Inclusion Criteria:  need for impacted tooth extractions over age 18 ability to understand and to sign an informed consent form  Exclusion Criteria:  allergy to penicillin contraindications to oral surgery treatment with immunosuppressive agents or immunocompromised treatment with amino-bisphosphonate and anti-angiogenetic medications irradiation to head and neck area uncontrolled diabetes renal failure drug and alcohol addiction psychiatric disorders