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Complex systematic review - Perioperative antibiotics in conjunction with dental implant placement.
Lund, Bodil; Hultin, Margareta; Tranaeus, Sofia; Naimi-Akbar, Aron; Klinge, Björn.
Afiliación
  • Lund B; Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.
  • Hultin M; Department of Oral and Maxillofacial Surgery, Karolinska University Hospital, Huddinge, Sweden.
  • Tranaeus S; Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.
  • Naimi-Akbar A; Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.
  • Klinge B; Swedish Council on Health Technology Assessment, Stockholm, Sweden.
Clin Oral Implants Res ; 26 Suppl 11: 1-14, 2015 Sep.
Article en En | MEDLINE | ID: mdl-26080862
OBJECTIVES: The aim of this study was to revisit the available scientific literature regarding perioperative antibiotics in conjunction with implant placement by combining the recommended methods for systematic reviews and complex systematic reviews. MATERIAL AND METHODS: A search of Medline (OVID), The Cochrane Library (Wiley), EMBASE, PubMed and Health technology assessment (HTA) organizations was performed, in addition to a complementary hand-search. Selected systematic reviews and primary studies were assessed using GRADE and AMSTAR, respectively. A meta-analysis was performed. RESULTS: The literature search identified 846 papers of which 10 primary studies and seven systematic reviews were included. Quality assessment of the systematic reviews revealed two studies of moderate risk of bias and five with high risk of bias. The two systematic reviews of moderate risk of bias stated divergent numbers needed to treat (NNT) to prevent one patient from implant failure. Four of the primary studies comparing antibiotic prophylaxis with placebo were estimated to be of low, or moderate, risk of bias and subjected to meta-analysis. The NNT was 50 (pooled RR 0.39, 95% CI 0.18, 0.84; P = 0.02). None of these four studies individually show a statistical significant benefit of antibiotic prophylaxis. Furthermore, narrative analysis of the studies eligible for meta-analysis reveals clinical heterogeneity regarding intervention and smoking. CONCLUSION: Antibiotic prophylaxis in conjunction with implant placement reduced the risk for implant loss by 2%. However, the sub-analysis of the primary studies suggests that there is no benefit of antibiotic prophylaxis in uncomplicated implant surgery in healthy patient.
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Texto completo: 1 Base de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Implantes Dentales / Profilaxis Antibiótica / Implantación Dental Endoósea Tipo de estudio: Clinical_trials / Health_technology_assessment / Systematic_reviews Idioma: En Revista: Clin Oral Implants Res Asunto de la revista: ODONTOLOGIA Año: 2015 Tipo del documento: Article

Texto completo: 1 Base de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Implantes Dentales / Profilaxis Antibiótica / Implantación Dental Endoósea Tipo de estudio: Clinical_trials / Health_technology_assessment / Systematic_reviews Idioma: En Revista: Clin Oral Implants Res Asunto de la revista: ODONTOLOGIA Año: 2015 Tipo del documento: Article