Prophylactic antibiotic regimen and dental implant failure: a meta-analysis
Chrcanovic, B. R., Albrektsson, T. and Wennerberg, A. (2014),
Prophylactic antibiotic regimen and dental implant failure: a
meta-analysis. Journal of Oral Rehabilitation. doi: 10.1111/joor.12211
Summary
The aim of this
meta-analysis was to investigate whether there are any positive effects
of prophylactic antibiotic regimen on implant failure rates and
post-operative infection when performing dental implant treatment in
healthy individuals. An electronic search without time or language
restrictions was undertaken in March 2014. Eligibility criteria included
clinical human studies, either randomised or not. The search strategy
resulted in 14 publications. The I2 statistic was
used to express the percentage of the total variation across studies due
to heterogeneity. The inverse variance method was used with a fixed- or
random-effects model, depending on the heterogeneity. The estimates of
relative effect were expressed in risk ratio (RR) with 95% confidence
interval. Six studies were judged to be at high risk of bias, whereas
one study was considered at moderate risk, and six studies were
considered at low risk of bias. The test for overall effect showed that
the difference between the procedures (use versus non-use of
antibiotics) significantly affected the implant failure rates (P = 0·0002),
with a RR of 0·55 (95% CI 0·41–0·75). The number needed to treat (NNT)
to prevent one patient having an implant failure was 50 (95% CI 33–100).
There were no apparent significant effects of prophylactic antibiotics
on the occurrence of post-operative infections in healthy patients
receiving implants (P = 0·520). A sensitivity analysis
did not reveal difference when studies judged as having high risk of
bias were not considered. The results have to be interpreted with
caution due to the presence of several confounding factors in the
included studies.
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