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Antibiotic Prophylaxis in Maxillofacial Surgery and Evidence-Based Practice: A Systematic Review.

Gayatri Moharana¹, Rajat Mohanty¹, Spandita Das²

¹Department of Oral and Maxillofacial Surgery, Kalinga Institute of Dental Sciences (KIDS) Kalinga Institute of Industrial Technology (KIIT) Deemed to be University, Bhubaneswar, IND.

|December 1, 2025

Summary

Antibiotic prophylaxis in maxillofacial surgery offers limited overall benefit. Its routine use is not consistently justified, though it may provide selective advantages in complex or high-risk procedures. Judicious application and further research are needed.

Keywords:

antibiotic prophylaxis dental implants fracture third molar tooth extraction

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Area of Science:

Oral and Maxillofacial Surgery
Infectious Disease Prevention
Evidence-Based Medicine

Background:

Antibiotic prophylaxis aims to prevent surgical site infections (SSIs) by administering antibiotics before, during, or after procedures.
The efficacy of prophylactic antibiotics in oral and maxillofacial surgery remains a subject of ongoing investigation.

Purpose of the Study:

To systematically review current literature on the influence of preoperative, perioperative, or postoperative antibiotic prophylaxis on patient outcomes in oral and maxillofacial surgeries.
To evaluate the overall benefit and specific indications for antibiotic prophylaxis in this surgical domain.

Main Methods:

Systematic review adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
Comprehensive literature search across PubMed, Scopus, and Web of Science up to May 2025.
Inclusion of randomized controlled trials (RCTs) and cohort studies focusing on various maxillofacial procedures.

Main Results:

Thirteen studies were included, covering dental implants, surgical tooth extraction, maxillofacial trauma, orthognathic surgery, and drug allergy.
Prophylactic antibiotics demonstrated limited overall benefit in maxillofacial surgery.
Selective advantages were noted in complex or high-risk cases, but routine use was not consistently justified.

Conclusions:

The routine administration of prophylactic antibiotics in oral and maxillofacial surgery is not consistently supported by current evidence.
Judicious application of antibiotics is recommended, tailored to specific patient and procedural risk factors.
Further high-quality research is necessary to refine guidelines for antibiotic prophylaxis in this field.