Which Antibiotic Regimen Prevents Implant Failure or Infection after Dental Implant Surgery? A Systematic Review and Meta-analysis

Publication date: Available online 26 February 2018
Source:Journal of Cranio-Maxillofacial Surgery
Author(s): Fabio Rodríguez Sánchez, Carlos Rodríguez Andrés, Iciar Arteagoitia Calvo
ObjectiveTo assess which antibiotic regimen prevents dental implant failures or postoperative infections following dental implant placement.Materials and MethodsSystematic review and meta-analysis. Data sources: Pubmed, Cochrane, Science Direct, and EMBASE via OVID were searched up to August 2017. Only randomized controlled clinical trials (RCT) using antibiotics were included. Outcome measures were set on dental implant failures or postoperative infection incidence after dental implant surgery. Three reviewers independently undertook risk of bias assessment and data extraction. Stratified meta-analyses of binary data using fixed-effects models were performed using Stata 14.0. The risk ratio (RR) and 95% confidence interval (CI) were estimated.ResultsNine articles were included corresponding to 15 RCTs. All RCTs tested only oral amoxicillin. Implant-failure analysis: overall RR=0.53 (P=.005, 95% CI: 0.34-0.82) and overall NNT=55 (95% CI, 33-167). Single-dose oral amoxicillin preoperatively (SDOAP) is beneficial (RR=0.50, CI: 0.29-0.86. P=.012), when compared to postoperative oral amoxicillin (POA): RR= 0.60, CI: 0.28-1.30. P=.197). Postoperative-infection analysis: overall RR=0.76 (P=0.250, 95% CI: 0.47-1.22). Neither SDOAP (RR=0.82, CI=0.46-1.45, P=.488) nor POA (RR=0.64, CI=0.27-1.51, P=.309) are beneficial. I²=0.0%, chi-squared tests P≈1.ConclusionOnly SDOAP is effective and efficacious at preventing implant failures, but it was not significant for postoperative infections following dental implant surgeries.



http://ift.tt/2CsOw3M