Systemic complications of use of antibiotics following removal of the third molar: A systematic review.

There are currently conflicting views on the value of using antimicrobial prophylaxis in dental procedures, including extractions and implants. This review intended to highlight the common use and misuse of antibiotic treatment regimens in a dental setting, particularly in third molar surgery. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, this study has been reported accordingly. The purpose of the present systematic review was to evaluate the use of antibiotics during therapeutic orthodontic treatment involving third molar extractions, with the aim of reducing the likelihood of postoperative complications. The systematic review was conducted using online databases such as the Cochrane Central Register of Controlled Trials, PubMed, and Scopus. A set of inclusion and exclusion criteria was applied, focusing on randomized controlled trials (RCTs) that investigated antibiotic treatment for third molar surgery and were published up to 2021. The total 20 RCTs were included. The findings indicated that amoxicillin, both with and without clavulanic acid, was frequently used as an antibacterial agent in various doses and durations. However, there were no statistically significant differences in postoperative complication rates between the treatment groups. There is currently insufficient evidence to recommend standard antibiotic prophylaxis for healthy young individuals undergoing third molar extraction surgery. Additionally, antibiotic-related adverse events were not statistically different from those observed in placebo groups. Based on our findings, the risk of allergic reactions and the potential for developing antimicrobial resistance necessitate a careful and judicious use of antibiotics in mandibular third molar extraction procedures, even if cost is not a limiting factor.