{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,9]],"date-time":"2026-11-09T23:29:25Z","timestamp":1794266965978,"version":"4.9.0"},"reference-count":45,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2023,4,5]],"date-time":"2023-04-05T00:00:00Z","timestamp":1680652800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: This project was developed from anecdotal evidence of varied practices around antibiotic prescribing in dental procedures. The aim of the study was to ascertain if there is evidence to support whether antibiotic (AB) use can effectively reduce postoperative infections after dental implant placements (DIPs). Materials and Methods: Following PRISMA-P\u00a9 methodology, a systematic review of randomised controlled clinical trials was designed and registered on the PROSPERO\u00a9 database. Searches were performed using PubMed\u00ae, Science Direct\u00ae and the Cochrane\u00a9 Database, plus the bibliographies of studies identified. The efficacy of prophylactic antibiotics, independent of the regimen used, versus a placebo, control or no therapy based on implant failure due to infection was the primary measured outcome. Secondary outcomes were other post-surgical complications due to infection and AB adverse events. Results: Twelve RCTs were identified and analysed. Antibiotic use was reported to be statistically significant in preventing infection (p &lt; 001). The prevention of complications was not statistically significant (p = 0.96), and the NNT was &gt;5 (14 and 2523 respectively), which indicates that the intervention was not sufficiently effective to justify its use. The occurrence of side effects was not statistically significant (p = 0.63). NNH was 528 indicating that possible harm caused by the use of ABs is very small and does not negate the AB use when indicated. Conclusion: The routine use of prophylactic antibiotics to prevent infection in dental implant placement was found to be not sufficiently effective to justify routine use. Clear clinical assessment pathways, such as those used for medical conditions, based on the patients\u2019 age, dental risk factors, such as oral health and bone health, physical risk factors, such as chronic or long-term conditions and modifiable health determinants, such as smoking, are required to prevent the unnecessary use of antibiotics.<\/jats:p>","DOI":"10.3390\/medicina59040713","type":"journal-article","created":{"date-parts":[[2023,4,6]],"date-time":"2023-04-06T02:29:58Z","timestamp":1680748198000},"page":"713","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Antibiotic Use in Dental Implant Procedures: A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"59","author":[{"given":"Elham","family":"Torof","sequence":"first","affiliation":[{"name":"School of Pharmacy, University of Wolverhampton, Wulfruna Street, Wolverhampton WV1 1LY, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9752-537X","authenticated-orcid":false,"given":"Hana","family":"Morrissey","sequence":"additional","affiliation":[{"name":"School of Pharmacy, University of Wolverhampton, Wulfruna Street, Wolverhampton WV1 1LY, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8918-2119","authenticated-orcid":false,"given":"Patrick A.","family":"Ball","sequence":"additional","affiliation":[{"name":"School of Pharmacy, University of Wolverhampton, Wulfruna Street, Wolverhampton WV1 1LY, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,4,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Misch, C. (2015). Dental Implant Prosthetics, Elsevier Health Sciences. [2nd ed.].","DOI":"10.1016\/B978-0-323-07845-0.00016-6"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Ho, C.K. (2021). Practical Procedures in Implant Dentistry, Wiley Online Library. [2nd ed.].","DOI":"10.1002\/9781119399186"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"52","DOI":"10.12998\/wjcc.v3.i1.52","article-title":"Implant biomaterials: A comprehensive review","volume":"3","author":"Saini","year":"2015","journal-title":"World J. Clin. Cases"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Gul, M., Celik, E., Mete, S., and Serin, F. (2020). Computational Intelligence and Soft Computing Applications in Healthcare Management Science, IGI Global.","DOI":"10.4018\/978-1-7998-2581-4"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1007\/s13191-014-0374-y","article-title":"Occlusal Concepts in Full Mouth Rehabilitation: An Overview","volume":"14","author":"Tiwari","year":"2014","journal-title":"J. Indian Prosthodont. Soc."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"S3","DOI":"10.1111\/j.1834-7819.2008.00036.x","article-title":"Patient assessment and diagnosis in implant treatment","volume":"53","author":"Zitzmann","year":"2008","journal-title":"Aust. Dent. J."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1111\/j.1708-8208.2001.tb00143.x","article-title":"Biologic and mechanical stability of single-tooth implants: 4- to 7-year follow-up","volume":"3","author":"Norton","year":"2001","journal-title":"Clin. Implant. Dent. Relat. Res."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2080","DOI":"10.1902\/jop.2006.060220","article-title":"A Retrospective Evaluation of 1387 Single-Tooth Implants: A 6-Year Follow-up","volume":"77","author":"Levin","year":"2006","journal-title":"J. Periodontol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1111\/j.1708-8208.2012.00456.x","article-title":"10-Year Survival and Success Rates of 511 Titanium Implants with a Sandblasted and Acid-Etched Surface: A Retrospective Study in 303 Partially Edentulous Patients","volume":"14","author":"Buser","year":"2012","journal-title":"Clin. Implant. Dent. Relat. Res."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"780","DOI":"10.1111\/cid.12056","article-title":"Long-Term Outcomes of Dental Implants with a Titanium Plasma-Sprayed Surface: A 20-Year Prospective Case Series Study in Partially Edentulous Patients","volume":"15","author":"Chappuis","year":"2013","journal-title":"Clin. Implant. Dent. Relat. Res."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"102","DOI":"10.5051\/jpis.2014.44.3.102","article-title":"Long-term implant success at the Academy for Oral Implantology: 8-year follow-up and risk factor analysis","volume":"44","author":"Busenlechner","year":"2014","journal-title":"J. Periodontal Implant. Sci."},{"key":"ref_12","first-page":"e275","article-title":"Long-Term Evaluation of ANKYLOS\u00ae Dental Implants, Part I: 20-Year Life Table Analysis of a Longitudinal Study of More than 12,500 Implants","volume":"17","author":"Krebs","year":"2013","journal-title":"Clin. Implant. Dent. Relat. Res."},{"key":"ref_13","first-page":"423","article-title":"Success or failure of dental implants? A literature review with treatment considerations","volume":"53","author":"Porter","year":"2005","journal-title":"Gen. Dent."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1097\/01.id.0000187956.59276.f8","article-title":"The Effect of Cigarette Smoking on Dental Implants and Related Surgery","volume":"14","author":"Levin","year":"2005","journal-title":"Implant. Dent."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"S234","DOI":"10.4103\/0975-7406.155926","article-title":"Immediate placement of endosseous implants into the extraction sockets","volume":"7","author":"Ebenezer","year":"2015","journal-title":"J. Pharm. Bioallied Sci."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"S28","DOI":"10.4103\/0975-7406.191961","article-title":"Antibiotics in dental implants: A review of literature","volume":"8","author":"Surapaneni","year":"2016","journal-title":"J. Pharm. Bioallied Sci."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Resnick, R., and Misch, C.E. (2017). Avoiding Complications in Oral Implantology, Elsevier.","DOI":"10.1016\/B978-0-323-37580-1.00017-2"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Hupp, J., and Ferneini, E. (2015). Head, Neck, and Orofacial Infections, Elsevier Science. [1st ed.].","DOI":"10.1016\/B978-0-323-28945-0.00032-6"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1177\/0022034511431252","article-title":"Success Criteria in Implant Dentistry: A systematic review","volume":"91","author":"Papaspyridakos","year":"2011","journal-title":"J. Dent. Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 Statement: An Updated Guideline for Reporting Systematic Reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1136\/bmj.327.7414.557","article-title":"Measuring inconsistency in meta-analyses","volume":"327","author":"Higgins","year":"2003","journal-title":"BMJ"},{"key":"ref_22","unstructured":"The UK Faculty of Public Health (2023, January 21). Numbers Needed to Treat (NNTs)\u2014Calculation, Interpretation, Advantages and Disadvantages. Available online: https:\/\/www.healthknowledge.org.uk\/public-health-textbook\/research-methods\/1a-epidemiology\/nnts."},{"key":"ref_23","unstructured":"Centre for Evidence-Based Medicine (CEBM), UK (2023, January 23). Number Needed to Treat. Available online: https:\/\/www.cebm.ox.ac.uk\/resources\/ebm-tools\/number-needed-to-treat-nnt."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1136\/emermed-2020-209567","article-title":"Population, Intervention, Comparison, Outcomes and Study (PICOS) design as a framework to formulate eligibility criteria in systematic reviews","volume":"37","author":"Janati","year":"2020","journal-title":"Emerg. Med. J."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1563\/AAID-JOI-D-09-00134.1","article-title":"A Pilot Study to Determine the Effectiveness of Different Amoxicillin Regimens in Implant Surgery","volume":"37","author":"Caiazzo","year":"2011","journal-title":"J. Oral Implant."},{"key":"ref_26","first-page":"283","article-title":"A mul-ticentre placebo-controlled randomised clinical trial of antibiotic prophylaxis for placement of single dental implants","volume":"2","author":"Anitua","year":"2009","journal-title":"Eur. J. Oral. Implantol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1111\/clr.12098","article-title":"Effect of systemic antibiotics on clinical and patient-reported outcomes of implant therapy\u2014A multicenter randomized controlled clinical trial","volume":"25","author":"Tan","year":"2013","journal-title":"Clin. Oral Implant. Res."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1111\/clr.13580","article-title":"The effect of systemic antibiotics on clinical and patient-reported outcome measures of oral implant therapy with simultaneous guided bone regeneration","volume":"31","author":"Payer","year":"2020","journal-title":"Clin. Oral Implant. Res."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1318","DOI":"10.1111\/clr.13832","article-title":"Do postoperative antibiotics influence one-year peri-implant crestal bone remodelling and morbidity? A double-blinded randomized clinical trial","volume":"32","author":"Durand","year":"2021","journal-title":"Clin. Oral Implant. Res."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1046","DOI":"10.1016\/S0895-4356(01)00377-8","article-title":"Funnel plots for detecting bias in meta-analysis: Guidelines on choice of axis","volume":"54","author":"Sterne","year":"2001","journal-title":"J. Clin. Epidemiol."},{"key":"ref_31","first-page":"135","article-title":"Effectiveness of prophylactic antibiotics at placement of dental implants: A pragmatic multicentre placebo-controlled randomised clinical trial","volume":"3","author":"Esposito","year":"2010","journal-title":"Eur. J. Oral Implant."},{"key":"ref_32","first-page":"58","article-title":"Asepsis during periodontal surgery involving oral implants and the usefulness of peri-operative antibiotics: A prospective, randomized, controlled clinical trial","volume":"35","author":"Quirynen","year":"2007","journal-title":"J. Clin. Periodontol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1111\/clr.12124","article-title":"The influence of prophylactic antibiotic administration on post-operative morbidity in dental implant surgery. A prospective double blind randomized controlled clinical trial","volume":"25","author":"Nolan","year":"2013","journal-title":"Clin. Oral Implant. Res."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1111\/cid.12724","article-title":"Influence of a single preoperative dose of antibiotics on the early implant failure rate. A randomized clinical trial","volume":"21","author":"Kashani","year":"2019","journal-title":"Clin. Implant. Dent. Relat. Res."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1904","DOI":"10.1902\/jop.2008.070670","article-title":"Early Wound Healing Following One-Stage Dental Implant Placement With and without Antibiotic Prophylaxis: A Pilot Study","volume":"79","author":"Khoury","year":"2008","journal-title":"J. Periodontol."},{"key":"ref_36","first-page":"95","article-title":"The efficacy of antibiotic prophylaxis at placement of dental implants: A Cochrane systematic review of randomised controlled clinical trials","volume":"1","author":"Esposito","year":"2008","journal-title":"Eur. J. Oral Implant."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1902\/annals.2000.5.1.166","article-title":"The Influence of Preoperative Antibiotics on Success of Endosseous Implants at 36 Months","volume":"5","author":"Laskin","year":"2000","journal-title":"Ann. Periodontol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1111\/j.1524-475X.2004.04006.x","article-title":"A Process for Systematically Reviewing the Literature: Providing the Research Evidence for Public Health Nursing Interventions","volume":"1","author":"Thomas","year":"2004","journal-title":"Worldviews Evid.-Based Nurs."},{"key":"ref_39","unstructured":"Higgins, J., Thomas, J., Chandler, J., Cumpston, M., Li, T., Page, M.M., and Welch, V. (2022). Cochrane Handbook for Systematic Reviews of Interventions, John Wiley and Sons. Version 6.3."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/j.ijom.2013.05.019","article-title":"Do antibiotics decrease implant failure and postoperative infections? A systematic review and meta-analysis","volume":"43","year":"2014","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_41","first-page":"CD004152","article-title":"Interventions for replacing missing teeth: Antibiotics at dental implant placement to prevent complications","volume":"2013","author":"Esposito","year":"2013","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"iii","DOI":"10.1111\/clr.12668","article-title":"The 4th EAO Consensus Conference 11\u201314 February 2015, Pf\u00e4ffikon, Schwyz, Switzerland","volume":"26","author":"Klinge","year":"2015","journal-title":"Clin. Oral Implant. Res."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"485","DOI":"10.11607\/jomi.7995","article-title":"The Use of Antibiotics in Implant Therapy: A Systematic Review and Meta-Analysis with Trial Sequential Analysis on Early Implant Failure","volume":"35","author":"Canullo","year":"2020","journal-title":"Int. J. Oral Maxillofac. Implant."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1007\/s10006-020-00872-5","article-title":"Efficacy of preoperative antibiotics in prevention of dental implant failure: A Meta-analysis of randomized controlled trials","volume":"24","author":"Jain","year":"2020","journal-title":"Oral Maxillofac. Surg."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"e61","DOI":"10.1016\/j.adaj.2018.10.015","article-title":"Prophylactic antibiotic regimens in dental implant failure: A systematic review and meta-analysis","volume":"150","author":"Braun","year":"2019","journal-title":"J. Am. Dent. Assoc."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/4\/713\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:10:33Z","timestamp":1760123433000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/4\/713"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,5]]},"references-count":45,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2023,4]]}},"alternative-id":["medicina59040713"],"URL":"https:\/\/doi.org\/10.3390\/medicina59040713","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,5]]}}}