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Antibiotic prophylaxis at dental implant placement: Which is the best protocol? A systematic review and network meta‐analysis

Romandini, M; De Tullio, I; Congedi, F; Kalemaj, Z; D'Ambrosio, M; Laforí, A; Quaranta, C; ... Perfetti, G; + view all (2019) Antibiotic prophylaxis at dental implant placement: Which is the best protocol? A systematic review and network meta‐analysis. Journal of Clinical Periodontology , 46 (3) pp. 382-395. 10.1111/jcpe.13080. Green open access

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Abstract

AIM: This systematic review of randomized controlled trials (RCTs) aims to answer to the following question: "In patients undergoing dental implant placement, which is the best antibiotic prophylaxis protocol to prevent early failures?". MATERIALS AND METHODS: The MEDLINE, SCOPUS, CENTRAL and Web of Knowledge electronic databases were searched in duplicate for RCTs up to July 2017. Additional relevant literature was identified through 1) hand-searching on both relevant journals and on reference lists, and 2) searching in databases for grey literature. A Network Meta-analysis (NMA) was conducted and the probability that each protocol is the "Best" was estimated. RESULTS: Nine RCTs were included, with a total of 1,693 participants. Due to the few events reported, it was not possible to conduct a NMA for adverse events, therefore it was conducted only for implant failures (IF). The protocol with the highest probability (32.5%) of being the "Best" one to prevent IF was the single dose of 3g of amoxicillin administered 1-h pre-operatively. Even if the single pre-operative dose of 2g of amoxicillin is the most used, it achieved only a probability of 0.2% to be the "Best" one. CONCLUSIONS: Basing on the available RCTs, the use of antibiotic prophylaxis is protective against early implant failures, but there is still insufficient evidence to confidently recommend a specific dosage. The use of post-operative courses does not seem however to be justified by the available literature.

Type: Article
Title: Antibiotic prophylaxis at dental implant placement: Which is the best protocol? A systematic review and network meta‐analysis
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/jcpe.13080
Publisher version: https://doi.org/10.1111/jcpe.13080
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Adverse Events, Antibiotic Prophylaxis, Early Failures, Early Implant Failures, Implant Placement, Implant Survival, Network Meta-Analysis, Penicillins, Side Effects, Systematic Review
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Eastman Dental Institute
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Eastman Dental Institute > Restorative Dental Sciences
URI: https://discovery.ucl.ac.uk/id/eprint/10067880
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