Do Perioperative Antibiotics Decrease Implant Failure?

Purpose: To execute an evidence-based review answering the following question: Among patients receiving dental implants, do those who receive perioperative antibiotic therapy, compared with those who do not, have a decreased likelihood of implant failure? Materials and Methods: We performed a literature review. The primary predictor variable was an antibiotic regimen, which was grouped into 3 categories: a single preoperative dose, a single preoperative dose and multiday postoperative therapy, and no antibiotic therapy. The primary and secondary outcome variables were implant failure and postoperative infection, respectively. Results: Eight studies meeting the inclusion criteria were reviewed. Two studies assessed the effect of a single preoperative antibiotic dose and reported a reduction in implant failure by 1.3% to 2% compared with no antibiotics use. Two studies compared the effect of pre- and postoperative antibiotics and no antibiotic use and found a 4.2% decrease to 1.1% increase in the failure rates when antibiotics were used. Four studies considered the effect of different antibiotic regimens. Only 2 studies found a statistically significant reduction in implant failure (2.5% to 5.4%) when a single preoperative antibiotic dose was used in conjunction with multiday treatment, compared with postoperative multiday treatment only. Four studies analyzed the rate of postoperative infection, which was 0.6% to 3% when no antibiotics were used, 0.6% when preoperative antibiotics alone were used, and 0.8% to 1% when preoperative and postoperative antibiotics were given. Conclusion: A single dose of preoperative antibiotic therapy may slightly decrease the failure rate of dental implants. However, the current data do not support the routine use of postoperative antibiotics, which can be tailored by the clinician to the patient's specific needs. (C) 2011 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 69:2345-2350, 2011