Impact of Topical Minocycline With Third Molar Surgery on Clinical Recovery and Health-Related Quality of Life Outcomes

Purpose: Compare recovery for clinical and health-related quality of life (HRQOL) outcomes after third molar surgery in patients treated with or without topical minocycline at surgery. Patients and Methods: Sixty-three patients at least 18 years of age with all 4 third molars below the occlusal plane were treated with topical minocycline during third molar surgery. Topical minocycline (1.0 mg in bioresorbable polyglycolide-co-dl-lactide [PGLA] sustained-release microspheres) was placed sequentially in bony defects after removal of lower third molars. Clinical and health-related quality of life (HRQOL) outcomes of these patients postsurgery were compared with those of a nonconcurrent control group (n = 60 patients) who did not receive antibiotics. The control group was selected using the same criteria and treated under the same surgical protocol as the antibiotic group. Differences between the groups were assessed with Cochran-Mantel-Haenszel row mean score statistics. Results: The 63 patients in the minocycline group were treated at 4 clinical centers. The incidence of delayed clinical recovery, defined as a postsurgery visit with treatment, was significantly lower in the minocycline group compared with the control group. In the minocycline group, 10% had 1 postsurgery visit with treatment; no patient had 2 visits. In the control group without antibiotics, 28% had at least 1 postsurgery visit with treatment (P = .01) and 13% had at least 2 postsurgery visits with treatment. Recovery time to "no" or "little trouble" with chewing and mouth opening was significantly improved in the minocycline group (P < .05). Conclusions: Administration of topical minocycline with third molar surgery may improve clinical and HRQOL recovery in healthy adult patients with all 4 third molars below the occlusal plane, a presenting characteristic that has been suggested as a risk factor for delayed recovery.