Efficacy of Amoxicillin Treatment in Preventing Postoperative Complications in Patients Undergoing Third Molar Surgery: A Prospective, Randomized, Double-Blind Controlled Study

Purpose: The aim of the present study was to evaluate and compare the occurrence of postoperative complications in patients receiving either pre- or postoperative amoxicillin versus placebo after third molar surgery. Patients and Methods: A randomized, double-blind, placebo-controlled clinical trial was performed in 123 patients undergoing third molar surgery. The patients were randomized to 3 groups, according to the treatment regimen: preoperative amoxicillin, postoperative amoxicillin, and placebo. Both surgeon and patients were unaware of the treatment assignment. The clinical outcomes, including pain, wound infection, trismus, temperature, intra-and extraoral swelling, dysphagia, side effects, and postoperative complications, were assessed. Results: Statistically significant differences were found in the incidence of pain, wound infection, temperature, trismus, and dysphagia between the groups receiving amoxicillin versus placebo. Suture dehiscence and infection of 5 sockets were only found in the placebo group. No cases of alveolitis were observed in the 3 groups studied. No significant differences in swelling were found among the different groups. No statistically significant differences in side effects were found between the groups. The efficacy was greatest in the group receiving postoperative amoxicillin compared with the group receiving a prophylactic preoperative dose. Conclusion: Amoxicillin administered pre- or postoperatively demonstrated greater efficacy than placebo in preventing postoperative complications in patients undergoing third molar surgery. The best results were obtained using the postoperative protocol. (C) 2011 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 69:e5-e14, 2011