Evaluation of complications after extraction of impacted lower third molars associated with the absence of antibiotics: randomized, placebo-controlled clinical trial with a split-mouth design

• Grant number: 24/04818-2
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: August 01, 2024
• End date: July 31, 2025
• Field of knowledge: Health Sciences - Dentistry - Oral and Maxillofacial Surgery
• Principal Investigator: Natacha Kalline de Oliveira
• Grantee: Henrique Teixeira Felix
• Host Institution: Faculdade de Odontologia (FO). Universidade de São Paulo (USP). São Paulo , SP, Brazil

Abstract

Introduction: Third molar extraction is a common intervention in the field of oral and maxillofacial surgery, with a complication rate ranging from 4.6% to 30.9%. Although infection is a complication with a low incidence (1% to 5.8%), its occurrence is a cause for concern. Therefore, the prescription of antibiotics in the postoperative period is the subject of several studies, which still present controversial results. The indiscriminate and excessive use of antibiotics is a global concern due to the increase in antimicrobial resistance, which compromises the effectiveness of treatments and is a threat to public health.Objective: The purpose of this study is to evaluate complications after extraction of lower third molars, with emphasis on the rate of postoperative infection and its association with the use of postoperative antibiotics.Material and Methods: The study will be conducted as a single-center, placebo-controlled, randomized clinical trial with a split-mouth design. Healthy adult participants of both sexes who require extraction of the two lower third molars will be recruited. Participants will be randomized to receive antibiotics or placebo postoperatively, following a standardized treatment protocol. To assess complications, pain, edema, trismus and scarring will be assessed pre- and post-operatively. To investigate bacteremia caused by the surgical procedure blood culture will be performed.Justification: This study is relevant due to the lack of consensus on the effectiveness of the use of antibiotics in the postoperative period of third molar extractions and the scarcity ofevidence on bacteremia associated with this procedure. The results of this study can provide important information to guide clinical practice and contribute to reducing inappropriate antibiotic use.Keywords: third molar, antibiotics, postoperative complications, antibiotic resistance.