Background: This article critically appraises a systematic review that was conducted in 2014 to investigate the effects of prophylactic antibiotic regimen on implant failure rates and postoperative infection when performing dental implant treatment in healthy individuals.
Clinical question: Does a prophylactic antibiotic regimen before implant placement in healthy patients have an effect on the prevention of implant failure and postoperative infection in comparison with those not receiving an antibiotic?
Summary of methods and results: Manual, ongoing trials and electronic searches without time or language restrictions were conducted. Three authors independently screened titles and abstracts of the identified studies. Related data were extracted by the review authors. The risk of bias of the studies was assessed. Implant failure and postoperative infection were the outcomes measured. The meta-analysis revealed that use of antibiotic prophylaxis significantly affected the implant failure rates (relative risk [RR] of 0.55, P = .0002). The number needed to treat (NNT) to prevent one patient having an implant failure was 50. There were no significant effects of prophylactic antibiotics on the occurrence of postoperative infections in healthy patients receiving implants (P = .520).
Critical appraisal: The results of this review should be interpreted with caution, as they include seven studies that were considered at high risk of bias with the presence of uncontrolled confounding factors.
Practical implications: The use of prophylactic antibiotics may decrease the rate of implant failure, but care should be taken as the emergence of resistant pathogens may result from indiscriminate use of antibiotics in addition to potential adverse effects.