Background: Prevention of alveolar osteitis can be either pharmacological or non pharmacological. The aim of this study was to compare the effects of different regimens for the prevention of alveolar osteitis following mandibular third molar extractions.

Material & Methods: This study was carried out on a total of 90 patients who have 17-30 years of age. To be eligible, patients had to be in good general health and have at least one mandibular third molar to be extracted. The patients of group I (N=45) was placed powder of 500 mg of amoxicillin capsule in socket after lower third molar extraction immediately. The second group (mixture of powder of 500 mg of amoxicillin+ 500mg metronidazole, n = 45) was treated similarly to group 1.

Results: Our study showed that the mean age was 23.70 yrs in group I & 24.5 yrs in group II. Male to female ratio and smoking habits was almost same in both groups. The pain, swelling was higher in group I as compare to group II, which was statistical significant (P=0.0374* & p=0.0496* respectively). Overall incidence of dry socket was 20%. There was a significant reduction in the incidence of AO in the second group (p = 0.0386*).

Conclusion: The results of this study suggest that placement of mixture of antibiotics in socket immediately after lower third molar extraction decreases the alveolar osteitis rate.

Keywords: Dry socket, extraction, impacted third molar, antibiotics.

1. Metin M, Tek M, Sener I. Comparison of two chlorhexidine rinse protocols on the incidence of alveolar osteitis following surgical removal of impacted third molars. J Contemp Dent Prac. 2006. 7:79-86.
2. Bloomer CR. Alveolar osteitis prevention by immediate placement of medicated packing. Oral Surg, Oral Med, Oral Pathol and Oral Radiol Endod. 2000. 90:282-84.
3. Field A, Speechley JA, Rotter E, Scoot J. Dry socket incidence prepared after 12 year interval. Br J Oral Maxillofac Surg. 1988. 23:419-27.
4. McArdle B.F. Preventing the negative squeal of tooth extraction. JADA, 2002; 133: 742-743.
5. Oginni F.O., Fatusi O.A., Alagbe A.O. A clinical evaluation of dry socket in a Nigerian teaching hospital. J Oral Maxillofac Surg, 2003; 61: 871-876.
6. Blum I.R. Contemporary views on dry socket (alveolar osteitis): a clinical appraisal of standardization, aetiopathogenesis and management: a critical review. Int J Oral Maxillofac Surg, 2002; 31: 309-317.
7. Delilbasi C., Saracoglu U., Keskin A. Effects of 0.2% chlorhexidine gluconate and amoxicillin plus clavulanic acid on the prevention of alveolar osteitis following mandibular third molar extractions. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2002; 94: 301-304.
8. Ren YF, Malstrom HS. Effectiveness of antibiotic prophylaxis in third molar surgery; a meta-analysis of randomized controlled clinical trials. J Oral Maxillofac Surg. 2007. 65:1909-21.
9. Siddiqi A, Morkel JA, Zafar S. Antibiotic prophylaxis in third molar surgery: a randomized double blind placebo-controlled clinical trial using split mouth technique. Int J Oral Surg. 2010. 39:107-14.
10. Heng CK, Badner VM, Clemens DL, Mercer LT, Mercer DW. The relationship of cigarette smoking to postoperative complications from dental extractions among female inmates. Oral Surg, Oral Med, Oral Pathol, Oral Radiol, Endod. 2007. 104: 757-62.
11. Hunt D.E., King T.J, Fuller G.E. Antibiotic susceptibility of bacteria isolated from oral infections. J Oral Surg, 1978; 36: 527-529.

Dr Rajesh Tak

Final year P.G. Resident, Department of Oral & Maxillofacial Surgery, MGDCH, Jaipur