Use of the antibiotic therapy in tooth extractions: controlled, single-blind, randomized clinical trial

Background. Tooth extraction is a common procedure in oral surgery. Despite this, little evidence is available in the literature as to the need for antibiotic management to avoid post-extraction local complication. Furthermore, antibiotics could provoke mild to severe adverse effects and lead to the selection of resistant bacteria, which is a major concern also for the World Health Organization. Aim.The aim of this randomized controlled trial is to evaluate whether the antibiotic post-surgical prophylaxis could be beneficial in preventing post-extraction local complications and whether the use of a probiotic could help reduce the antibiotic gastro-intestinal side effects. Materials and Methods. 150 patients meeting the inclusion criteria were screened in this Randomized Clinical Trial. They were randomly allocated to one of the three experimental groups and treated accordingly: Group 1: Amoxicillin&Clavulanic Acid; Group 2: Amox&Clav+probiotic; Group 3: control. Follow-up visits were performed at 7, 14 and 21 days after the extraction. Results. After 7 days no infections were registered. Pain seemed to be the main complication with a higher incidence in the control group, even though the magnitude was very low in all the groups. Two cases of dry socket were recorded in the control group. At 14 days the symptoms were almost disappeared in all the groups.The use of the antibiotic was associated with a higher incidence of gastro-intestinal side effects, especially intestinal distension and diarrhea. Those complications were significant also at 14 days. Conclusions.In the light of the present data, we do not have sufficient evidence to encourage the antibiotic therapy to tackle post-extraction complications in healthy patients.