The Role of Antibiotic Prophylaxis in the Prevention of Early Dental Implant Failure: A Systematic Review
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Abstract
Introduction: The routine use of antibiotic prophylaxis in dental implant surgery remains controversial. This systematic review and meta-analysis aimed to evaluate the effectiveness of preoperative antibiotics in preventing early implant failure and postoperative infection in healthy individuals. Materials and Methods: An electronic search of PubMed, Scopus, ScienceDirect, Web of Science, Google Scholar, and the Cochrane Library was conducted for studies published between 2000 and 2024. Randomized controlled trials and clinical studies comparing preoperative systemic antibiotic administration with placebo or no antibiotic use were included. The primary outcome was early implant failure; secondary outcomes included postoperative infection and complications. Two reviewers independently extracted data using a standardized form. Methodological quality was assessed with the Cochrane RoB 2.0 tool, and certainty of evidence was evaluated using GRADE. Meta-analysis was performed in Review Manager (RevMan) v5.4 using a fixed-effect Mantel-Haenszel model to estimate pooled risk ratios (RRs) with 95% confidence intervals (CIs); heterogeneity was assessed with I2 and Cochrane Q statistics. Results: Eight studies involving 2,026 evaluable patients met the inclusion criteria. The pooled patient-level implant-failure rate was 2.7% in the antibiotic group and 6.9% in the control group. The overall RR was 0.42 (95% CI: 0.27-0.66; p < 0.001), indicating a statistically significant 58% relative risk reduction; the 95% CI did not cross the null (RR = 1). Postoperative infection rates were lower with antibiotics in several trials, although definitions varied across studies (I2 = 0%; Cochrane Q p = 0.730). Conclusion: Preoperative antibiotics significantly reduced early implant failure in pooled analysis, yet absolute event rates remained low in healthy patients. Routine antibiotic prophylaxis should be individualized, balancing modest clinical benefit against antibiotic stewardship principles. Keywords: Antibiotic; Antibiotic prophylaxis; Dental implant; Implant failure; Implant placement; Preoperative antibiotics.
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2. Ikram J, Shado R, Pereira IN, Madruga D, Hassan H. Efficacy and safety of using antibiotics to prevent post-operative complications in oral implant treatment: evidence-based review. BDJ Open. 2023;9(1):47.
3. Jain A, Rai A, Singh A, Taneja S. Efficacy of preoperative antibiotics in prevention of dental implant failure: a meta-analysis of randomized controlled trials. Oral Maxillofac Surg. 2020;24(4):469–75.
4. Mohajerani H, Roozbayani R, Taherian S, Tabrizi R. The risk factors in early failure of dental implants: a retrospective study. J Dent (Shiraz). 2017;18(4):298–303.
5. Staedt H, Rossa M, Lehmann KM, Al-Nawas B, Kammerer PW, Heimes D. Potential risk factors for early and late dental implant failure: a retrospective clinical study on 9080 implants. Int J Implant Dent. 2020;6(1):81.
6. Tan LW, Ng YE, Giok KC, Veettil SK, Menon RK. Comparative efficacy of different amoxicillin dosing regimens in preventing early implant failure: a systematic review with network meta-analysis. Antibiotics (Basel). 2023;12(3).
7. Kim AS, Abdelhay N, Levin L, Walters JD, Gibson MP. Antibiotic prophylaxis for implant placement: a systematic review of effects on reduction of implant failure. Br Dent J. 2020;228(12):943–51.
8. Momand P, Naimi-Akbar A, Hultin M, Lund B, Gotrick B. Is routine antibiotic prophylaxis warranted in dental implant surgery to prevent early implant failure? A systematic review. BMC Oral Health. 2024;24(1):842.
9. Ahmad N, Saad N. Effects of antibiotics on dental implants: a review. J Clin Med Res. 2012;4(1):1–6.
10. Xu L, Wang Y, Nguyen VT, Chen J. Effects of topical antibiotic prophylaxis on wound healing after flapless implant surgery: a pilot study. J Periodontol. 2016;87(3):275–80.
11. Esposito M, Cannizzaro G, Bozzoli P, Consolo U, Felice P, Ferri V, et al. Efficacy of prophylactic antibiotics for dental implants: a multicentre placebo-controlled randomised clinical trial. Eur J Oral Implantol. 2008;1(1):23–31.
12. Esposito M, Coulthard P, Oliver R, Thomsen P, Worthington HV. Antibiotics to prevent complications following dental implant treatment. Cochrane Database Syst Rev. 2003;(3):CD004152.
13. Romandini M, De Tullio I, Congedi F, Kalemaj Z, D'Ambrosio M, Lafori A, et al. Antibiotic prophylaxis at dental implant placement: which is the best protocol? A systematic review and network meta-analysis. J Clin Periodontol. 2019;46(3):382–95.
14. Mauceri R, Campisi G, Matranga D, Mauceri N, Pizzo G, Melilli D. The role of antibiotic prophylaxis in reducing bacterial contamination of autologous bone graft collected from implant site. Biomed Res Int. 2017;2017:2175019.
15. Anitua E, Aguirre JJ, Gorosabel A, Barrio P, Errazquin JM, Roman P, et al. A multicentre placebo-controlled randomised clinical trial of antibiotic prophylaxis for placement of single dental implants. Eur J Oral Implantol. 2009;2(4):283–92.
16. Kashani H, Hilon J, Rasoul MH, Friberg B. Influence of a single preoperative dose of antibiotics on the early implant failure rate: a randomized clinical trial. Clin Implant Dent Relat Res. 2019;21(2):278–83.
17. Nolan R, Kemmoona M, Polyzois I, Claffey N. The influence of prophylactic antibiotic administration on post-operative morbidity in dental implant surgery: a prospective double blind randomized controlled clinical trial. Clin Oral Implants Res. 2014;25(2):252–9.
18. Esposito M, Worthington HV, Loli V, Coulthard P, Grusovin MG. Interventions for replacing missing teeth: antibiotics at dental implant placement to prevent complications. Cochrane Database Syst Rev. 2010;(7):CD004152.
19. Momand P, Becktor JP, Naimi-Akbar A, Tobin G, Gotrick B. Effect of antibiotic prophylaxis in dental implant surgery: a multicenter placebo-controlled double-blinded randomized clinical trial. Clin Implant Dent Relat Res. 2022;24(1):116–24.
20. Mascarenhas LS, Pedreira KL, Cosme FD, Oliveira AS, de Oliveira G, Azoubel MCF, et al. Effect of antibiotic prophylaxis on early loss of implants installed by unexperienced operators. J Oral Implantol. 2023;49(5):537–43.
21. Roca-Millan E, Estrugo-Devesa A, Merlos A, Jane-Salas E, Vinuesa T, Lopez-Lopez J. Systemic antibiotic prophylaxis to reduce early implant failure: a systematic review and meta-analysis. Antibiotics (Basel). 2021;10(6).
22. Bernabeu-Mira JC, Penarrocha-Diago M, Penarrocha-Oltra D. Prescription of antibiotic prophylaxis for dental implant surgery in healthy patients: a systematic review of survey-based studies. Front Pharmacol. 2020;11:588333.
23. Cuevas-Gonzalez MV, Cuevas-Gonzalez JC, Espinosa-Cristobal LF, Donohue-Cornejo A, Reyes Lopez SY, Saucedo Acuna RA, et al. Use or abuse of antibiotics as prophylactic therapy in oral surgery: a systematic review. Medicine (Baltimore). 2023;102(37):e35011.
24. Ponce Vera MS, Criollo Jimenez ME, Idalgo FA, Pereira SA dos S, Nunes AG, Kassis EN, et al. Major evidence and guidelines for antibiotic therapy in implant dentistry: a systematic review. MedNEXT J Med Health Sci. 2023;4(S3).
25. Dehghani N AM, Mahmoudi X. Evaluation of Antibiotic Prescription for Dental Implant Success: A Review. J Craniomaxillofac Res 2025;12(2):70-78.
26. Mahmood Hashemi H SR, Hasheminasab M, Mortazavi M. Epidemiologic evaluation of maxillofacial infections and their risk factors and associated complications in a one year period in Shariati hospital in 2013-2014. J Craniomaxillofac Res 2019;6(1):11-19.
2. Ikram J, Shado R, Pereira IN, Madruga D, Hassan H. Efficacy and safety of using antibiotics to prevent post-operative complications in oral implant treatment: evidence-based review. BDJ Open. 2023;9(1):47.
3. Jain A, Rai A, Singh A, Taneja S. Efficacy of preoperative antibiotics in prevention of dental implant failure: a meta-analysis of randomized controlled trials. Oral Maxillofac Surg. 2020;24(4):469–75.
4. Mohajerani H, Roozbayani R, Taherian S, Tabrizi R. The risk factors in early failure of dental implants: a retrospective study. J Dent (Shiraz). 2017;18(4):298–303.
5. Staedt H, Rossa M, Lehmann KM, Al-Nawas B, Kammerer PW, Heimes D. Potential risk factors for early and late dental implant failure: a retrospective clinical study on 9080 implants. Int J Implant Dent. 2020;6(1):81.
6. Tan LW, Ng YE, Giok KC, Veettil SK, Menon RK. Comparative efficacy of different amoxicillin dosing regimens in preventing early implant failure: a systematic review with network meta-analysis. Antibiotics (Basel). 2023;12(3).
7. Kim AS, Abdelhay N, Levin L, Walters JD, Gibson MP. Antibiotic prophylaxis for implant placement: a systematic review of effects on reduction of implant failure. Br Dent J. 2020;228(12):943–51.
8. Momand P, Naimi-Akbar A, Hultin M, Lund B, Gotrick B. Is routine antibiotic prophylaxis warranted in dental implant surgery to prevent early implant failure? A systematic review. BMC Oral Health. 2024;24(1):842.
9. Ahmad N, Saad N. Effects of antibiotics on dental implants: a review. J Clin Med Res. 2012;4(1):1–6.
10. Xu L, Wang Y, Nguyen VT, Chen J. Effects of topical antibiotic prophylaxis on wound healing after flapless implant surgery: a pilot study. J Periodontol. 2016;87(3):275–80.
11. Esposito M, Cannizzaro G, Bozzoli P, Consolo U, Felice P, Ferri V, et al. Efficacy of prophylactic antibiotics for dental implants: a multicentre placebo-controlled randomised clinical trial. Eur J Oral Implantol. 2008;1(1):23–31.
12. Esposito M, Coulthard P, Oliver R, Thomsen P, Worthington HV. Antibiotics to prevent complications following dental implant treatment. Cochrane Database Syst Rev. 2003;(3):CD004152.
13. Romandini M, De Tullio I, Congedi F, Kalemaj Z, D'Ambrosio M, Lafori A, et al. Antibiotic prophylaxis at dental implant placement: which is the best protocol? A systematic review and network meta-analysis. J Clin Periodontol. 2019;46(3):382–95.
14. Mauceri R, Campisi G, Matranga D, Mauceri N, Pizzo G, Melilli D. The role of antibiotic prophylaxis in reducing bacterial contamination of autologous bone graft collected from implant site. Biomed Res Int. 2017;2017:2175019.
15. Anitua E, Aguirre JJ, Gorosabel A, Barrio P, Errazquin JM, Roman P, et al. A multicentre placebo-controlled randomised clinical trial of antibiotic prophylaxis for placement of single dental implants. Eur J Oral Implantol. 2009;2(4):283–92.
16. Kashani H, Hilon J, Rasoul MH, Friberg B. Influence of a single preoperative dose of antibiotics on the early implant failure rate: a randomized clinical trial. Clin Implant Dent Relat Res. 2019;21(2):278–83.
17. Nolan R, Kemmoona M, Polyzois I, Claffey N. The influence of prophylactic antibiotic administration on post-operative morbidity in dental implant surgery: a prospective double blind randomized controlled clinical trial. Clin Oral Implants Res. 2014;25(2):252–9.
18. Esposito M, Worthington HV, Loli V, Coulthard P, Grusovin MG. Interventions for replacing missing teeth: antibiotics at dental implant placement to prevent complications. Cochrane Database Syst Rev. 2010;(7):CD004152.
19. Momand P, Becktor JP, Naimi-Akbar A, Tobin G, Gotrick B. Effect of antibiotic prophylaxis in dental implant surgery: a multicenter placebo-controlled double-blinded randomized clinical trial. Clin Implant Dent Relat Res. 2022;24(1):116–24.
20. Mascarenhas LS, Pedreira KL, Cosme FD, Oliveira AS, de Oliveira G, Azoubel MCF, et al. Effect of antibiotic prophylaxis on early loss of implants installed by unexperienced operators. J Oral Implantol. 2023;49(5):537–43.
21. Roca-Millan E, Estrugo-Devesa A, Merlos A, Jane-Salas E, Vinuesa T, Lopez-Lopez J. Systemic antibiotic prophylaxis to reduce early implant failure: a systematic review and meta-analysis. Antibiotics (Basel). 2021;10(6).
22. Bernabeu-Mira JC, Penarrocha-Diago M, Penarrocha-Oltra D. Prescription of antibiotic prophylaxis for dental implant surgery in healthy patients: a systematic review of survey-based studies. Front Pharmacol. 2020;11:588333.
23. Cuevas-Gonzalez MV, Cuevas-Gonzalez JC, Espinosa-Cristobal LF, Donohue-Cornejo A, Reyes Lopez SY, Saucedo Acuna RA, et al. Use or abuse of antibiotics as prophylactic therapy in oral surgery: a systematic review. Medicine (Baltimore). 2023;102(37):e35011.
24. Ponce Vera MS, Criollo Jimenez ME, Idalgo FA, Pereira SA dos S, Nunes AG, Kassis EN, et al. Major evidence and guidelines for antibiotic therapy in implant dentistry: a systematic review. MedNEXT J Med Health Sci. 2023;4(S3).
25. Dehghani N AM, Mahmoudi X. Evaluation of Antibiotic Prescription for Dental Implant Success: A Review. J Craniomaxillofac Res 2025;12(2):70-78.
26. Mahmood Hashemi H SR, Hasheminasab M, Mortazavi M. Epidemiologic evaluation of maxillofacial infections and their risk factors and associated complications in a one year period in Shariati hospital in 2013-2014. J Craniomaxillofac Res 2019;6(1):11-19.
| Files | ||
| Issue | Vol 13, No 3 (Summer 2026) | |
| Section | Review Article(s) | |
| Keywords | ||
| Antibiotic; Antibiotic prophylaxis; Dental implant; Implant failure; Implant placement; Preoperative antibiotics. | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Keyhanlou F, Hasani Mehraban S, Hosseini A. The Role of Antibiotic Prophylaxis in the Prevention of Early Dental Implant Failure: A Systematic Review. J Craniomaxillofac Res. 2026;13(3):267-278.
