Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

107 questions · 121 findings · 21 reviews · All outcomes

No studies found 22 · 18.2%GRADE not reported 52 · 43%Very low 30 · 24.8%Low 16 · 13.2%Moderate 1 · 0.8%High 0 · 0%

Hyperbaric oxygen therapy plus standard care (surgery, antibiotics, oral rinse) vs Standard care alone (surgery, antibiotics, oral rinse)

Quality of life · People with BRONJ (mean age ~66 years; most treated with bisphosphonates for cancer (multiple myeloma, breast cancer) or osteoporosis)
1 finding from 1 review

Adjunctive local antibiotic (8.5% doxycycline hyclate, Atridox) added to manual debridement vs Manual debridement plus chlorhexidine irrigation/gel

Change in probing attachment level (PAL) · People with at least one dental implant affected by perimplantitis

Adjunctive local antibiotic (8.5% doxycycline hyclate, Atridox)… led to higher change in probing attachment level (PAL) compared with manual debridement with chlorhexidine (no antibiotic); GRADE not reported.

1 finding from 1 review

Adjunctive local antibiotic (8.5% doxycycline hyclate, Atridox) added to manual debridement vs Manual debridement plus chlorhexidine irrigation/gel

Recurrence of peri-implantitis · People with at least one dental implant affected by perimplantitis
1 finding from 1 review

Adjunctive local antibiotic (8.5% doxycycline hyclate, Atridox) added to manual debridement vs Manual debridement plus chlorhexidine irrigation/gel

Change in probing pocket depth (PPD) · People with at least one dental implant affected by perimplantitis

Adjunctive local antibiotic (8.5% doxycycline hyclate, Atridox)… led to higher change in probing pocket depth (PPD) compared with manual debridement with chlorhexidine (no antibiotic); GRADE not reported.

1 finding from 1 review

Systemic antibiotic (oral penicillin 500 mg) plus analgesic vs Placebo plus analgesic

Total number of ibuprofen tablets · Adults over 18 years presenting with a single tooth with a clinical diagnosis of irreversible pulpitis

Systemic antibiotic (oral penicillin 500 mg) plus analgesic showed no clear difference in total number of ibuprofen tablets compared with placebo plus analgesic (low certainty).

1 finding from 1 review

Systemic antibiotic (oral penicillin 500 mg) plus analgesic vs Placebo plus analgesic

Patient-reported pain intensity (sum of pain intensity difference (SPID) and sum of pain percussion intensity difference (SPPID)) · Adults over 18 years presenting with a single tooth with a clinical diagnosis of irreversible pulpitis
1 finding from 1 review
  • Antibiotic use for irreversible pulpitis 2019 · Cochrane All outcomes
    7 days
    Corresponding risk (Antibiotics): The in between-group differences (median +/- IQR) in SPID for the penicillin group were 6.0 +/- 10.5, and for placebo 6.0 +/- 9.5. The SPPID for the penicillin group was 3.5 +/- 7.5…
    1 study · 40 participants
    Low

Systemic antibiotic (oral penicillin 500 mg) plus analgesic vs Placebo plus analgesic

Total number of paracetamol (acetaminophen) with codeine (Tylenol) tablets · Adults over 18 years presenting with a single tooth with a clinical diagnosis of irreversible pulpitis

Systemic antibiotic (oral penicillin 500 mg) plus analgesic showed no clear difference in total number of paracetamol (acetaminophen) with codeine (Tylenol)… compared with placebo plus analgesic (low certainty).

1 finding from 1 review

Systemic antibiotics without surgical intervention (with or without analgesics) vs Matched placebo without surgical intervention (with or without analgesics)

Outcome not reported · Adults with symptomatic apical periodontitis or acute apical abscess

The review found no eligible studies for this question.

1 finding from 1 review

Triple antibiotic paste (TAP) vs Abscess remedy (AR)

Overall success (composite of clinical and radiographic success) · Immature (young) permanent teeth with open apex and vital pulp exposed to dental caries or trauma, in children aged 6-14 years

A single RCT found higher pulpotomy success with triple antibiotic paste than abscess remedy (100% vs 80%; statistically significant, P<0.05; not pooled; ungraded).

1 finding from 1 review

Systemic antibiotic prophylaxis (any regimen; topical therapy excluded) administered before and/or after tooth extraction vs placebo

Presence of dry socket · People undergoing tooth extraction (21 of 23 trials: healthy patients undergoing impacted third molar extraction; 1 routine intra-alveolar…

Systemic antibiotic prophylaxis (any regimen; topical therapy… may leads to lower dry socket compared with placebo (low certainty).

1 finding from 1 review

Systemic antibiotic prophylaxis (any regimen; topical therapy excluded) administered before and/or after tooth extraction vs placebo

Infectious complications · People undergoing tooth extraction (21 of 23 trials: healthy patients undergoing impacted third molar extraction; 1 routine intra-alveolar…

Systemic antibiotic prophylaxis (any regimen; topical therapy… may leads to lower postsurgical infectious complications compared with placebo (low certainty).

1 finding from 1 review

Systemic antibiotic prophylaxis (any regimen; topical therapy excluded) administered before and/or after tooth extraction vs placebo

Swelling (7th day) · People undergoing tooth extraction (21 of 23 trials: healthy patients undergoing impacted third molar extraction; 1 routine intra-alveolar…

It is very uncertain whether systemic antibiotic prophylaxis (any regimen; topical therapy… changes swelling (7th day) compared with placebo (very low certainty).

1 finding from 1 review

Systemic antibiotic prophylaxis (any regimen; topical therapy excluded) administered before and/or after tooth extraction vs placebo

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · People undergoing tooth extraction (21 of 23 trials: healthy patients undergoing impacted third molar extraction; 1 routine intra-alveolar…

It is very uncertain whether systemic antibiotic prophylaxis (any regimen; topical therapy… changes pain (continuous, VAS 0-10 cm, 7th day) compared with placebo (very low certainty).

1 finding from 1 review

Systemic antibiotic prophylaxis (any regimen; topical therapy excluded) administered before and/or after tooth extraction vs placebo

Pain (dichotomous, present/absent on 6th-7th day) · People undergoing tooth extraction (21 of 23 trials: healthy patients undergoing impacted third molar extraction; 1 routine intra-alveolar…

It is very uncertain whether systemic antibiotic prophylaxis (any regimen; topical therapy… changes presence of pain (dichotomous, yes/no on 6th-7th day) compared with placebo (very low certainty).

1 finding from 1 review

Systemic antibiotic prophylaxis (any regimen; topical therapy excluded) administered before and/or after tooth extraction vs placebo

Adverse effects · People undergoing tooth extraction (21 of 23 trials: healthy patients undergoing impacted third molar extraction; 1 routine intra-alveolar…

It is very uncertain whether systemic antibiotic prophylaxis (any regimen; topical therapy… changes adverse effects compared with placebo (very low certainty).

1 finding from 1 review

Systemic antibiotic prophylaxis (any regimen; topical therapy excluded) administered before and/or after tooth extraction vs placebo

Trismus (dichotomous, 7th day) · People undergoing tooth extraction (21 of 23 trials: healthy patients undergoing impacted third molar extraction; 1 routine intra-alveolar…

It is very uncertain whether systemic antibiotic prophylaxis (any regimen; topical therapy… changes trismus (dichotomous, 7th day) compared with placebo (very low certainty).

1 finding from 1 review