The role of antibiotic prophylaxis for healthy patients in tooth extraction and implantation procedures: A systematic review.

Abstract

Background and objectives: Prophylactic antibiotics are frequently prescribed following outpatient oral surgical procedures to minimize the risk of surgical site infections. However, the overuse of antibiotics contributes to microbial resistance and increases the likelihood of adverse side effects. This highlights the need for a rational approach in assessing the necessity and appropriate dosing of antibiotics after outpatient oral surgeries. The primary aim of this study was to systematically analyze the literature on the use of prophylactic antibiotics in outpatient oral surgery.

Materials and methods: Scientific articles were selected following PRISMA guidelines. The review included randomized controlled trials (RCTs) published in English between 2013 and 2023. Data searches were conducted on PubMed, ClinicalKey, and Cochrane Library databases.

Results: A total of 15 RCTs involving 3,032 participants were included in this review. Of these, six studies reported no statistically significant differences between groups in terms of post-operative outcomes. In contrast, six studies focusing on tooth extraction reported significant differences in pain, swelling, trismus, and bleeding between the groups. Additionally, three studies on dental implant procedures revealed significant differences concerning implant failure rates, flap closure, and pain levels. Despite these findings, the overall evidence did not demonstrate statistically significant benefits of prophylactic antibiotics in reducing post-operative infectious complications. Furthermore, no evidence was found to support the importance of timing in the administration of prophylactic antibiotic therapy.

Conclusions: The findings of this systematic review do not support the routine use of prophylactic antibiotics for healthy patients to prevent post-operative infections in outpatient oral surgical procedures. Further research is needed to establish clear guidelines on the necessity and optimal timing of antibiotic use in such cases.