Do systemic antibiotics prevent dry socket and infection after third molar extraction? A systematic review and meta-analysis

Eva Ramos; Joseba Santamaría; Gorka Santamaría; Luis Barbier; Icíar Arteagoitia

doi:10.1016/j.oooo.2016.04.016

Do systemic antibiotics prevent dry socket and infection after third molar extraction? A systematic review and meta-analysis

Oral Surg Oral Med Oral Pathol Oral Radiol. 2016 Oct;122(4):403-25. doi: 10.1016/j.oooo.2016.04.016. Epub 2016 May 11.

Authors

Eva Ramos¹, Joseba Santamaría², Gorka Santamaría³, Luis Barbier⁴, Icíar Arteagoitia⁵

Affiliations

¹ BioCruces Health Research Institute, Cruces University Hospital, University of the Basque Country (UPV/EHU), Bizkaia, Spain.
² Professor and Chair, Maxillofacial Surgery Department, BioCruces Health Research Institute, Cruces University Hospital, University of the Basque Country (UPV/EHU), Bizkaia, Spain; Consolidated research group (UPV/EHU IT821-13).
³ Associate Professor, Stomatology I Department, University of the Basque Country (UPV/EHU), BioCruces Health Research Institute, Spain; Consolidated research group (UPV/EHU IT821-13).
⁴ Chair Professor, Maxillofacial Surgery Department, BioCruces Health Research Institute, Cruces University Hospital, University of the Basque Country (UPV/EHU), Spain; Consolidated research group (UPV/EHU IT821-13).
⁵ Associate Professor, Stomatology I Department, University of the Basque Country (UPV/EHU), BioCruces Health Research Institute, Spain; Consolidated research group (UPV/EHU IT821-13). Electronic address: Arteagoitia@gmail.com.

PMID: 27499028
DOI: 10.1016/j.oooo.2016.04.016

Abstract

Objectives: The use of antibiotics to prevent dry socket and infection is a controversial but widespread practice. The aim of the study is to assess the efficacy of systemic antibiotics in reducing the frequencies of these complications after extraction.

Study design: A systematic review and meta-analysis, according to the PRISMA statement, based on randomized double-blind placebo-controlled trials evaluating systemic antibiotics to prevent dry socket and infection after third molar surgery. Databases were searched up to June 2015. Relative risks (RRs) were calculated with inverse variance-weighted, fixed-effect, or random-effect models.

Results: We included 22 papers in the qualitative and 21 in the quantitative review (3304 extractions). Overall-RR was 0.43 (95% confidence interval [CI] 0.33-0.56; P < .0001); number needed to treat, 14 (95% CI 11-19). Penicillins-RR: 0.40 (95% CI 0.27-0.59). Nitroimidazoles-RR: 0.56 (95% CI 0.38-0.82). No serious adverse events were reported.

Conclusions: Systemic antibiotics significantly reduce the risk of dry socket and infection in third molar extraction.

Publication types

Meta-Analysis
Review
Systematic Review

MeSH terms

Antibiotic Prophylaxis*
Dry Socket / prevention & control*
Humans
Molar, Third / surgery*
Postoperative Complications / prevention & control*
Tooth Extraction*