Antibioticoprofilaxia na prevenção da alveolite após exodontia de terceiros molares

Abstract

Third molar extraction is one of the most frequently performed surgical procedures in dentistry and may be associated with postoperative complications such as infection and dry socket. In this context, antibiotic prophylaxis has been widely used to reduce these complications; however, its routine use remains controversial due to the limited benefits observed in healthy patients and the growing concern over antimicrobial resistance.

This study aimed to evaluate the effectiveness of antibiotic prophylaxis in preventing dry socket and postoperative infections following third molar extraction, as well as to discuss its clinical indications and associated risks. A narrative literature review was conducted through searches of the PubMed, SciELO, LILACS, and Google Scholar databases. Studies published between 2015 and 2025 in Portuguese, English, and Spanish were prioritized, although earlier publications considered classical and scientifically relevant were also included. The search strategy employed the descriptors "antibiotic prophylaxis", "third molar extraction", "alveolitis", "wisdom tooth surgery", and "oral surgery".

The reviewed studies indicated that antibiotics such as amoxicillin and metronidazole may slightly reduce the incidence of postoperative infections in selected cases. However, there is no consistent evidence supporting their routine use for preventing dry socket in healthy patients. Furthermore, surgical technique, operative time, and patient-related factors appear to have a greater influence on the development of this complication.

It is concluded that antibiotic prophylaxis should not be routinely prescribed for third molar extractions and should be reserved for patients with well-established clinical indications, thereby promoting the rational use of antibiotics and helping to minimize antimicrobial resistance.