Antibiotic prophylaxis and postoperative complications after tooth extraction and implant placement: a review of the literature.
OBJECTIVE
To assess published evidence regarding the use of preoperative antibiotic prophylaxis among children and adults undergoing dental extraction or implant placement.


METHODS
Research published between 12/31/97 and 6/30/07 in English.


METHODS
MEDLINE, PUBMED, EMBASE, EBM Reviews, and Cochrane Central Register for Controlled Trials using the following search terms linked with Boolean AND logic: prophylactic antibiotics, dentistry, tooth, third molar, extraction, implant, endosseous, prophylaxis, prophylactic, infective endocarditis, bacterial, infection, and bacteremia.


METHODS
Eight randomized clinical trials and one retrospective study was found involving preoperative use of antibiotics before tooth extraction. Four additional non-randomized intervention studies among patients undergoing implant placement were found. These 13 studies comprised all of the published research found that met our inclusion criteria. Overall, this body of literature was limited and of poor quality. In general, sample sizes were small and provided insufficient statistical power to avoid type II, or false-negative errors. In some studies no comparison group was included and/or it was difficult to determine the extent to which the intervention had actually been implemented.


CONCLUSIONS
With the recent improvements in the current standards of antibiotic prophylaxis in dentistry, further monitoring of antibiotic use among dental practitioners as well as continuing education for practitioners concerning the public health risks related to the over-prescription of antibiotics are needed.
Schwartz
Aaron B
AB
Columbia University College of Dental Medicin, NY 11217, USA. abs2107@columbia.edu
Larson
Elaine L
EL
D019072:Antibiotic Prophylaxis; D003758:Dental Implantation, Endosseous / Q000009:adverse effects; D015921:Dental Implants / Q000009:adverse effects; D006801:Humans; D011183:Postoperative Complications; D016032:Randomized Controlled Trials as Topic; D012107:Research Design; D012189:Retrospective Studies; D012307:Risk Factors; D014081:Tooth Extraction / Q000009:adverse effects
D015921:Dental Implants