Do antibiotics decrease the risk of inflammatory complications after third molar removal in community practices?

Abstract Purpose The role of antibiotic use in third molar (M3) surgery is controversial. The purpose of this study was to measure the association between antibiotic use and postoperative inflammatory complications following M3 surgery in the community office-based ambulatory private practice setting. Materials and Methods The investigators designed and implemented a prospective cohort study and enrolled a sample composed of patients who had at least one M3 removed in a private practice setting by oral and maxillofacial surgeons participating in a practice-based research collaborative between June, 2011 and May, 2012. The predictor variable was antibiotic use of any type, categorized as yes or no. The primary outcome variable was the presence or absence of an inflammatory complication, i.e. surgical site infection (SSI) or alveolar osteitis (AO), after M3 removal. Descriptive, bivariate, and multiple logistic regression statistics were computed to measure the association between antibiotic use and inflammatory complications after M3 removal with statistical significance set at p-value ≤0.05. Results The study sample was composed of 2954 subjects. Three-quarters (75.2%) of the sample received antibiotics in some form. The overall inflammatory complication (AO or SSI) frequencies in the antibiotic and non-antibiotic groups were 5.0 and 7.5%, respectively (p=0.012). After adjusting for differences between the two groups, statistical significance between the groups persisted. Conclusions The results of this study suggest that antibiotic therapy, regardless of type, dose, frequency or pattern of delivery, was associated with a decreased risk of inflammatory complications after M3 removal.