Third‑molar extraction: do antibiotics really prevent postoperative infection?

A COMMENTARY ON: Raiesian S, Ahmadiyeh ADP, Rad MM. A systematic review on prior/postoperative antibiotic therapy efficiency in reducing surgical complications after third molar extraction surgery. J Maxillofac Oral Surg. 2025;24(5):1427-1433 https://doi.org/10.1007/s12663-024-02355-6 .

DESIGN

Systematic review conducted in accordance with PRISMA recommendations, aimed at evaluating the efficacy of prophylactic antibiotic therapy in reducing postoperative complications following third molar extraction.

CASE SELECTION: Randomised clinical trials and prospective and retrospective studies published between 2000 and 2021 were included, involving patients undergoing surgical removal of third molars. Selected studies evaluated different antibiotic protocols administered pre- and postoperatively.

DATA ANALYSIS: Eighteen English-language studies were selected from PubMed, Scopus, Web of Science, and Google Scholar databases.

RESULTS

No statistically significant differences were observed between patients undergoing prophylactic antibiotic therapy and control groups regarding main clinical outcomes, including postoperative pain and swelling in simple third molar extractions. Findings also highlight growing concern regarding microbial resistance, adverse drug effects, and costs associated with the indiscriminate use of antibiotics.

CONCLUSIONS

Routine antibiotic administration, both pre- and postoperatively in third molar surgery, demonstrated no relevant clinical benefit in systemically healthy patients.