Antibiotic Prophylaxis in Implant Dentistry: Significant Reduction in Implant Failure

Objectives: Background: The benefits of antibiotic prophylaxis in implant dentistry exhibit lack of consensus among current literature. Existing heterogeneity regarding their efficacy in oral procedures render challenges among clinicians conducting implant surgery. Implant failures are caused by peri-implant instability, overloading, inadequate bone volume and inferior bone quality. The controversy regarding the routine use of prophylactic antibiotics in oral surgery persisted, and their ambivalent efficacy in implant procedures remain equivocal. Purpose: The study's aim was to investigate the efficacy of prophylactic antibiotics prescribed to patients prior to or immediately following dental implant surgery (PIFS), and whether it reduced implant failure rate and postoperative complications, or had no effects at all.
Methods: Literature search was conducted among two electronic databases, with defined inclusion/exclusion criteria to filter appropriate studies. Each record was assessed for inclusion eligibility and risk of bias, following the Cochrane Systematic review guideline. Essential components (i.e. antibiotic regimen, treatment duration, pre- and postoperative interventions, etc.) were extracted and summarized in a table. Studies were divided into two groups based on the type of interventions. The Chi-square test of homogeneity was used to test the statistical significance of the difference in implant success rates between two groups.
Results: 13 publications were gathered in total, reporting unique implant success/failure rates based on the allowed interventions. 6,723 implants were placed with antibiotics given either preoperatively or PIFS, and 3,834 placed with no antibiotics or placebo tablets. The antibiotic group exhibited implant success rate of 97.6% and the control group exhibited 94.2%. Observed difference in implant success rates were statistically significant (P<0.00001), and no apparent distinctions among success or failure rates that have used different antibiotic type, regimen, and duration.
Conclusions: Antibiotic prophylaxis administered preoperatively or right after surgery can reduce the occurrences of implant failures. Further investigation is recommended for establishing a standardized protocol for proper use of antibiotics in oral implantology.