This review of antibiotic prophylactic treatments in relation to the risk of developing dry socket (DS) and site-specific infection (SSI) after lower third molar extraction included 16 RCTs. Antibiotic did reduce the risk of DS and SSI in health patients but the number needed to treat (NNT) was high so the use should be considered only after a careful assessment of an individual patient’s risk.
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This review of the effectiveness of locally administered antibiotics in the treatment of peri-implantitis included 12 small studies 7 of which were RCTs. While the findings suggest a small additional benefit with antibiotic use however the clinical importance of this is debatable.
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This review of the efficacy of prophylactic oral antibiotics in the management of post-operative endodontic symptoms included 10 RCTs. The findings and show that there is no superiority in using adjunctive antibiotics for the prevention of post-operative endodontic symptoms.
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This Cochrane review of the effects of systemic antimicrobials as an adjunct to scaling and root planing (SRP) for the non-surgical treatment of patients with periodontitis identified 45 RCTs. However the evidence is of very low certainty to inform tclinicians and patients if adjunctive antibiotics are beneficial.
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This review of the the effectiveness of different antibiotic protocols to prevent early dental implant failure includes 9 RCTs showing that antibiotics were protective against early implant failures.
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This review of amoxicillin & metronidazole as an adjunct to non-surgical periodontal treatment included 18 trials . A small benefit was seen with antibiotic use but no clinically meaningful difference between different doses or duration of amoxicillin-plus-metronidazole at 3 months post-treatment.
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This review of antibiotic prophylaxis for the removal of third molars included 22 RCTs and suggest that antibiotic use lowered the infection risk by 60%. The number pf patients needed to treat to prevent one infection was 14 (95%CI;11-19).
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Another new review of local or systemic azithromycin as an adjunct in non-surgical periodontal therapy includes 14 RCTs and demonstrates small benefits in periodontal parameters. However, the included studies are small and it is unclear if the benefits are clinically important.
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This review of antibiotic prophylaxis during dental implant placement considered both systematic reviews and RCTs. Evidence from the 10 included RCTs suggests a small reduction (2%) in the risk of implant loss. These results are similar to a recent Cochrane review.
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This review update includes 23 new studies comparing the effects of antibiotic therapy adjunctive to scaling and root planning for periodontal disease. While some additional benefit was shown the authors could not establish definitive conclusions and guidelines regarding their use.
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