Poeschl Paul W, Eckel Doris, Poeschl Ellen
University Hospital for Cranio-Maxillofacial and Oral Surgery, Vienna Medical School, Vienna, Austria.
J Oral Maxillofac Surg. 2004 Jan;62(1):3-8; discussion 9. doi: 10.1016/j.joms.2003.05.004.
We evaluated the need for prophylactic postoperative oral antibiotic treatment in the removal of asymptomatic third molars.
In a prospective study of more than 30 months, a total of 528 impacted lower third molars were surgically removed in 288 patients. All patients were referred to our department by a dentist or a general practitioner. No patient showed any sign of pain, inflammation, or swelling at the time of removal. Three groups were established. In the first group, antibiotic treatment with amoxicillin/clavulanic acid as an oral medication was carried out for 5 days postoperatively. In the second group, we used clindamycin. In the third group, the patients received no antibiotic treatment. Clinical and radiologic factors were recorded for each case, and the rationale for assigning the patients to the groups was strictly random. The surgical technique was the same in all cases, and the follow-up period was 4 weeks. Parameters that were evaluated were pain, differences in mouth opening, infection, the occurrence of dry socket, and adverse postoperative side effects.
We could not find any significant difference between the 3 groups regarding the evaluated parameters, but in 69.6% of the patients with dry socket, the teeth were partially erupted, which showed a significant difference.
The results of our study show that specific postoperative oral prophylactic antibiotic treatment after the removal of lower third molars does not contribute to a better wound healing, less pain, or increased mouth opening and could not prevent the cases of inflammatory problems after surgery, respectively, and therefore is not recommended for routine use.
我们评估了拔除无症状第三磨牙后进行术后预防性口服抗生素治疗的必要性。
在一项超过30个月的前瞻性研究中，288例患者共手术拔除528颗低位阻生第三磨牙。所有患者均由牙医或全科医生转诊至我科。拔牙时所有患者均无疼痛、炎症或肿胀迹象。设立三组。第一组术后口服阿莫西林/克拉维酸进行抗生素治疗5天。第二组使用克林霉素。第三组患者不接受抗生素治疗。记录每个病例的临床和影像学因素，将患者分组的依据严格随机。所有病例手术技术相同，随访期为4周。评估的参数包括疼痛、开口度差异、感染、干槽症的发生及术后不良反应。
在评估的参数方面，我们未发现三组之间有任何显著差异，但在69.6%的发生干槽症的患者中，牙齿为部分萌出，这显示出显著差异。
我们的研究结果表明，拔除下颌第三磨牙后进行特定的术后口服预防性抗生素治疗并不能促进更好的伤口愈合、减轻疼痛或增加开口度，也不能分别预防术后的炎症问题，因此不建议常规使用。
