Do antibiotics help reduce implant failure? A systematic review
Marco Esposito, Maria Gabriella Grusovin, and Helen V. Worthington
- Some dental implant failures may be due to bacterial contamination at implant insertion. Infections around biomaterials are difficult to treat, and almost all infected implants have to be removed.
- In general, antibiotic prophylaxis in surgery is only indicated for patients:
- At risk of infectious endocarditis;
- With reduced host-response;
- When surgery is performed in infected sites;
- In cases of extensive and prolonged surgical interventions; and
- When large foreign materials are implanted.
- A variety of prophylactic systemic antibiotic regimens have been suggested to minimize infections after dental implant placement. More recent protocols recommended short-term prophylaxis, if antibiotics have to be used.
- Adverse events may occur with the administration of antibiotics, and can range from diarrhea to life-threatening allergic reactions.
- Another major concern associated with the widespread use of antibiotics is the selection of antibiotic-resistant bacteria. The use of prophylactic antibiotics in implant dentistry is controversial.
Purpose of the Review
To assess the beneficial or harmful effects of systemic prophylactic antibiotics at dental implant placement versus no antibiotic or placebo administration and, if antibiotics are beneficial, to determine which type, dosage and duration is the most effective.
- Scientific evidence suggests that, in general, antibiotics are beneficial for reducing failure of dental implants placed in ordinary conditions.
- Specifically 2 g or 3 g of amoxicillin given orally, as a single administration, one hour preoperatively significantly reduces failure of dental implants.
- No significant adverse events were reported.
- It might be sensible to suggest the use of a single dose of 2 g prophylactic amoxicillin prior to dental implant placement.
- It is still unknown whether postoperative antibiotics are beneficial, and which antibiotic is the most effective.