A multicentre placebo-controlled randomised clinical trial of antibiotic prophylaxis for placement of single dental implants. Efficacy of prophylactic antibiotics for dental implants: a multicentre placebo-controlled randomised clinical trial. Efficacy of amoxicillin treatment in preventing postoperative complications in patients undergoing third molar surgery: a prospective, randomized, double-blind controlled study.
To compare the efficacy and safety of 2 g amoxicillin orally with identical placebo tablets 1 hour before implant placement when placing single implants in bone types II and III.
                12 private dental clinics in Spain agreed to participate in this trial. A total of 105 patients were recruited. Patients were randomised for consumption orally of 2g amoxicillin or identical placebo tablets. Only patients needing single implants were included. Outcome measures were post-operative infections, adverse events and implant failures. Characteristics of the saprophytic flora were also studied in all patients. Patients were seen 3 days, 10 days, 1 month and 3 months postoperatively. Results: A total of 105 patients (n = 52 in the amoxicillin group and n = 53 in the placebo group) were evaluated and none were excluded from the study at 3 months. Six post-operative infections occurred and two implants were lost in each group. There were no statistically significant differences for postoperative infection, adverse events, implant failures and the characteristics of saprophytic flora between groups. The use of amoxicillin did not either alter or modify the characteristics of the saprophytic flora nor provoke remarkable side effects.
                Antibiotic prophylaxis may not be needed when placing single implants in patients with bone types II and III. To evaluate the efficacy of prophylactic antibiotics for dental implant placement.
                Twelve Italian private practices agreed to participate in this trial, each centre providing 30 patients. One hour prior to implant placement, patients were randomised, for consumption orally of 2 g amoxicillin or identical placebo tablets. Patients needing bone augmentation procedures were not included. Outcome measures were prosthesis and implant failures, adverse events and post-operative biological complications. Patients were seen 1 week, 2 weeks and 4 months post-operatively.
                One centre did not deliver any data and 14 patients had to be excluded from the trial for various reasons. One hundred and fifty-eight patients were evaluated in each group and none dropped out at 4 months. Two prostheses and two implants failed in the antibiotics group, compared with four prostheses and nine implants in the placebo group. There were no statistically significant differences for prosthesis failures, implant losses, complications and side effects.
                No statistically significant differences were observed. However, four times more patients in the placebo group experienced implant failures than in the antibiotic group, and this requires further investigation. The aim of the present study was to evaluate and compare the occurrence of postoperative complications in patients receiving either pre- or postoperative amoxicillin versus placebo after third molar surgery.
                A randomized, double-blind, placebo-controlled clinical trial was performed in 123 patients undergoing third molar surgery. The patients were randomized to 3 groups, according to the treatment regimen: preoperative amoxicillin, postoperative amoxicillin, and placebo. Both surgeon and patients were unaware of the treatment assignment. The clinical outcomes, including pain, wound infection, trismus, temperature, intra- and extraoral swelling, dysphagia, side effects, and postoperative complications, were assessed.
                Statistically significant differences were found in the incidence of pain, wound infection, temperature, trismus, and dysphagia between the groups receiving amoxicillin versus placebo. Suture dehiscence and infection of 5 sockets were only found in the placebo group. No cases of alveolitis were observed in the 3 groups studied. No significant differences in swelling were found among the different groups. No statistically significant differences in side effects were found between the groups. The efficacy was greatest in the group receiving postoperative amoxicillin compared with the group receiving a prophylactic preoperative dose.
                Amoxicillin administered pre- or postoperatively demonstrated greater efficacy than placebo in preventing postoperative complications in patients undergoing third molar surgery. The best results were obtained using the postoperative protocol.
                Copyright © 2011 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
There is some evidence suggesting that 2 g of amoxicillin given orally 1 hour preoperatively significantly reduce failures of dental implants placed in ordinary conditions. No significant adverse events were reported. It might be sensible to suggest the use of a single dose of 2 g prophylactic amoxicillin prior to dental implant placement. It is still unknown whether postoperative antibiotics are beneficial, and which is the most effective antibiotic.