Do systemic antibiotics prevent dry socket and infection after third molar extraction? A systematic review and

Objectives. The use of antibiotics to prevent dry socket and infection is a controversial but widespread practice. The aim of the study is to assess the efficacy of systemic antibiotics in reducing the frequencies of these complications after extraction. Study Design. A systematic review and meta-analysis, according to the PRISMA statement, based on randomized doubleblind placebo-controlled trials evaluating systemic antibiotics to prevent dry socket and infection after third molar surgery. Databases were searched up to June 2015. Relative risks (RRs) were calculated with inverse variance-weighted, fixed-effect, or random-effect models. Results. We included 22 papers in the qualitative and 21 in the quantitative review (3304 extractions). Overall-RR was 0.43 (95% confidence interval [CI] 0.33-0.56; P < .0001); number needed to treat, 14 (95% CI 11-19). Penicillins-RR: 0.40 (95% CI 0.27-0.59). Nitroimidazoles-RR: 0.56 (95% CI 0.38-0.82). No serious adverse events were reported. Conclusions. Systemic antibiotics significantly reduce the risk of dry socket and infection in third molar extraction. (Oral Surg Oral Med Oral Pathol Oral Radiol 2016;122:403-425) Third molar surgery produces a clean-contaminated surgical site, and although the incidence of complications is not high, the most common postoperative problems are dry socket and infection. The use of systemic antibiotics to treat these complications is a