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Preventive Antibiotic Therapy in Sinus Elevation Procedures: A Systematic Review.

Ángel-Orión Salgado-Peralvo, Alvaro Garcia-Sanchez, Naresh Kewalramani

The International Journal of Oral & Maxillofacial Implants

|April 26, 2023

Summary

Preventive antibiotic therapy for maxillary sinus elevation surgery shows no clear benefit. Current evidence does not support its routine use or specific protocols for reducing sinus graft infection or dental implant failure.

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Area of Science:

Oral and Maxillofacial Surgery
Periodontology
Dental Implantology

Background:

Maxillary sinus elevation surgery is crucial for dental implant placement in atrophic maxillae.
Preventive antibiotic therapy is often considered to mitigate risks like sinus graft infection and implant failure.

Approach:

A systematic literature search was conducted across major databases (MEDLINE, Web of Science, Scopus, LILACS, OpenGrey) from December 2006 to December 2021.
Included were prospective and retrospective comparative clinical studies with ≥50 patients; excluded were reviews, case reports, and non-English publications.
Data extraction and risk of bias assessment were performed independently by two reviewers.

Key Points:

Only one retrospective study compared antibiotic use versus no use, finding no significant difference in implant failure rates (sinus infection data unavailable).
One randomized clinical trial comparing antibiotic duration (surgery day vs. 7 days post-op) found no significant difference in sinus infection rates.
A total of 12 studies met the inclusion criteria.

Conclusions:

Insufficient evidence exists to recommend for or against preventive antibiotic therapy in sinus elevation procedures.
Current data do not support the superiority of any specific antibiotic protocol for these surgeries.
Further high-quality research is needed to establish optimal antibiotic guidelines.