Antibiotic Therapy in Impacted Mandibular Third Molar Surgery

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.

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