Does the prosthetic phase of dental implants justify the prescription of preventive antibiotics in healthy patients? A systematic review.

INTRODUCTION:   Recently published surveys data show that the routine prescription of preventive antibiotics (PA) in the prosthetic phase of dental implants is more common than might be expected. The present study aimed to answer the PICO question " In healthy patients starting the implant prosthetic phase, does the prescription of PA compared to not prescribing PA decrease the incidence of infectious complications? " by a systematic literature review.

MATERIAL AND METHODS:  A search was performed in 5 databases. The criteria employed were those described in the PRISMA® Declaration. Studies included were those that provided information on the need to prescribe PA in the prosthetic phase of implants, i.e., in second-stage surgeries, impression-taking and prosthesis placement.

RESULTS:   The electronic search identified three studies that met the established criteria.

CONCLUSIONS:   The prescription of PA in the prosthetic phase of implants does not show a justified benefit/risk ratio. PA may be indicated in the second stages or in peri-implant plastic surgery procedures lasting more than two hours and/or where soft tissue grafts are used extensively. In these cases, given the current lack of evidence, it is recommended to prescribe 2 g of amoxicillin 1 h before surgery and, in allergic patients, to prescribe 500 mg of azithromycin 1 h preoperatively.