The findings of a new systematic review by the Cochrane Oral Health Group suggest that people given antibiotics before having dental implants placed have a reduced risk of implant failure. The study found that 2 or 3 grams of amoxicillin given orally, as a single administration, 1 hour before placement of dental implants reduces implant failures. The patient benefits reported in the study amount to one person avoiding early implant losses for every 25 people given antibiotics

Although a variety of prophylactic antibiotic regimens have been suggested to prevent infections associated with dental implant placement, their use is controversial because of the known risks of taking antibiotics and a concern that their widespread use could promote antibiotic resistance. In general, prophylactic use of antibiotics in surgery is indicated only for people at risk, when surgery is extensive or performed in infected sites, and when large foreign materials are implanted

The study included results of 6 randomised controlled clinical trials that compared use of amoxicillin to prevent infection with no treatment or a placebo. A total of 1162 participants, followed for at least 3 months, were included. The authors considered the overall body of evidence to be of moderate quality

The review did not examine whether there are benefits to using antibiotics postoperatively, or which antibiotic is most effective

There are many reasons for dental implant failure, the development of bacteremia is concern for dentists. This is due to the possibility of unfavorable result such as implant loss or the need for re-treatment. In general, antibiotic prophylaxis is recommended for high risk patients such as individuals with an immunodeficiency, infectious endocarditis, or previous prosthetic instrumentation. However regarding clinically healthy, low and moderate risk individuals the use of antibiotics in implant dentistry is controversial. Another major concern regarding the over prescription of antibiotics is the selection of antibiotic resistant bacteria. A better understanding of the efficacy of prophylactic treatments regarding dental implantation is crucial. Thus a literature review and comparison of survival rates of dental implants with regimens of no, pre or post prophylaxis was performed using systematic literature review using reliable electronic databases. Retrospective or prospective controlled studies were examined for the influence of preoperative and/or postoperative or no antibiosis on dental implant success rate. Of the 11406 implants used in this literature review, cases with no antibiotics had a 92 % success rate, cases with pre-op antibiotic alone had a 96% success rate, cases with post-op antibiotic alone had a 97% success rate and cases with both pre and post-op antibiotic had a success rate of 96%. Thus, the results from this literature review show a > 90% success rate when antibiotics are used compared to when they are not used. Thus, no benefit is seen from the use of antibiotic prophylaxis in low and moderate risk dental implant patients