TOPICAL ANTISEPTICS AS SYSTEMIC ANTIBIOTICS IN THE PREVENTION OF ALVEOLAR OSTEITIS AFTER EXTRACTION OF LOWER THIRD MOLARS

Abstract

Alveolar Osteitis (AO) and infection are common post-operative complications in third molar surgery. Topical antiseptics (chlorhexidine gluconate) and systemic antibiotics are the most commonly used antimicrobial agents to prevent these complications. However, their use is controversial in dental practice. The aim of this study is to evaluate the efficacy of topical antiseptics and systemic antibiotics in reducing the incidences of these complications and to compare them.

A systematic review and meta-analysis, based on clinical trials that were evaluating the efficacy of topical antiseptics and systemic antibiotics, was carried out. The primary outcome variable was AO. The relative risk (RR) of antiseptics and antibiotics as well as the total effect of all studies was calculated using random effect model.

The study included 20 clinical trials. A total of 3004 dental extractions, 868 in the antiseptic group and 2136 in the antibiotic group, were included in the quantitative analysis. The overall RR of all studies was 0.49[95% confidence interval (CI), 0.35-0.68; P < 0.001]. The RR for antiseptics was 0.42 (95& CI; 0.28-0.64; P <0.001). The RR for antibiotics was 0.56 (95% CI; 0.34-0.91; P <0.001). The difference between two groups was not statistically significant (P = 0.28).

The topical antiseptics and systemic antibiotics significantly reduce the risk of AO in third molar surgery. However, there was no difference between antiseptics and antibiotics regarding the efficacy in the prevention of AO.