaciones postoperatorias en pacientes sometidos a cirugía del tercer molar: un estudio doble ciego]. International Journal of Odontostomatology 2011;5(2):147-52.
Foy 2004 {published data only}
    1. Foy SP, Shugars DA, Phillips C, Marciani RD, Conrad SM, White RP Jr. The impact of intravenous antibiotics on health-related quality of life outcomes and clinical recovery after third molar surgery. Journal of Oral and Maxillofacial Surgery 2004;62(1):15-21. - PubMed
Fridrich 1990 {published data only}
    1. Fridrich KL, Olson RA. Alveolar osteitis following surgical removal of mandibular third molars. Anesthesia Progress 1990;37(1):32-41. - PMC - PubMed
Graziani 2005 {published data only}
    1. Graziani F, Corsi L, Fornai M, Antonioli L, Tonelli M, Ceia S, et al. Clinical evaluation of piroxicam-FDDF and azithromycin in the prevention of complications associated with impacted lower third molar extraction. Pharmacological Research 2005;52(6):485-90. - PubMed
Grossi 2007 {published data only}
    1. Grossi GB, Maiorana C, Garramone RA, Borgonovo A, Creminelli L, Santoro F. Assessing postoperative discomfort after third molar surgery: a prospective study. Journal of Oral and Maxillofacial Surgery 2007;65(5):901-17. - PubMed
Head 1984 {published data only}
    1. Head TW, Bentley KC, Millar EP, deVries JA. A comparative study of the effectiveness of metronidazole and penicillin V in eliminating anaerobes from postextraction bacteremias. Oral Surgery, Oral Medicine, and Oral Pathology 1984;58(2):152-5. - PubMed
Krekmanov 1980 {published data only}
    1. Krekmanov L, Hallander HO. Relationship between bacterial contamination and alveolitis after third molar surgery. International Journal of Oral Surgery 1980;9(4):274-80. - PubMed
Krekmanov 1981 {published data only}
    1. Krekmanov L. Alveolitis after operative removal of third molars in the mandible. International Journal of Oral Surgery 1981;10(3):173-9. - PubMed
Krekmanov 1986 {published data only}
    1. Krekmanov L, Nordenram A. Postoperative complications after surgical removal of mandibular third molars. Effects of penicillin V and chlorhexidine. International Journal of Oral and Maxillofacial Surgery 1986;15(1):25-9. - PubMed
Laird 1972 {published data only}
    1. Laird WR, Stenhouse D, Macfarlane TW. Control of post-operative infection. A comparative evaluation of clindamycin and phenoxymethylpenicillin. British Dental Journal 1972;133(3):106-9. - PubMed
Limeres 2009 {published data only}
    1. Limeres J, Sanromán JF, Tomás I, Diz P. Patients' perception of recovery after third molar surgery following postoperative treatment with moxifloxacin versus amoxicillin and clavulanic acid: a randomized, double-blind, controlled study. Journal of Oral and Maxillofacial Surgery 2009;67(2):286-91. - PubMed
Lombardia Garcia 1987 {published data only}
    1. Lombardía García E, García Pola MJ, González García M, Gener González M. Antimicrobial prophylaxis in surgery of the third molar. Analytic study of postoperative complications. Archivos de Odonto Estomatologia 1987;3(3):130-4. - PubMed
Lopes 2011 {published data only}
    1. Lopes DR, Peres MP, Levin AS. Randomized study of surgical prophylaxis in immunocompromised hosts. Journal of Dental Research 2011;90(2):225-9. - PubMed
Luaces‐Rey 2010 {published data only}
    1. Luaces-Rey R, Arenaz-Búa J, Lopez-Cedrun-Cembranos JL, Martínez-Roca C, Pértega-Díaz S, Sironvalle-Soliva S. Efficacy and safety comparison of two amoxicillin administration schedules after third molar removal. A randomized, double-blind and controlled clinical trial. Medicina Oral, Patologia Oral y Cirugia Bucal 2010;15(4):633-8. - PubMed
Lyall 1991 {published data only}
    1. Lyall JB. Third molar surgery: the effect of primary closure, wound dressing and metronidazole on postoperative recovery. Journal of the Royal Army Medical Corps 1991;137(2):100-3. - PubMed
MacGregor 1973 {published data only}
    1. MacGregor AJ, Hutchinson D. The effect of Nivemycin on pain and swelling following lower third molar removal. British Journal of Oral Surgery 1973;10(3):321-5. - PubMed
Milani 2012 {published data only}
    1. Milani BA, Jorge WA, Peixoto IF, Ratto Tempestini Horlana AC, Bauer HC. Clinical evaluation of the efficacy of Amoxiline given in multiple doses in the postoperative period of extraction of lower third molars [Avaliacao clinica da eficacia da Amoxilina ministrada em multiplas doses no pos-operatorio de exodontias de terceiros molares inferiores]. RPG - Revista da Pós-Graduação 2012;19:69-75.
Mitchell 1987 {published data only}
    1. Mitchell DA, Morris TA. Tinidazole or pivampicillin in third molar surgery. International Journal of Oral and Maxillofacial Surgery 1987;16(2):171-4. - PubMed
Monaco 1999 {published data only}
    1. Monaco G, Staffolani C, Gatto MR, Checchi L. Antibiotic therapy in impacted third molar surgery. European Journal of Oral Science 1999;6(107):437-41. - PubMed
Monaco 2009 {published data only}
    1. Monaco G, Tavernese L, Agostini R, Marchetti C. Evaluation of antibiotic prophylaxis in reducing postoperative infection after mandibular third molar extraction in young patients. Journal of Oral and Maxillofacial Surgery 2009;67(7):1467-72. - PubMed
Olusanya 2011 {published data only}
    1. Olusanya AA, Arotiba JT, Fasola OA, Akadiri AO. Prophylaxis versus pre-emptive antibiotics in third molar surgery: a randomised control study. Nigerian Postgraduate Medical Journal 2011;18(2):105-10. - PubMed
Osborn 1979 {published data only}
    1. Osborn JF, Jaques WA, Thalmann R, Spiessl B. Efficiency of systemic prophylactic antibiotics in the surgical removal of lower wisdom teeth. SSO: Schweizerische Monatsschrift fur Zahnheilkunde 1979;89(5):458-66. - PubMed
Poeschl 2004 {published data only}
    1. Poeschl PW, Eckel D, Poeschl E. Postoperative prophylactic antibiotic treatment in third molar surgery - a necessity? Journal of Oral and Maxillofacial Surgery 2004;62(1):3-9. - PubMed
    1. Poeschl PW, Eckel D. Antibiotic prophylaxis after out-patient removal of wisdom teeth: a necessity? Stomatologie 2003;100(5):115.
Reekie 2006 {published data only}
    1. Reekie D, Downes P, Devlin CV, Nixon GM, Devlin H. The prevention of 'dry socket' with topical metronidazole in general dental practice. British Dental Journal 2006;200(4):210-3. - PubMed
Rood 1979 {published data only}
    1. Rood JP, Murgatroyd J. Metronidazole in the prevention of 'dry socket'. British Journal of Oral Surgery 1979;17(1):62-70. - PubMed
Samsudin 1994 {published data only}
    1. Samsudin AR, Mason DA. Symptoms from impacted wisdom teeth. British Journal of Oral & Maxillofacial Surgery 1994;32(6):380-3. - PubMed
Siddiqi 2010 {published data only}
    1. Siddiqi A, Morkel JA, Zafar S. Antibiotic prophylaxis in third molar surgery: a randomized double-blind placebo-controlled clinical trial using split-mouth technique. International Journal of Oral and Maxillofacial Surgery 2010;39(2):107-4. - PubMed
Stavropoulos 2006 {published data only}
    1. Stavropoulos MF, Shugars DA, Phillips C, Conrad SM, Fleuchaus PT, White RP Jr. Impact of topical minocycline with third molar surgery on clinical recovery and health-related quality of life outcomes. Journal of Oral and Maxillofacial Surgery 2006;64(7):1059-65. - PubMed
Sulejmanagić 2005 {published data only}
    1. Sulejmanagić N, Sulejmanagić H, Ljutović Z, Salihagić D, Sijercić M. Combined application of amoxicillin and clavulanic acid after oral surgical interventions. Bosnian Journal of Basic Medical Science 2005;5(1):61-8. - PMC - PubMed
Swanson 1989 {published data only}
    1. Swanson AE. A double-blind study on the effectiveness of tetracycline in reducing the incidence of fibrinolytic alveolitis. Journal of Oral and Maxillofacial Surgery 1989;47(2):165-7. - PubMed
Uluibau 2005 {published data only}
    1. Uluibau IC, Jaunay T, Goss AN. Severe odontogenic infections. Australian Dental Journal 2005;50(2):S74-81. - PubMed
Walkow 1995 {published data only}
    1. Walkow T, Papageorge M, Norris L, Cottrell D. Prophylactic antibiotic efficacy in third molar surgery (AADR Abstract 1995). Journal of Dental Research 1995;74(Special Issue):138 (Abs No 1013).
Xue 2015 {published data only}
    1. Xue P, Wang J, Wu B, Ma Y, Wu F, Hou R. Efficacy of antibiotic prophylaxis on postoperative inflammatory complications in Chinese patients having impacted mandibular third molars removed: a split-mouth, double-blind, self-controlled, clinical trial. British Journal of Oral & Maxillofacial Surgery 2015;53:416-20. [DOI: 10.1016/j.bjoms.2015.02.001] - DOI - PubMed
Yoshii 2002 {published data only}
    1. Yoshii T, Hamamoto Y, Muraoka S, Furudoi S, Komori T. Differences in postoperative morbidity rates, including infection and dry socket, and differences in the healing process after mandibular third molar surgery in patients receiving 1-day or 3-day prophylaxis with lenampicillin. Journal of Infection & Chemotherapy 2002;8(1):87-93. - PubMed

References to ongoing studies

CTRI/2019/12/022342 {published data only}
    1. CTRI/2019/12/022342. Necessity of antibiotic administration following dental extraction- A triple blinded randomized controlled trial [Comparative evaluation of necessity of antibiotic administration following dental extraction among population of age group 30- 60 years - Triple blinded randomized control trial.]. http://ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=35292&EncHid... 12/12/2019.
EudraCT 2017‐004986‐28 {published data only}
    1. EudraCT 2017-004986-28. Effect of systemic antibiotic therapy on postoperative complications in patients undergoing wisdom teeth removal surgery. A double-blind, randomised, placebo-controlled Trial [Effect of the usage of antibiotic treatment in patients undergoing wisdom teeth removal surgery]. https://www.clinicaltrialsregister.eu/ctr-search/trial/2017-004986-28/AT First received 2019-02-08.

Additional references

Aida 2009
    1. Aida J, Morita M, Akhter R, Aoyama H, Masui M, Ando Y. Relationships between patient characteristics and reasons for tooth extraction in Japan. Community Dental Health 2009;26(2):104-9. - PubMed
Akhter 2008
    1. Akhter R, Hassan NM, Aida J, Zaman KU, Morita M. Risk indicators for tooth loss due to caries and periodontal disease in recipients of free dental treatment in an adult population in Bangladesh. Oral Health & Preventive Dentistry 2008;6(3):199-207. - PubMed
Al‐Shammari 2006
    1. Al-Shammari KF, Al-Ansari JM, Al-Melh MA, Al-Khabbaz AK. Reasons for tooth extraction in Kuwait. Medical Principles & Practice 2006;15(6):417-22. - PubMed
Anand 2010
    1. Anand PS, Kamath KP, Nair B. Trends in extraction of permanent teeth in private dental practices in Kerala state, India. Journal of Contemporary Dental Practice 2010;11(3):41-8. - PubMed
Antibiotic Resistance Threats in the United States
    1. Centers for Disease Control and Prevention. Antibiotic Resistance Threats in the United States, 2019. Atlanta, GA: U.S: Centers for Disease Control and Prevention, 2019. [DOI: ]
Arteagoitia 2016
    1. Arteagoitia MI, Barbier L, Santamaría J, Santamaría G, Ramos E. Efficacy of amoxicillin and amoxicillin/clavulanic acid in the prevention of infection and dry socket after third molar extraction. A systematic review and meta-analysis. Medicina Oral, Patologia Oral y Cirugia Bucal 2016;21(4):e494-504. - PMC - PubMed
Baqain 2007
    1. Baqain ZH, Khraisat A, Sawair F, Ghanam S, Shaini FJ, Rajab LD. Dental extraction for patients presenting at oral surgery student clinic. Compendium of Continuing Education in Dentistry 2007;28(3):146-50. - PubMed
Bortoluzzi 2010
    1. Bortoluzzi MC, Manfro R, De Déa BE, Dutra TC. Incidence of dry socket, alveolar infection, and postoperative pain following the extraction of erupted teeth. Journal of Contemporary Dental Practice 2010;11(1):E033-E040. [PMID: ] - PubMed
Bouloux 2007
    1. Bouloux GF, Steed MB, Perciaccante VJ. Complications of third molar surgery. Oral and Maxillofacial Surgery Clinics of North America 2007;19(1):117-28. - PubMed
Byahatti 2011
    1. Byahatti SM, Ingafou MS. Reasons for extraction in a group of Libyan patients. International Dental Journal 2011;61(4):199-203. - PMC - PubMed
Chestnutt 2000
    1. Chestnutt IG, Binnie VI, Taylor MM. Reasons for tooth extraction in Scotland. Journal of Dentistry 2000;28(4):295-7. - PubMed
Chrysanthakopoulos 2011
    1. Chrysanthakopoulos NA. Reasons for extraction of permanent teeth in Greece: a five-year follow-up study. International Dental Journal 2011;61(1):19-24. - PMC - PubMed
Costelloe 2010
    1. Costelloe C, Metcalfe C, Lovering A, Mant D, Hay AD. Effect of antibiotic prescribing in primary care on antimicrobial resistance in individual patients: systematic review and meta-analysis. BMJ 2010;340:c2096. - PubMed
Da'ameh 2006
    1. Da'ameh D. Reasons for permanent tooth extraction in the north of Afghanistan. Journal of Dentistry 2006;34(1):48-51. - PubMed
Daly 2012
    1. Daly B, Sharif MO, Newton T, Jones K, Worthington HV. Local interventions for the management of alveolar osteitis (dry socket). Cochrane Database of Systematic Reviews 2012, Issue 12. Art. No: CD006968. [DOI: 10.1002/14651858.CD006968.pub2] - DOI - PubMed
Danielson 2011
    1. Danielson OE, Chinedu AC, Oluyemisi EA, Bashiru BO, Ndubuisi OO. Frequency, causes and pattern of adult tooth extraction in a Nigerian rural health facility. Odonto-stomatologie Tropicale 2011;34(134):5-10. - PubMed
Dar‐Odeh 2010
    1. Dar-Odeh NS, Abu-Hammad OA, Al-Omiri MK, Khraisat AS, Shehabi AA. Antibiotic prescribing practices by dentists: a review. Therapeutics and Clinical Risk Management 2010;6:301-6. - PMC - PubMed
Dellinger 1994
    1. Dellinger EP, Gross PA, Barrett TL, Krause PJ, Martone WJ, McGowan JE Jr, et al. Quality standard for antimicrobial prophylaxis in surgical procedures. Infectious Diseases Society of America. Clinical Infectious Diseases 1994;18:422-7. - PubMed
Egger 1997
    1. Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ 1997;315(7109):629-34. - PMC - PubMed
Epstein 2000
    1. Epstein JB, Chong S, Le ND. A survey of antibiotic use in dentistry. Journal of the American Dental Association 2000;131(11):1600-9. - PubMed
EU Commission 2011
    1. European Commission Directorate-General for Health & Consumers. Antimicrobial resistance — EU action [Communication (COM(2011 748 final) — Action plan against the rising threats from antimicrobial resistance]. https://eur-lex.europa.eu/legal-content/EN/LSU/?uri=CELEX:52011DC0748 last update 04.10.2019.
EU Commission 2019
    1. Implementation of the EU One Health Action Plan against AMR. European Commission 2019.
Ford 2017
    1. Ford PJ, Saladine C, Zhang K, Hollingworth SA. Prescribing patterns of dental practitioners in Australia from 2001 to 2012. Antimicrobials. Australian Dental Journal 2017;62(1):52-7. - PubMed
Ghaeminia 2020
    1. Ghaeminia H, Perry J, Nienhuijs MEL, Toedtling V, Tummers M, Hoppenreijs TJM, et al. Surgical removal versus retention for the management of asymptomatic disease-free impacted wisdom teeth. Cochrane Database of Systematic Reviews 2020, Issue 5. Art. No: CD003879. [DOI: 10.1002/14651858.CD003879.pub5] - DOI - PMC - PubMed
Higgins 2017
    1. Higgins JPT, Green S, editor(s). Cochrane Handbook for Systematic Reviews of Interventions version 5.2 (updated June 2017). Cochrane, 2017. Available from training.cochrane.org/handbook/archive/v5.2.
Howe 1985
    1. Howe LH. Minor Oral Surgery. 3rd edition. Bristol: Wright, 1985.
Ioannidis 2009
    1. Ioannidis JP. Adverse events in randomized trials: neglected, restricted, distorted, and silenced. Archives of Internal Medicine 2009;169(19):1737-9. - PubMed
Isiordia‐Espinoza 2015
    1. Isiordia-Espinoza MA, Aragon-Martinez OH, Martínez-Morales JF, Zapata-Morales JR. Risk of wound infection and safety profile of amoxicillin in healthy patients which required third molar surgery: a systematic review and meta-analysis. British Journal of Oral & Maxillofacial Surgery 2015;53(9):796-804. - PubMed
Isiordia‐Espinoza 2018
    1. Isiordia-Espinoza MA, Aragon-Martinez OH, Bollogna-Molina RE, Alonso-Castro ÁJ. Infection, alveolar osteitis, and adverse effects using metronidazole in healthy patients undergoing third molar surgery: a meta-analysis. Journal of Maxillofacial and Oral Surgery 2018;17(2):142-9. - PMC - PubMed
Jaafar 2000
    1. Jaafar N, Nor GM. The prevalence of post-extraction complications in an outpatient dental clinic in Kuala Lumpur Malaysia - a retrospective survey. Singapore Dental Journal 2000;23(1):24-8. - PubMed
Jafarian 2013
    1. Jafarian M, Etebarian A. Reasons for extraction of permanent teeth in general dental practices in Tehran, Iran. Medical Principles and Practice 2013;22(3):239-44. - PMC - PubMed
Jamghili 2016
    1. Jamghili H, Greenwood WJ, Guevara PH, Dunn WJ. Reasons for non-third molar extractions in a military population. US Army Medical Department Journal 2016:85-92. - PubMed
Jovino‐Silveira 2005
    1. Jovino-Silveira RC, Caldas Ade F Jr, Souza EH, Gusmão ES. Primary reason for tooth extraction in a Brazilian adult population. Oral Health & Preventive Dentistry 2005;3(3):151-7. - PubMed
Kassebaum 2014
    1. Kassebaum NJ, Bernabé E, Dahiya M, Bhandari B, Murray CJL, Marcenes W. Global burden of severe tooth loss: a systematic review and meta-analysis. Journal of Dental Research 2014;93(7 Suppl):20S-8S. - PMC - PubMed
Khalil 2015
    1. Khalil D, Hultin M, Andersson FL, Parkbring Olsson N, Lund B. Antibiotic prescription patterns among Swedish dentists working with dental implant surgery: adherence to recommendations. Clinical Oral Implants Research 2015;26(9):1064-9. - PubMed
Kim 2017
    1. Kim Min K, Chuang S-K, August M. Antibiotic resistance in severe orofacial infections. Journal of Oral and Maxillofacial Surgery: Official Journal of the American Association of Oral and Maxillofacial Surgeons 2017;75(5):962-8. - PubMed
Lee 2015
    1. Lee CY, Chang YY, Shieh TY, Chang CS. Reasons for permanent tooth extractions in Taiwan. Asia Pacific Journal of Public Health 2015;27(2):Np2350-7. - PubMed
Lefebvre 2019
    1. Lefebvre C, Glanville J, Briscoe S, Littlewood A, Marshall C, Metzendorf M-I, et al. Technical Supplement to Chapter 4: Searching for and selecting studies. In: Higgins JPT, Thomas J, Chandler J, Cumpston MS, Li T, Page MJ, Welch VA, editor(s). Cochrane Handbook for Systematic Reviews of Interventions, Version 6 (updated October 2019). Cochrane, 2019. Available from training.cochrane.org/handbook/archive/v6.
Lesolang 2009
    1. Lesolang RR, Motloba DP, Lalloo R. Patterns and reasons for tooth extraction at the Winterveldt Clinic: 1998-2002. South African Dental Journal 2009;64(5):214-5, 218. - PubMed
Lökken 1975
    1. Lökken P, Olsen I, Bruaset I, Norman-Pedersen K. Bilateral surgical removal of impacted lower third molar teeth as a model for drug evaluation: a test with ibuprofen. European Journal of Clinical Pharmacology 1975;8(3-4):209-16. - PubMed
Marra 2016
    1. Marra F, George D, Chong M, Sutherland S, Patrick DM. Antibiotic prescribing by dentists has increased: Why? Journal of the American Dental Association 2016;147(5):320-7. - PubMed
McCaul 2001
    1. McCaul LK, Jenkins WMM, Kay EJ. The reasons for extraction of permanent teeth in Scotland: a 15-year follow-up study. British Dental Journal 2001;190(12):658-62. - PubMed
Menon 2019
    1. Menon RK, Gopinath D, Li KY, Leung YY, Botelho MG. Does the use of amoxicillin/amoxicillin-clavulanic acid in third molar surgery reduce the risk of postoperative infection? A systematic review with meta-analysis. International Journal of Oral and Maxillofacial Surgery 2019;48(2):263-73. - PubMed
Passarelli 2020
    1. Passarelli PC, Pagnoni S, Piccirillo GB, Desantis V, Benegiamo M, Liguori A, et al. Reasons for tooth extractions and related risk factors in adult patients: a cohort study. International Journal of Environmental Research and Public Health 2020;17(7):2575. - PMC - PubMed
Preus 2017
    1. Preus HR, Fredriksen KW, Vogsland AE, Sandvik L, Grytten JI. Antibiotic-prescribing habits among Norwegian dentists: a survey over 25 years (1990-2015). European Journal of Oral Sciences 2017;125(4):280-7. - PubMed
Ramos 2016
    1. Ramos E, Santamaría J, Santamaría G, Barbier L, Arteagoitia I. Do systemic antibiotics prevent dry socket and infection after third molar extraction? A systematic review and meta-analysis. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology 2016;122(4):403-25. - PubMed
Ren 2007
    1. Ren YF, Malmstrom HS. Effectiveness of antibiotic prophylaxis in third molar surgery: a meta-analysis of randomized controlled clinical trials. Journal of Oral and Maxillofacial Surgery 2007;65(10):1909-21. - PubMed
Richards 2005
    1. Richards W, Ameen J, Coll AM, Higgs G. Reasons for tooth extraction in four general dental practices in South Wales. British Dental Journal 2005;198(5):275-8. - PubMed
Rücker 2008
    1. Rücker G, Schwarzer G, Carpenter J. Arcsine test for publication bias in meta-analyses with binary outcomes. Statistics in Medicine 2008;27(5):746-63. - PubMed
Sleeman 1995
    1. Sleeman D, Barry H, Ryan C, Allen F. Day case oral surgery: a review of 25 years experience at the Dublin Dental Hospital. British Dental Journal 1995;179(6):221-4. - PubMed
Suda 2019
    1. Suda KJ, Calip GS, Zhou J, Rowan S, Gross AE, Hershow RC, et al. Assessment of the appropriateness of antibiotic prescriptions for infection prophylaxis before dental procedures, 2011 to 2015. JAMA Network Open 2019;2(5):e193909. - PMC - PubMed
Teoh 2018
    1. Teoh L, Stewart K, Marino RJ, McCullough MJ. Current prescribing trends of antibiotics by dentists in Australia from 2013 to 2016. Part 1. Australian Dental Journal 2018;63:329-37. - PubMed
Thomas 1994
    1. Thomas D, Walker R, Smith A, Shepherd J. The provision of oral surgery services in England and Wales 1984-1991. British Dental Journal 1994;176(6):215-9. - PubMed
Thornhill 2019
    1. Thornhill MH, Dayer MJ, Durkin MJ, Lockhart PB, Baddour LM. Risk of adverse reactions to oral antibiotics prescribed by dentists. Journal of Dental Research 2019;98(10):1081-7. - PMC - PubMed
Thornhill 2019a
    1. Thornhill MH, Dayer MJ, Durkin MJ, Lockhart PB, Baddour LM. Oral antibiotic prescribing by NHS dentists in England 2010-2017. British Dental Journal 2019;227(12):1044-50. - PMC - PubMed
Trovik 2000
    1. Trovik TA, Klock KS, Haugejorden O. Trends in reasons for tooth extractions in Norway from 1968 to 1998. Acta Odontolologica Scandinavica 2000;58(2):89-96. - PubMed
Worthington 1999
    1. Worthington H, Clarkson J, Davies R. Extraction of teeth over 5 years in regularly attending adults. Community Dentistry and Oral Epidemiology 1999;27(3):187-94. - PubMed

References to other published versions of this review

Lodi 2012
    1. Lodi G, Figini L, Sardella A, Carrassi A, Del Fabbro M, Furness S. Antibiotics to prevent complications following tooth extractions. Cochrane Database of Systematic Reviews 2012, Issue 11. Art. No: CD003811. [DOI: 10.1002/14651858.CD003811.pub2] - DOI - PubMed

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