Cochrane · intervention · CD004152

Interventions for replacing missing teeth: antibiotics at dental implant placement to prevent complications

Esposito, M, Grusovin, MG, Worthington, HV · Cochrane Database of Systematic Reviews · 2013 · Cochrane Library

Oral Health Implants and prosthodontics4 versionsAMSTAR 2: not assessed

Full textEvery question was extracted from the full review (methods and results), not only its Summary of Findings table.

Questions

6

current version

GRADE rated

1

No studies

1

Included studies

6

as reported

No studies 1 · 16.7%Ungraded 4 · 66.7%Very low 0 · 0%Low 0 · 0%Moderate 1 · 16.7%High 0 · 0%

Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.

Review question

Element	Planned (methods)	Found (results)
Population	Any group of people undergoing dental implant placement	Adults (>18 years) undergoing dental implant placement (n=1162)
Intervention	Prophylactic antibiotics; different antibiotics; different doses or duration of the same antibiotic	Amoxicillin 2 g orally 1 hour preoperatively, single dose (n=4 trials); amoxicillin 3 g preoperatively (n=1); amoxicillin 1 g preoperatively plus 500 mg 4 times/day for 2 days (n=1); amoxicillin 2 g preoperatively plus 1 g 2 times/day for 7 days (n=1); amoxicillin 1 g postoperatively 2 times/day for 7 days (n=1)
Comparison	No antibiotics or placebo; a different antibiotic; a different dose or duration of the same antibiotic	Placebo (n=4); no antibiotics (n=2)
Outcomes	Prosthesis failure (prosthesis could not be placed or failed secondary to implant failure); Implant failure (mobility/removal for progressive marginal bone loss or infection); Postoperative infections; Adverse events (gastrointestinal, hypersensitivity)	Implant failure (n=6); Prosthesis failure (n=5); Postoperative infection (n=6); Adverse events (n=6)
Study designs	RCTs with follow-up of at least three months	RCT (n=6)
Timing	At least 3 months follow-up	3 to 5 months

Search date: 2013-06. Databases: Cochrane Oral Health Group's Trials Register; Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE; EMBASE

Questions and results

Current version only

Prophylactic systemic antibiotics (amoxicillin) vs No antibiotics or placebo

Population: Adults undergoing dental implant placement

CD004152.PUB4 (current) · 4 questions

Outcome	Effect	Evidence	Status / GRADE
Prosthesis failure 3 to 5 months same question in other reviews	RR 0.44 [0.19, 1.00]	5 studies · 1107 participants	Ungraded
Postoperative infection 3 to 5 months same question in other reviews	RR 0.69 [0.36, 1.35]	6 studies · 1162 participants	Ungraded
Implant failure 4 months same question in other reviews	RR 0.33 [0.16, 0.67] Low risk 10 per 1000; High risk 100 per 1000 vs Low risk 4 per 1000 (2 to 7); High risk 40 per 1000 (16 to 67)	6 studies · 1162 participants	Moderate Downgraded: risk of bias
Adverse events 3 to 5 months same question in other reviews	RR 1.0 [0.06, 15.85]	6 studies · 1162 participants	Ungraded

One prophylactic antibiotic vs A different prophylactic antibiotic

Population: Adults undergoing dental implant placement

CD004152.PUB4 (current) · 1 question

Outcome	Effect	Evidence	Status / GRADE
Outcome NR At least 3 months (planned) same question in other reviews	no estimate extracted	0 studies	No studies

Prophylactic antibiotic at one dose or duration vs Same antibiotic at a different dose or duration

Population: Adults undergoing dental implant placement

CD004152.PUB4 (current) · 1 question

Outcome	Effect	Evidence	Status / GRADE
Outcome NR 3 months same question in other reviews	No conclusive information can be derived from the only trial that compared three different durations of antibiotic prophylaxis, since no event (implant or prosthesis failures, infections or adverse events) occurred in…	1 study · 100 participants	Ungraded

Prophylactic systemic antibiotics (amoxicillin) vs No antibiotics or placebo

Population: Adults undergoing dental implant placement

CD004152.PUB3 · 4 questions

Outcome	Effect	Evidence	Status / GRADE
Postoperative infection 3 to 5 months	RR 0.74 [0.37, 1.47]	4 studies · 1007 participants	Ungraded
Implant failure 4 months	RR 0.40 [0.19, 0.84] Low risk 10 per 1000; High risk 100 per 1000 vs Low risk 4 per 1000 (2 to 8); High risk 40 per 1000 (19 to 84)	4 studies · 1007 participants	Moderate Downgraded: risk of bias
Prosthesis failure 3 to 5 months	RR 0.50 [0.22, 1.17]	4 studies · 1007 participants	Ungraded
Adverse events 3 to 5 months	RR 1.0 [0.06, 15.85]	4 studies · 1007 participants	Ungraded

One prophylactic antibiotic vs A different prophylactic antibiotic

Population: Adults undergoing dental implant placement

CD004152.PUB3 · 1 question

Outcome	Effect	Evidence	Status / GRADE
Outcome NR At least 3 months (planned)	no estimate extracted	0 studies	No studies

Prophylactic antibiotic at one dose or duration vs Same antibiotic at a different dose or duration

Population: Adults undergoing dental implant placement

CD004152.PUB3 · 1 question

Outcome	Effect	Evidence	Status / GRADE
Outcome NR At least 3 months (planned)	no estimate extracted	0 studies	No studies

Prophylactic systemic antibiotics (amoxicillin) vs No antibiotics or placebo

Population: Adults undergoing dental implant placement

CD004152.PUB2 · 4 questions

Outcome	Effect	Evidence	Status / GRADE
Implant failure 4 to 5 months	RR 0.22 [0.06, 0.86]	2 studies · 396 participants	Ungraded
Adverse events 4 to 5 months	RR 1.0 [0.06, 15.85]	2 studies · 396 participants	Ungraded
Prosthesis failure 4 to 5 months	RR 0.5 [0.09, 2.69]	2 studies · 396 participants	Ungraded
Postoperative infection 4 to 5 months	RR 0.68 [0.12, 3.92]	2 studies · 396 participants	Ungraded

One prophylactic antibiotic vs A different prophylactic antibiotic

Population: Adults undergoing dental implant placement

CD004152.PUB2 · 1 question

Outcome	Effect	Evidence	Status / GRADE
Outcome NR At least 3 months (planned)	no estimate extracted	0 studies	No studies

Prophylactic antibiotic at one dose or duration vs Same antibiotic at a different dose or duration

Population: Adults undergoing dental implant placement

CD004152.PUB2 · 1 question

Outcome	Effect	Evidence	Status / GRADE
Outcome NR At least 3 months (planned)	no estimate extracted	0 studies	No studies

Prophylactic systemic antibiotics (amoxicillin) vs No antibiotics or placebo

Population: Adults undergoing dental implant placement

CD004152 · 1 question

Outcome	Effect	Evidence	Status / GRADE
Outcome NR At least 3 months (planned)	no estimate extracted	0 studies	No studies

One prophylactic antibiotic vs A different prophylactic antibiotic

Population: Adults undergoing dental implant placement

CD004152 · 1 question

Outcome	Effect	Evidence	Status / GRADE
Outcome NR At least 3 months (planned)	no estimate extracted	0 studies	No studies

Prophylactic antibiotic at one dose or duration vs Same antibiotic at a different dose or duration

Population: Adults undergoing dental implant placement

CD004152 · 1 question

Outcome	Effect	Evidence	Status / GRADE
Outcome NR At least 3 months (planned)	no estimate extracted	0 studies	No studies