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Does antibiotic prophylaxis at implant placement decrease early implant failures? A Cochrane systematic review
Marco Esposito1, Maria Gabriella Grusovin, Vasiliki Loli
1School of Dentistry, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK. espositomarco@hotmail.com
European Journal of Oral Implantology
|July 13, 2010
Summary
A single preoperative dose of amoxicillin (2 g) can significantly reduce dental implant failures. This prophylactic antibiotic use is associated with a lower risk of implant failure and no reported adverse events in ordinary conditions.
Area of Science:
- Dental Implantology
- Evidence-Based Dentistry
- Pharmacology
Background:
- This review is based on a Cochrane systematic review examining antibiotic use during dental implant placement.
- Systematic reviews are regularly updated to incorporate new research and reader feedback.
- The review authors' opinions may differ from the Cochrane Collaboration's official stance.
Purpose of the Study:
- To evaluate the benefits and harms of systemic prophylactic antibiotics given at the time of dental implant placement.
- To compare antibiotic administration against no antibiotic or placebo.
- To identify the most effective antibiotic type, dosage, and duration, if benefits are found.
Main Methods:
- Searched Cochrane Oral Health Group's Trials Register, CENTRAL, MEDLINE, and EMBASE for randomized controlled trials (RCTs) up to June 2, 2010.
- Included RCTs with a minimum 3-month follow-up comparing prophylactic antibiotics with no antibiotics in patients undergoing dental implant placement.
- Assessed outcomes including prosthesis and implant failures, postoperative infections, and adverse events. Data extraction and quality assessment were performed by two independent reviewers. Meta-analyses were conducted.
Main Results:
- Four RCTs were analyzed: three compared 2g of preoperative amoxicillin with placebo (927 patients), and one compared 1g preoperative amoxicillin plus 500mg for 2 days with no antibiotics (80 patients).
- Meta-analyses revealed a statistically significant reduction in implant failures for patients receiving antibiotics (risk ratio=0.40; 95% CI 0.19 to 0.84).
- The number needed to treat to prevent one implant failure was 33 (95% CI 17-100). No other outcomes were statistically significant, and only two minor adverse events were reported.
Conclusions:
- Evidence suggests that a single oral dose of 2g amoxicillin given 1 hour preoperatively significantly reduces dental implant failures in standard procedures.
- No significant adverse events were associated with this prophylactic antibiotic regimen.
- Further research is needed to determine the efficacy of postoperative antibiotics and identify optimal antibiotic choices.
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