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Antibiotic prophylaxis at dental implant placement: Which is the best protocol? A systematic review and network meta‐analysis
Author(s) -
Romandini Mario,
De Tullio Ilaria,
Congedi Francesca,
Kalemaj Zamira,
D‘Ambrosio Mattia,
Laforí Andreina,
Quaranta Ciro,
Buti Jacopo,
Perfetti Giorgio
Publication year - 2019
Publication title -
journal of clinical periodontology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.456
H-Index - 151
eISSN - 1600-051X
pISSN - 0303-6979
DOI - 10.1111/jcpe.13080
Subject(s) - antibiotic prophylaxis , meta analysis , medicine , protocol (science) , systematic review , dental implant , dentistry , antibiotics , implant , medline , surgery , biology , alternative medicine , pathology , microbiology and biotechnology , biochemistry
Aim This systematic review of randomized controlled trials ( RCT s) aims to answer to the following question: “In patients undergoing dental implant placement, which is the best antibiotic prophylaxis protocol to prevent early failures?” Materials and Methods The MEDLINE , SCOPUS , CENTRAL and Web of Knowledge electronic databases were searched in duplicate for RCT s up to July 2017. Additional relevant literature was identified through (i) handsearching on both relevant journals and reference lists, and (ii) searching in databases for grey literature. A network meta‐analysis ( NMA ) was conducted, and the probability that each protocol is the “Best” was estimated. Results Nine RCT s were included, with a total of 1,693 participants. Due to the few events reported, it was not possible to conduct a NMA for adverse events, therefore it was conducted only for implant failures ( IF ). The protocol with the highest probability (32.5%) of being the “Best” one to prevent IF was the single dose of 3 g of amoxicillin administered 1 hr pre‐operatively. Even if the single pre‐operative dose of 2 g of amoxicillin is the most used, it achieved only a probability of 0.2% to be the “Best” one. Conclusions Basing on the available RCT s, the use of antibiotic prophylaxis is protective against early implant failures. Whenever an antibiotic prophylaxis is needed, there is still insufficient evidence to confidently recommend a specific dosage. The use of post‐operative courses does not seem however to be justified by the available literature. Prospero registration number: CRD 42015029708.