Impacted Lower Third Molar
Conditions
Keywords
Procalcitonin, antibiotic prophylaxis, C-reactive protein
Brief summary
This study compared three antibiotic approaches in healthy young adults undergoing surgical removal of impacted lower wisdom teeth: a single dose of antibiotics before surgery, antibiotic treatment after surgery, and no antibiotics. Participants had similar impacted lower wisdom teeth on both sides and underwent surgery in two separate sessions. The study evaluated postoperative pain, facial swelling, mouth opening, and changes in blood markers related to inflammation, including C-reactive protein, erythrocyte sedimentation rate, procalcitonin, and white blood cell counts. The aim was to determine whether antibiotic use before or after surgery affected postoperative recovery and systemic inflammatory responses compared with no antibiotic use.
Detailed description
This prospective randomized study included 30 systemically healthy young adults with bilaterally symmetrical, asymptomatic impacted mandibular third molars classified as Pell and Gregory Class II, Position B. Each participant underwent two surgical procedures, performed four weeks apart by the same surgeon. Three antibiotic strategies were evaluated: a single preoperative antibiotic dose, postoperative antibiotic therapy, and no antibiotic treatment. Because each participant received two of the three interventions, participants were assigned to one of three treatment sequences. Clinical outcomes, including postoperative pain, facial swelling, and maximum mouth opening, were assessed during follow-up. Blood samples were collected before surgery and on postoperative days 1, 3, and 7 to evaluate systemic inflammatory biomarkers, including C-reactive protein, erythrocyte sedimentation rate, procalcitonin, and white blood cell parameters.
Interventions
Amoxicillin-clavulanate 875/125 mg was administered twice daily for 7 days after surgery.
Sponsors
Abant Izzet Baysal University
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
PREVENTION
Masking
SINGLE (Investigator)
Intervention model description
Participants underwent two surgical sessions, four weeks apart, and received two of the three antibiotic strategies according to a randomized balanced incomplete-block crossover design with a split-mouth component.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Age 18 years or older Systemically healthy status Presence of bilateral, symmetrical, asymptomatic impacted mandibular third molars classified as Pell and Gregory Class II, Position B No antibiotic use within the 4 weeks preceding surgery Ability and willingness to provide written informed consent
Exclusion criteria
* Uncontrolled systemic disease Pregnancy or lactation Active pericoronal infection History of allergy to amoxicillin, clavulanic acid, or articaine hydrochloride Presence of local pathology at the surgical site Previous radiotherapy to the head and neck region Syndromic conditions Any postoperative complication following the first surgery that prevented completion of the second surgical procedure according to the study protocol
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Serum C-Reactive Protein (CRP) Level | Baseline (preoperative) and postoperative days 1, 3, and 7 | Serum C-reactive protein (CRP) levels were measured to assess the systemic inflammatory response following impacted mandibular third molar surgery and to compare the effects of preoperative antibiotic prophylaxis, postoperative antibiotic therapy, and no antibiotic therapy. CRP levels were measured using an Architect c16000 automated analyzer (Abbott Laboratories, Abbott Park, IL, USA). |
Countries
Turkey (Türkiye)
Outcome results
None listed