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Review
. 2025 Feb 28;13(3):107.
doi: 10.3390/dj13030107.

Antibiotic Prescription for the Prevention of Postoperative Complications After Third-Molar Extractions: A Systematic Review

Nicola De Angelis  1 , Lorenzo Denegri  1 , Ioana Cristina Miron  2 , Catherine Yumang  3 , Paolo Pesce  1 , Domenico Baldi  1 , Francesca Delucchi  1 , Francesco Bagnasco  1 , Maria Menini  1
Affiliations
Review

Antibiotic Prescription for the Prevention of Postoperative Complications After Third-Molar Extractions: A Systematic Review

Nicola De Angelis et al. Dent J (Basel). .

Abstract

Background: Third-molar extractions are common procedures often complicated by infections and alveolitis. The use of antibiotics as prophylaxis to prevent these complications is debated due to potential risks and side effects. Therefore, the aim of the present systematic review was to determine the efficacy of antibiotic prescription for the prevention of these complications.

Methods: A comprehensive literature search was conducted in MEDLINE/PubMed, Cochrane, and SCOPUS databases up until June 2024. The focused question was "Does the antibiotic prescription influence the incidence of postoperative complications following third-molar extractions in healthy patients?" Systematic reviews assessing complications after third-molar extractions were included.

Results: A total of 16 studies were included, revealing that antibiotic use significantly reduces infection risk and dry socket incidence compared to no prescription. Amoxicillin-clavulanic acid was particularly effective.

Conclusions: Antibiotics, especially amoxicillin-clavulanic acid, are effective in preventing postoperative infections and alveolitis after third-molar extraction. However, their administration should be carefully considered to balance benefits against potential risks. Evidence supports the judicious use of antibiotics in dental surgery to optimize patient outcomes, minimizing possible adverse effects and the risk of developing antibiotic resistance.

Keywords: antibiotic prophylaxis; antibiotic therapy; dry socket; extraction; third molar.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
PRISMA 2020 flow diagram for new systematic reviews, including searches of databases and registers only. Search has been conducted by reading full texts of all the records, before judging the exclusion.
Figure 2
Figure 2
(a) Distribution of included RCTs across systematic reviews. (b) Number of patients enrolled in included RCTs [46,47,48,49,50,51,52,53,55,56,57,58,59,60,61].
Figure 3
Figure 3
Distribution of antibiotic usage across RCTs included in systematic reviews.
See this image and copyright information in PMC

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