Vol.73 No.4 July 2025
Preliminary comparison of the postoperative course of after extraction of an impacted mandibular third molar tooth extraction with the use of different antibiotic administration protocols
1)Division of Oral and Maxillofacial Reconstructive Surgery, Department of Disease Management Dentistry, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, Japan
2)Department of Oral and Maxillofacial Surgery, Tohoku University Hospital
Abstract
Impacted mandibular third molar extraction is a frequently performed surgery in the field of oral surgery, and surgical site infection (SSI) is one of the possible complications. Herein, we report the results of a prospective preliminary study of the postoperative course after the extraction procedure with different periods of prophylactic antibiotics administration protocols.
We enrolled patients who visited our department for impacted mandibular third molar extraction between May 2022 and October 2023 and provided consent for participating in this study. Patients were randomized into two groups: a group that received a single antibiotic administration before the surgery (Group S) and a group that received multiple doses of antibiotic postoperatively (Group M). The following characteristics/parameters were compared between the two groups: sex, age, smoking status, Pell-Gregory classification, Numerical Rating Scale (NRS) score, painless mouth opening range, presence/absence of swelling at the tooth extraction wound, presence/absence of drainage from the tooth extraction wound, and incidence of SSI.
The mean age was 25.8 (±5.5) years in Group S and 25.9 (±5.9) years in Group M. There was one smoker in Group S and two in Group M. The impaction status according to the Pell-Gregory classification was Class I or II, Position A or B in most cases of both groups. The average NRS score was the highest on the first postoperative day in both groups, and decreased over time, with no significant difference between the two groups. Although the average painless mouth opening range decreased postoperatively, the trismus resolved almost completely by day 7 after the surgery, and there was no significant difference between the two groups. Swelling at the tooth extraction wound was observed until 7 days after surgery, but resolved almost completely by 14 days after surgery, with no significant difference observed between the two groups. None of the cases (0%) developed SSI in Group S, while 1 case (3.5%) developed SSI in Group M.
This study suggested that patients at a low risk of developing SSI showed a favorable postoperative course after impacted mandibular third molar extraction even with single preoperative prophylactic antibiotic administration.
Key word
surgical site infection, tooth extracted wound, prophylactic administration, amoxicillin, antimicrobial resistance
Received
June 25, 2024
Accepted
March 24, 2025
Jpn. J. Chemother. 73 (4): 322-328, 2025
