EFFECTIVENESS OF ANTIBIOTIC TREATMENT IN REDUCING PAIN AND TRISMUS POST IMPACTED MANDIBULAR THIRD MOLAR SURGICAL EXTRACTION. A RANDOMIZED CLINICAL TRIAL

Abstract

Background: Impacted mandibular third molars frequently necessitate surgical extraction, often resulting in postoperative complications such as pain and trismus. While antibiotics are commonly prescribed, their routine use remains a subject of debate due to concerns over resistance and varying clinical outcomes. Understanding the role of postoperative antibiotic therapy in enhancing recovery is particularly important in settings where minimizing complications can alleviate patient burden and resource strain.

Objective: To assess and compare the effectiveness of postoperative antibiotic therapy versus no antibiotic therapy in reducing pain and trismus following surgical removal of impacted mandibular third molars.

Methods: A randomized clinical trial was conducted at the 30 Military Dental Centre, CMH Peshawar, from August 2023 to February 2024. Sixty patients aged 20–35 years undergoing impacted mandibular third molar extraction were randomly allocated into two equal groups (n=30 each). Group I received amoxicillin-clavulanic acid (625 mg three times daily) and metronidazole (400 mg twice daily) along with ibuprofen (400 mg twice daily) for five days. Group II received only ibuprofen at the same dosage. Pain was evaluated using a visual analog scale (VAS), and trismus was measured by interincisal mouth opening on the second and fifth postoperative days. Data were analyzed using SPSS version 28 with p≤0.05 considered statistically significant.

Results: On the fifth postoperative day, Group I exhibited significantly improved mouth opening (33.23 ± 1.18 mm) compared to Group II (30.17 ± 1.19 mm) (p=0.0001). Pain reduction was also more prevalent in Group I (83.3%) than in Group II (56.7%) (p=0.02).

Conclusion: Postoperative antibiotic therapy demonstrated a significant benefit in improving mouth opening and reducing pain following third molar extraction, supporting its selective use in surgical dental care.