Antibiotic prophylaxis for preventing dental implant failure and postoperative infection: A systematic review of randomized controlled trials.

Purpose: To investigate whether prophylactic antibiotics are beneficial on patients undergoing routine dental implant placement procedures and to investigate which administration regimen is the most effective. Methods: The primary outcome was implant failure; the secondary outcome was postoperative infection. In the fixed-effects model, the Mantel-Haenszel method was used to calculate pooled relative risks (RRs) at 95% confidence intervals (CIs). To determine the outcomes, the quality of available evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Results: Prophylactic antibiotics significantly decreased the incidence of implant failure (RR, 0.29; 95% CI, 0.15-0.55; P=0.0002; I-2=0%) but did not decrease infection. There was no statistically significant difference between single preoperative antibiotics (SPA) and preoperative and postoperative antibiotics (PPA) while treating patients with dental implant failure (RR, 1.07; 95% CI, 0.31-3.62; P=0.92). No statistically significant difference was observed between SPA and PPA when prescribed to treat infection postoperatively (RR, 1.05; 95% CI, 0.29-3.85; P=0.94; I-2=0%). CLINICAL SIGNIFICANCE: The administration of prophylactic antibiotics significantly reduced the failure of dental implants under ordinary conditions. Furthermore, single preoperative antibiotics and preoperative and postoperative antibiotics had similar effects on dental implant failures and infections.