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Review
. 2024 Jan-Apr;15(1):29-35.
doi: 10.4103/njms.njms_163_22. Epub 2024 Mar 19.

Comparative efficacy of pre-operative and post-operative administration of amoxicillin in third molar extraction surgery - A systematic review and meta-analysis

Tapasya V Karemore  1 , Kanchan A Ashtankar  1 , Mukta Motwani  1
Affiliations
Review

Comparative efficacy of pre-operative and post-operative administration of amoxicillin in third molar extraction surgery - A systematic review and meta-analysis

Tapasya V Karemore et al. Natl J Maxillofac Surg. 2024 Jan-Apr.

Abstract

To compare the effectiveness of pre-operative and post-operative administration of amoxicillin in patients undergoing third molar extraction surgery. A systematic search was executed according to PRISMA guidelines for studies published till December 2021. Studies were included based on the pre-eligibility criteria. The risk of bias was assessed using the Cochrane risk of bias tool. The heterogeneity was evaluated, and a random effect model was used for meta-analysis. A total of five studies were included from an initial search of 96 studies. The included studies were randomized controlled trials and comparative studies assessing pre-operative and post-operative administration of antibiotics among patients undergoing third molar extraction surgery. For comparison between pre-operative and post-operative groups, interincisal distance, complications, pain, and swelling were systematically reviewed and meta-analysis was done for interincisal distance and complications. The mean change in interincisal distance ranged from 5.5 to 47.9 and from 4.56 to 46.1 in the pre-operative and post-operative amoxicillin groups, respectively. Complications reported were infections, alveolar osteitis, nausea, diarrhea, gastric pain, rash, and headache with a pooled incidence of 4.3-33% in the pre-operative amoxicillin group and 0-22.7% in the post-operative amoxicillin group. Quantitative synthesis of data carried out from meta-analysis shows a significant difference in the pre-operative and post-operative amoxicillin groups in improving the interincisal distance and incidence of complications post surgery. The qualitative synthesis of data derived from systematic review for pain provides favoring results for post-operative amoxicillin administration. In case of swelling, a non-conclusive result was obtained.

Keywords: Amoxicillin; meta-analysis; pre-operative and post-operative; third molar surgery.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
PRISMA flow chart representing screening process of articles
Figure 2
Figure 2
Forest plot representing mean difference in interincisal distance between groups (preoperative amoxicillin and post-operative amoxicillin)
Figure 3
Figure 3
Forest plot representing odds ratio for adverse reaction/complications between groups (preoperative amoxicillin and post-operative amoxicillin)
Figure 4
Figure 4
Funnel plots representing publication bias
See this image and copyright information in PMC

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