CDA Essentials 2019 • Volume 6 • Issue 6

For oral surgeons, preventing infections at the surgical site and promoting good wound healing are important considerations after placing dental implants. The infection risk is considered to be approximately 10–15%, although good technique and prophylactic antibiotics can reduce this risk. 1 However, the use of antibiotics for dental implant remains controversial. A recent systematic review 2 and meta-analysis aimed to determine the efficacy of antibiotic prophylaxis and specific antibiotic regimens in dental implant placement for prevention of post-operative infection. Randomized controlled trials (RCTs) comparing antibiotic with no antibiotics or placebo for dental implant placement were considered. The primary outcome was post-operative infection (early, late, total) with wound dehiscence, pain, and adverse events of antibiotic treatment as secondary outcomes. Ten RCTs involving 1,934 patients were included. All 10 individual studies reported no statistically significant difference for post-operative infection. Meta-analysis found no statistically significant differences between antibiotic and no antibiotic groups with the variables of early, late or total post-operative infection, wound dehiscence, or adverse effects. The authors concluded: “The results of the present systematic review and meta-analysis indicate that antibiotic prophylaxis may not be indicated for prevention of post-operative infections following dental implant placement in overall healthy patients. These findings, and in light of antibiotic-associated risks for individual and public health, demand revaluation of routine prescription of antibiotic prophylaxis in dental implant placement procedures.” 2 Overall a very low level of post-operative infections was reported. The reviewers highlight that there is a lack of clarity regarding the definition of post-operative infection and wound dehiscence, so the review is based on the definitions used within the individual studies. Clearly, as with other areas, having recognized common outcomes sets would be valuable and improve the quality of systematic reviews. All the included studies employed pre- and post-operative chlorhexidine mouth rinsing regimens which very likely contributed to the low infection rates. This detailed review article found no differences in infection rates between antibiotic and no antibiotic/ placebo groups which suggests no benefit from their use in overall healthy patients. 1 a References 1. Richards D. Antibiotic prophylaxis for dental implants in healthy patients, is it necessary? The Dental Elf. May 9, 2019. Available at: nationalelfservice.net/dentistry/restorative- dentistry/antibiotic-prophylaxis-dental-implants-healthy-patients-necessary (accessed May 13, 2019) 2. Khouly I, Braun RS, Chambrone L. Antibiotic prophylaxis may not be indicated for prevention of dental implant infections in healthy patients. A systematic review and meta-analysis. Clin Oral Investig . 2019 Apr;23(4):1525-53. Antibiotic Prophylaxis for Dental Implants S tudy Questions Use in Healthy Patients 31 Issue 6 | 2019 |