Relationship between route of antibiotic administration and post-surgical complications following removal of lower third molars

ABSTRACT

This prospective clinical trial aims at evaluating the effects of antibiotic therapy following different administration routes on the postoperative complications of surgical removal of lower impacted third molars. Two hundred and fourty eight consecutive patients [100 males and 148 females] aged 18 to 38 years old [mean=24 +/- 5 years] were recruited into this study. The lower third molars of all recruited patients were surgically extracted. Participants received preoperative antibiotic cover either as intravenous Cephradine injection [1 gram] or oral dose of 500 mg Cephalexin. Immediate and late complications following the surgery; including pain, swelling, trismus, paraesthesia, bleeding, dry socket, infection and fracture of mandible; were assessed 3 days and 7-14 days following the surgery. The most frequent complications were slight pain, swelling, and trismus. Oral route of antibiotic administration was associated with more immediate and late complications [p<0.001]. Oral route of antibiotic administration was associated with more pain, swelling, trismus, and dry socket [p<0.05]. Following surgical extraction of third molars, intravenous antibiotic administration was more effective in reducing the post surgical complications than oral antibiotic administration