What is the effectiveness of antibiotic prophylaxis in preventing early complications following implant surgery? a systematic review

Introduction: This systematic review of double-blind randomized controlled trials (RCTs) aimed to answer the following question: “Is antibiotic prophylaxis administered prior to implant surgery, in comparison with a placebo, effective in preventing early osseointegration complications and failure in immunocompetent patients?”. Materials and methods: A systematic review was carried out using the electronic databases PubMed, Scopus, and Web of Science, searching for articles published up to May 2023. Study selection and data extraction were performed in a double-blind manner. The primary outcome assessed was early implant failure within the first 6 months after surgery. Secondary outcomes includes: surgical complications, patient-reported adverse events and postoperative pain level. The risk of bias was evaluated with the RoB 2 tool. Results: Seven RCTs were included, encompassing a total of 1,846 participants. Two trials involved patients undergoing simultaneous bone grafting during implant placement. Six studies administered amoxicillin, while one used clindamycin. None of the trials reported statistically significant differences in implant stability or postoperative complications between the antibiotic and placebo groups (p > 0.05). Conclusion: Antimicrobial resistance remains a critical public health concern. The findings of this systematic review do not support the routine use of antibiotic prophylaxis in healthy patients undergoing implant surgery.