In the review article Does antibiotic prophylaxis at implant placement decrease early

implant failures? A Cochrane systemic review, by Dr. Marco Esposito, we learn there is a
growing recommendation to give dental patients receiving implant placement short-term
prophylactic systemic antibiotics. Dental researchers deem bacterial contamination may cause
some dental implant complications in patients and thus prosthesis failure. As a result, the object
of Dr. Espositos review is to determine if short-term prophylactic antibiotics do reduce dental
implant failures, and if so, what is the most effective antibiotic. Also, the review articles
determines if any adverse effects like diarrhea or allergic reactions result from taking antibiotics.
Dr. Esposito and associates included only randomized controlled clinical trials (RCTs)
with at least a three month follow-up evaluating prophylactic antibiotic administration versus a
placebo/no antibiotics in their review. The following databases with electronic searches up to
June 2nd, 2010 were used in the review: The Cochrane Oral Health Groups Trial Register, The
Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, and EMBASED. Two
review authors independently identified reports to use from the aforementioned electronic
searches and extracted data via a specific data extraction form. They also assessed the risk of
bias by using a two-part tool that involves detailing what happened in the projects and then
assigning a judgement of yes, no, or unclear. The two review authors narrowed down 4
RCTs that met all the criteria, giving a total of 1007 patients. One RCT compared 1 gram of
amoxicillin given 1 hour preoperatively plus 500 milligrams of amoxicillin four times a day for
two days versus no antibiotics, while the other three compared 2 grams of amoxicillin given 1
hour preoperatively with identical placebo tablets. Analysis of the four RCTs showed more
patients had implant failure when they didnt take short-term prophylactic antibiotics and so
statistically significant results of 95% confidence interval. Also, there were no significant
adverse effects reported from the four RCTs. Future considerations include long-term antibiotic
prophylaxis and determining those most effective antibiotic since the latter wasnt concluded
from this review article.