Non-Cochrane · intervention · PM41640922
Perioperative Antimicrobial Prophylaxis for Invasive Dental Procedures: A Systematic Review and Random-Effects Meta-Analysis of Randomized and Placebo-Controlled Studies.
Iturbe Cordero Alberto A, Jaramillo Arturo P, Vasquez Jhanmarie · Cureus · 2026 · PubMed · doi:10.7759/cureus.100755
Findings
Population Patients undergoing invasive dental procedures (implant placement, tooth extraction, third-molar surgery)
3 findings
| Perioperative antimicrobial/antibiotic prophylaxis (systemic antibiotics and/or local antiseptic) | Placebo or no prophylaxis | Primary pooled endpoint: procedure-related bacteremia or early infectious outcome (event proportion on a 0-1 scale entered as mean) Early perioperative · Outpatient invasive dental care · Dental surgery | MD -0.17 [-0.45, 0.11] GRADE not reported 8 studies · 1407 participants |
| Perioperative antimicrobial/antibiotic prophylaxis (systemic antibiotics and/or local antiseptic) | Placebo or no prophylaxis | Secondary continuous postoperative outcome (postoperative morbidity indicator, not further specified) Postoperative · Outpatient invasive dental care | MD 0.02 [-0.38, 0.42] GRADE not reported 5 studies · 596 participants |
| Perioperative antimicrobial/antibiotic prophylaxis (systemic antibiotics and/or local antiseptic) | Placebo or no prophylaxis | Primary pooled endpoint: procedure-related bacteremia or early infectious outcome (event proportion on a 0-1 scale entered as mean) Early perioperative · Outpatient invasive dental care | MD -0.12 [-0.31, 0.07] GRADE not reported 10 studies · 1950 participants |
Included primary studies 17
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Barbosa 2015 Post-Tooth Extraction Bacteraemia: A Randomized Clinical Trial on the Efficacy of Chlorhexidine Prophylaxis DOI:10.1371/journal.pone.0124249 | 2015 | this review only | not stated | not extracted yet |
| Barbosa 2015 Post-tooth extraction bacteraemia: a randomized clinical trial on the efficacy of chlorhexidine prophylaxis. PMID:25955349 | 2015 | this review only | Primary pooled endpoint: procedure-related bacteremia or early infectious outcome (event proportion on a 0-1 scale entered as mean) | not extracted yet |
| Bravo-Olmedo 2025 Effect of Antibiotic Prophylaxis in Dental Implant Surgery: A Randomized Controlled Clinical Trial DOI:10.3390/dj13110500 | 2025 | this review only | Primary pooled endpoint: procedure-related bacteremia or early infectious outcome (event proportion on a 0-1 scale entered as mean) | not extracted yet |
| García-Blanco 2025 Randomized controlled trial comparing antibiotics to placebo for single simple dental extractions in diabetic patients. PMID:40741811 | 2025 | this review only | Primary pooled endpoint: procedure-related bacteremia or early infectious outcome (event proportion on a 0-1 scale entered as mean); Secondary continuous postoperative outcome (postoperative morbidity indicator, not further specified) | not extracted yet |
| Khalil 2016 Oral microflora and selection of resistance after a single dose of amoxicillin DOI:10.1016/j.cmi.2016.08.008 | 2016 | this review only | not stated | not extracted yet |
| Khalil 2016 Oral microflora and selection of resistance after a single dose of amoxicillin. PMID:27569711 | 2016 | this review only | Primary pooled endpoint: procedure-related bacteremia or early infectious outcome (event proportion on a 0-1 scale entered as mean); Secondary continuous postoperative outcome (postoperative morbidity indicator, not further specified) | not extracted yet |
| Kirnbauer 2022 Is perioperative antibiotic prophylaxis in the case of routine surgical removal of the third molar still justified? A randomized,… DOI:10.1007/s00784-022-04597-5 | 2022 | this review only | not stated | not extracted yet |
| Kirnbauer 2022 Is perioperative antibiotic prophylaxis in the case of routine surgical removal of the third molar still justified? A randomized,… PMID:35792962 | 2022 | this review only | Primary pooled endpoint: procedure-related bacteremia or early infectious outcome (event proportion on a 0-1 scale entered as mean); Secondary continuous postoperative outcome (postoperative morbidity indicator, not further specified) | not extracted yet |
| Limeres Posse 2016 Intravenous amoxicillin/clavulanate for the prevention of bacteraemia following dental procedures: a randomized clinical trial DOI:10.1093/jac/dkw081 | 2016 | this review only | not stated | not extracted yet |
| Limeres Posse 2016 Intravenous amoxicillin/clavulanate for the prevention of bacteraemia following dental procedures: a randomized clinical trial. PMID:27029851 | 2016 | this review only | Primary pooled endpoint: procedure-related bacteremia or early infectious outcome (event proportion on a 0-1 scale entered as mean) | not extracted yet |
| Momand 2022 Effect of antibiotic prophylaxis in dental implant surgery: A multicenter placebo‐controlled double‐blinded randomized clinical trial DOI:10.1111/cid.13068 | 2022 | this review only | not stated | not extracted yet |
| Momand 2022 Effect of antibiotic prophylaxis in dental implant surgery: A multicenter placebo-controlled double-blinded randomized clinical trial. PMID:35075765 | 2022 | this review only | Primary pooled endpoint: procedure-related bacteremia or early infectious outcome (event proportion on a 0-1 scale entered as mean) | not extracted yet |
| Momand 2024 Is routine antibiotic prophylaxis warranted in dental implant surgery to prevent early implant failure? – a systematic review DOI:10.1186/s12903-024-04611-0 | 2024 | this review only | not stated | not extracted yet |
| Momand 2024 Is routine antibiotic prophylaxis warranted in dental implant surgery to prevent early implant failure? - a systematic review. PMID:39054434 | 2024 | this review only | Primary pooled endpoint: procedure-related bacteremia or early infectious outcome (event proportion on a 0-1 scale entered as mean); Secondary continuous postoperative outcome (postoperative morbidity indicator, not further specified) | not extracted yet |
| Santamaría Arrieta 2023 The effect of preoperative clindamycin in reducing early oral implant failure: a randomised placebo-controlled clinical trial DOI:10.1007/s00784-022-04701-9 | 2022 | this review only | not stated | not extracted yet |
| Santamaría Arrieta 2023 The effect of preoperative clindamycin in reducing early oral implant failure: a randomised placebo-controlled clinical trial. PMID:36098814 | 2023 | this review only | Primary pooled endpoint: procedure-related bacteremia or early infectious outcome (event proportion on a 0-1 scale entered as mean) | not extracted yet |
| Yves 2021 [Ulcerative colitis]. PMID:4872021 | 1967 | this review only | Primary pooled endpoint: procedure-related bacteremia or early infectious outcome (event proportion on a 0-1 scale entered as mean); Secondary continuous postoperative outcome (postoperative morbidity indicator, not further specified) | not extracted yet |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Patients undergoing invasive dental procedures (implant surgery and extraction-based procedures) | Implant surgery, tooth extraction, third-molar surgery and dental procedures with bacteremia assessment (n=1,950 units of analysis) |
| Intervention | Perioperative antimicrobial/antibiotic prophylaxis, including preoperative single-dose and perioperative systemic regimens and/or local antiseptic strategies | Systemic amoxicillin, amoxicillin-clavulanate, clindamycin and chlorhexidine mouthwash prophylaxis (n=10 studies) |
| Comparison | Placebo and/or no prophylaxis | Placebo or no prophylaxis |
| Outcomes | Early procedure-related infectious outcomes and/or bacteremia-related endpoints; secondary postoperative morbidity indicators (pain/recovery measures) | Bacteremia/early infectious endpoints pooled as mean difference of event proportions (n=10); secondary continuous postoperative outcome (n=5) |
| Study designs | Randomized controlled trials published in the past 10 years in English | 10 studies (randomized trials, plus one before-after study and one systematic review pooled) |
| Timing | Early postoperative window | Immediate post-procedure to 90 days |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | No | No | yes |
| 3Choice of study designs explained | No | No | yes |
| 4Comprehensive literature searchcritical | No | No | yes |
| 5Study selection in duplicate | No | No | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | No | No | yes |
| 8Included studies described in detail | Partial Yes | Partial Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | RCT: Yes · NRSI: No | NRSI: No · RCT: Yes | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: No · NRSI: No | NRSI: No · RCT: No | no |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | No | No | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | Yes | Yes | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Critically Low | Critically Low | yes |