ASSESSING THE NECESSITY OF ANTIBIOTICS AFTER LOWER WISDOM TOOTH REMOVAL: A COHORT STUDY
Main Article Content
Keywords
Lower wisdom teeth, surgical extraction, osteotomy, follow-ups.
Abstract
Background: Lower wisdom tooth removal is one of the most common surgical procedures, use of antibiotics after lower wisdom tooth removal is debatable since the excessive advent of drug-resistant bacteria
Objective: The main purpose of this study was to examine the need for antibiotics used in routine after lower wisdom removal with osteotomy,
Setting, Duration, Study Type: Research was conducted in the Oral and Maxillofacial Surgery OPD in AIDC over the period of 6 months. The study type is Cohort.
Materials and Methods: This cohort study was conducted on 52 patients in the oral maxillofacial department. Each patient was recalled after 7 days of extraction. Eligibility criteria was patient between 21-60 years were considered for the study. Any patients with systemic disorder were excluded from the study. A clinical proforma was developed & validated which was then filled by 2 surgeons working in oral maxillofacial department along with consent form duly filled by every individual.
Result: 36.5% were male and 63.5% were female out of 52 patients while majority of patient’s age were between 21-40. The majority of patients reported in OPD after vertical impacted wisdom extraction were with pain while only 2 patients came with pain & swelling, 1 with pain and pus and 1 with only swelling. Patients with swelling or pus had extraction of either horizontal or mesio-angular impaction having only 19% in combine. Majority of patient range under 31–40-year group. The majority in this group also came with pain while very few came with signs of infection.
Conclusion: Current study suggests that if the patient is coming without any infection or any factors contributing to risk of infection and co-morbities for extraction of lower molar extraction, use of pre and post antibiotics operatively is not necessary.
Objective: The main purpose of this study was to examine the need for antibiotics used in routine after lower wisdom removal with osteotomy,
Setting, Duration, Study Type: Research was conducted in the Oral and Maxillofacial Surgery OPD in AIDC over the period of 6 months. The study type is Cohort.
Materials and Methods: This cohort study was conducted on 52 patients in the oral maxillofacial department. Each patient was recalled after 7 days of extraction. Eligibility criteria was patient between 21-60 years were considered for the study. Any patients with systemic disorder were excluded from the study. A clinical proforma was developed & validated which was then filled by 2 surgeons working in oral maxillofacial department along with consent form duly filled by every individual.
Result: 36.5% were male and 63.5% were female out of 52 patients while majority of patient’s age were between 21-40. The majority of patients reported in OPD after vertical impacted wisdom extraction were with pain while only 2 patients came with pain & swelling, 1 with pain and pus and 1 with only swelling. Patients with swelling or pus had extraction of either horizontal or mesio-angular impaction having only 19% in combine. Majority of patient range under 31–40-year group. The majority in this group also came with pain while very few came with signs of infection.
Conclusion: Current study suggests that if the patient is coming without any infection or any factors contributing to risk of infection and co-morbities for extraction of lower molar extraction, use of pre and post antibiotics operatively is not necessary.
References
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9. Ković M, Pribisalić A, Viskić J, Martinić J, Grubišić J, Vardić A, Poklepović Peričić T. Antibiotic Prophylaxis Prescribing Practices for Dental Implant Placement in Croatia: A Questionnaire-Based Cross-Sectional Study. Antibiotics. 2025 Jan 8;14(1):47. https://doi.org/10.3390/antibiotics14010047
10. Banjar AA. Dentists' Awareness of Antibiotic Stewardship and Their Willingness to Support Its Implementation: A Cross‐Sectional Survey in a Dental School. Journal of Evaluation in Clinical Practice. 2025 Feb;31(1):e70023. https://doi.org/10.1111/jep.70023
11. Barone S, Bennardo F, Salviati M, Antonelli A, Giudice A. Evaluation of the usefulness of platelet-rich fibrin (PRF) in mandibular third molar surgery with 3D facial swelling analysis: a split-mouth randomized clinical trial. Head & Face Medicine. 2025 Feb 22;21:8. https://doi.org/10.1186/s13005-025-00482-0
12. Galvão GS, Franco JB, de Melo Peres MP, Melo GB, Tenório JR, Medina JB, de Barros Gallo C, Ortega KL. Spontaneous bacterial peritonitis and soft tissue healing after tooth extraction in liver cirrhosis patients. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology. 2025 Feb 1;139(2):177-87. https://doi.org/10.1016/j.oooo.2024.09.003
13. Ribeiro ED, de Santana IH, Viana MR, Fan S, Mohamed A, Dias JC, Forte AG, Pereira Júnior JM, Ferreira AJ, Sant’Ana E. Optimal treatment time with systemic antimicrobial therapy in odontogenic infections affecting the jaws: a systematic review. BMC Oral Health. 2025 Feb 18;25(1):253. https://doi.org/10.1186/s12903-025-05585-3
14. Fagoni TG, Rafalovich VC, Brozoski MA, Deboni MC, de Oliveira NK. Selective outcome reporting concerning antibiotics and third molar surgery. Clinical Oral Investigations. 2025 Jan 3;29(1):42. https://doi.org/10.1007/s00784-024-06130-2
15. Yadav A, Sharma P, Bali RK, Gaba S. A Comparative Evaluation of Single-Suture Versus Conventional Three-Suture Technique for Closure After Surgical Removal of Impacted Mandibular Third Molar: A Randomized Controlled Trial. Journal of Maxillofacial and Oral Surgery. 2025 Feb 19:1-6. https://doi.org/10.1007/s12663-025-02443-1
16. Monaco G, Tavernese L, Agostini R, Marchetti C. Evaluation of antibiotic prophylaxis in reducing postoperative infection after mandibular third molar extraction in young patients. Journal of Oral and Maxillofacial Surgery. 2009 Jul 1;67(7):1467-72. https://doi.org/10.1016/j.joms.2008.12.066
17. Singh Gill A, Morrissey H, Rahman A. A systematic review and meta-analysis evaluating antibiotic prophylaxis in dental implants and extraction procedures. Medicina. 2018 Dec 1;54(6):95. https://doi.org/10.3390/medicina54060095
18. Cervino G, Cicciù M, Biondi A, Bocchieri S, Herford AS, Laino L, Fiorillo L. Antibiotic prophylaxis on third molar extraction: systematic review of recent data. Antibiotics. 2019 May 2;8(2):53. https://doi.org/10.3390/antibiotics8020053
19. Poeschl PW, Eckel D, Poeschl E. Postoperative prophylactic antibiotic treatment in third molar surgery—a necessity?. Journal of oral and maxillofacial surgery. 2004 Jan 1;62(1):3-8. https://doi.org/10.1016/j.joms.2003.05.004
20. Yanine N, Sabelle N, Vergara-Gárate V, Salazar J, Araya-Cabello I, Carrasco-Labra A, Martin C, Villanueva J. Effect of antibiotic prophylaxis for preventing infectious complications following impacted mandibular third molar surgery. A randomized controlled trial. Medicina oral, patologia oral y cirugia bucal. 2021 Oct 27;26(6):e703. https://DOI:10.4317/medoral.24274
21. McGregor JC, Wilson GM, Gibson G, Jurasic MM, Evans CT, Suda KJ. The effect of antibiotic premedication on postoperative complications following dental extractions. Journal of Public Health Dentistry. 2024 Dec;84(4):343-50. https://doi.org/10.1111/jphd.12634
2. Sologova D, Diachkova E, Gor I, Sologova S, Grigorevskikh E, Arazashvili L, Petruk P, Tarasenko S. Antibiotics efficiency in the infection complications prevention after third molar extraction: a systematic review. Dentistry Journal. 2022 Apr 18;10(4):72. https://doi.org/10.3390/dj10040072
3. Cabras M, Gambino A, Broccoletti R, Sciascia S, Arduino PG. Lack of evidence in reducing risk of MRONJ after teeth extractions with systemic antibiotics. Journal of oral science. 2021;63(3):217-26.
4. Kirnbauer B, Jakse N, Truschnegg A, Dzidic I, Mukaddam K, Payer M. Is perioperative antibiotic prophylaxis in the case of routine surgical removal of the third molar still justified? A randomized, double-blind, placebo-controlled clinical trial with a split-mouth design. Clinical Oral Investigations. 2022 Oct;26(10):6409-21. https://doi.org/10.1007/s00784-022-04597-5
5. Sykara M, Maniatakos P, Tentolouris A, Karoussis IK, Tentolouris N. The necessity of administrating antibiotic prophylaxis to patients with diabetes mellitus prior to oral surgical procedures-a systematic review. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2022 Oct 1;16(10):102621. https://doi.org/10.1016/j.dsx.2022.102621
6. Milic T, Raidoo P, Gebauer D. Antibiotic prophylaxis in oral and maxillofacial surgery: a systematic review. British Journal of Oral and Maxillofacial Surgery. 2021 Jul 1;59(6):633-42. https://doi.org/10.1016/j.bjoms.2020.09.020
7. Contaldo M, D’Ambrosio F, Ferraro GA, Di Stasio D, Di Palo MP, Serpico R, Simeone M. Antibiotics in dentistry: A narrative review of the evidence beyond the myth. International Journal of Environmental Research and Public Health. 2023 Jun 1;20(11):6025. https://doi.org/10.3390/ijerph20116025
8. Fagoni TG, Rafalovich VC, Brozoski MA, Deboni MC, de Oliveira NK. Selective outcome reporting concerning antibiotics and third molar surgery. Clinical Oral Investigations. 2025 Jan 3;29(1):42.
9. Ković M, Pribisalić A, Viskić J, Martinić J, Grubišić J, Vardić A, Poklepović Peričić T. Antibiotic Prophylaxis Prescribing Practices for Dental Implant Placement in Croatia: A Questionnaire-Based Cross-Sectional Study. Antibiotics. 2025 Jan 8;14(1):47. https://doi.org/10.3390/antibiotics14010047
10. Banjar AA. Dentists' Awareness of Antibiotic Stewardship and Their Willingness to Support Its Implementation: A Cross‐Sectional Survey in a Dental School. Journal of Evaluation in Clinical Practice. 2025 Feb;31(1):e70023. https://doi.org/10.1111/jep.70023
11. Barone S, Bennardo F, Salviati M, Antonelli A, Giudice A. Evaluation of the usefulness of platelet-rich fibrin (PRF) in mandibular third molar surgery with 3D facial swelling analysis: a split-mouth randomized clinical trial. Head & Face Medicine. 2025 Feb 22;21:8. https://doi.org/10.1186/s13005-025-00482-0
12. Galvão GS, Franco JB, de Melo Peres MP, Melo GB, Tenório JR, Medina JB, de Barros Gallo C, Ortega KL. Spontaneous bacterial peritonitis and soft tissue healing after tooth extraction in liver cirrhosis patients. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology. 2025 Feb 1;139(2):177-87. https://doi.org/10.1016/j.oooo.2024.09.003
13. Ribeiro ED, de Santana IH, Viana MR, Fan S, Mohamed A, Dias JC, Forte AG, Pereira Júnior JM, Ferreira AJ, Sant’Ana E. Optimal treatment time with systemic antimicrobial therapy in odontogenic infections affecting the jaws: a systematic review. BMC Oral Health. 2025 Feb 18;25(1):253. https://doi.org/10.1186/s12903-025-05585-3
14. Fagoni TG, Rafalovich VC, Brozoski MA, Deboni MC, de Oliveira NK. Selective outcome reporting concerning antibiotics and third molar surgery. Clinical Oral Investigations. 2025 Jan 3;29(1):42. https://doi.org/10.1007/s00784-024-06130-2
15. Yadav A, Sharma P, Bali RK, Gaba S. A Comparative Evaluation of Single-Suture Versus Conventional Three-Suture Technique for Closure After Surgical Removal of Impacted Mandibular Third Molar: A Randomized Controlled Trial. Journal of Maxillofacial and Oral Surgery. 2025 Feb 19:1-6. https://doi.org/10.1007/s12663-025-02443-1
16. Monaco G, Tavernese L, Agostini R, Marchetti C. Evaluation of antibiotic prophylaxis in reducing postoperative infection after mandibular third molar extraction in young patients. Journal of Oral and Maxillofacial Surgery. 2009 Jul 1;67(7):1467-72. https://doi.org/10.1016/j.joms.2008.12.066
17. Singh Gill A, Morrissey H, Rahman A. A systematic review and meta-analysis evaluating antibiotic prophylaxis in dental implants and extraction procedures. Medicina. 2018 Dec 1;54(6):95. https://doi.org/10.3390/medicina54060095
18. Cervino G, Cicciù M, Biondi A, Bocchieri S, Herford AS, Laino L, Fiorillo L. Antibiotic prophylaxis on third molar extraction: systematic review of recent data. Antibiotics. 2019 May 2;8(2):53. https://doi.org/10.3390/antibiotics8020053
19. Poeschl PW, Eckel D, Poeschl E. Postoperative prophylactic antibiotic treatment in third molar surgery—a necessity?. Journal of oral and maxillofacial surgery. 2004 Jan 1;62(1):3-8. https://doi.org/10.1016/j.joms.2003.05.004
20. Yanine N, Sabelle N, Vergara-Gárate V, Salazar J, Araya-Cabello I, Carrasco-Labra A, Martin C, Villanueva J. Effect of antibiotic prophylaxis for preventing infectious complications following impacted mandibular third molar surgery. A randomized controlled trial. Medicina oral, patologia oral y cirugia bucal. 2021 Oct 27;26(6):e703. https://DOI:10.4317/medoral.24274
21. McGregor JC, Wilson GM, Gibson G, Jurasic MM, Evans CT, Suda KJ. The effect of antibiotic premedication on postoperative complications following dental extractions. Journal of Public Health Dentistry. 2024 Dec;84(4):343-50. https://doi.org/10.1111/jphd.12634
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Published
Mar 22, 2025
Article Details
How to Cite
Abdul Wali Khan, Nazish, Sharique Nazir, Zainab Akbar, Aamna Javed, & Haseeb Ahmad. (2025). ASSESSING THE NECESSITY OF ANTIBIOTICS AFTER LOWER WISDOM TOOTH REMOVAL: A COHORT STUDY. Journal of Population Therapeutics and Clinical Pharmacology, 32(2), 1242-1250. https://doi.org/10.53555/rffnrq51
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Author Biographies
Abdul Wali Khan
Assistant Professor, Oral and Maxillofacial Surgery, Saidu Dental College, Swat, Pakistan
Nazish
Resident FCPS
Sharique Nazir
Senior Registrar, Oral and Maxillofacial Surgery, Liaqat Institute of Medical and Health Sciences, Makli Thatta, Pakistan
Zainab Akbar
Assistant Professor Oral Medicine, Rehman College of Dentistry, Peshawar, Pakistan
Aamna Javed
Assistant Professor Oral Pathology, Abbottabad International Dental College, Abbottabad, Pakistan
Haseeb Ahmad
Assistant Professor Oral Biology, Abbottabad International Dental College, Abbottabad, Pakistan
How to Cite
Abdul Wali Khan, Nazish, Sharique Nazir, Zainab Akbar, Aamna Javed, & Haseeb Ahmad. (2025). ASSESSING THE NECESSITY OF ANTIBIOTICS AFTER LOWER WISDOM TOOTH REMOVAL: A COHORT STUDY. Journal of Population Therapeutics and Clinical Pharmacology, 32(2), 1242-1250. https://doi.org/10.53555/rffnrq51