Antibiotic Therapy in Impacted Mandibular Third Molar Surgery

Overview

This study compared three antibiotic approaches in healthy young adults undergoing surgical removal of impacted lower wisdom teeth: a single dose of antibiotics before surgery, antibiotic treatment after surgery, and no antibiotics. Participants had similar impacted lower wisdom teeth on both sides and underwent surgery in two separate sessions. The study evaluated postoperative pain, facial swelling, mouth opening, and changes in blood markers related to inflammation, including C-reactive protein, erythrocyte sedimentation rate, procalcitonin, and white blood cell counts. The aim was to determine whether antibiotic use before or after surgery affected postoperative recovery and systemic inflammatory responses compared with no antibiotic use.

This prospective randomized study included 30 systemically healthy young adults with bilaterally symmetrical, asymptomatic impacted mandibular third molars classified as Pell and Gregory Class II, Position B. Each participant underwent two surgical procedures, performed four weeks apart by the same surgeon. Three antibiotic strategies were evaluated: a single preoperative antibiotic dose, postoperative antibiotic therapy, and no antibiotic treatment. Because each participant received two of the three interventions, participants were assigned to one of three treatment sequences. Clinical outcomes, including postoperative pain, facial swelling, and maximum mouth opening, were assessed during follow-up. Blood samples were collected before surgery and on postoperative days 1, 3, and 7 to evaluate systemic inflammatory biomarkers, including C-reactive protein, erythrocyte sedimentation rate, procalcitonin, and white blood cell parameters.