Interventions for replacing missing teeth: antibiotics at dental implant placement to prevent complications

Book an Appointment Call Now

July 22, 2016

Review question

This review, carried out by authors of the Cochrane Oral Health Group, has been produced to assess the possible benefits of antibiotics taken orally at the time of the placement of a dental implant in order to prevent infection. If antibiotics are shown to be of benefit in preventing infection, this review also seeks to establish which type, dosage and duration of treatment is the most effective. The use of antibiotics to prevent infection in implant dentistry is controversial, and there is a need to answer these questions in order to improve the success rates of dental implants whilst minimising complications, harms or adverse effects.


Missing teeth can sometimes be replaced with dental implants to which a crown, bridge or denture can be attached. Bacteria introduced during the placement of implants can lead to infection, and sometimes implant failure. Infections around biomaterials (such as dental implants) are difficult to treat and almost all infected implants have to be removed, which is why it is so important to prevent infection if possible.

It has been suggested that taking antibiotics orally either before or after placement (or both) can minimise the chances of infection.

Generally the use of antibiotics in surgery in order to prevent infection is only recommended for people at risk, when surgery is extensive, or performed in infected sites, and when large foreign materials are implanted in the body. Recently, a short term course of antibiotics has been recommended when antibiotics have to be used, because sometimes antibiotics can cause side effects that range from diarrhoea to life-threatening allergic reactions. Another major concern associated with the widespread use of antibiotics is the increase in the appearance of antibiotic-resistant bacteria.

Study characteristics

The evidence on which this review is based was up to date as of 17 June 2013. Six trials were included with a total of 1162 participants.

All six of these trials compared the use of antibiotics to prevent infection (failures and complications) with no treatment or treatment with a placebo (a fake medicine with no active ingredient). The antibiotic used in all the trials was amoxicillin; doses and timing of doses varied, although most used a single dose taken just before the implant was placed. One of the trials, with 100 participants, also looked at different doses of amoxicillin taken at different times.

There were no trials that looked at alternative antibiotics.

Participants were people over 18 years of age who were able to give consent to taking part in a medical trial. Potential participants were excluded for a variety of reasons that included: if they were at risk of heart disease, had artificial joints, had problems with their immune system, were affected by diabetes, had received radiotherapy in the head and neck area, had need of additional procedures at the time of implant placement, were allergic to penicillin, had chronic/acute infections near the planned implant site, were already receiving antibiotic treatment for any other reasons (or had taken them up to six months previously), had been treated with or were receiving intravenous amino-bisphosphonates, were pregnant or breast feeding, were receiving long-term nonsteroidal anti-inflammatory drug therapy, or had blood clotting problems. The follow-up period in all the trials was at least three months.

Key results

It appears that the oral administration of two grams of amoxicillin one hour before placement of dental implants is effective in reducing implant failures. More specifically, giving antibiotics to 25 people will avoid one person experiencing early implant losses. It is still unclear whether postoperative antibiotics are beneficial, or which antibiotics work best.

Quality of the evidence

The evidence from the six trials (1162 participants) that compared the use of antibiotics with placebo or no treatment was considered to be of moderate quality. However, the one trial (100 participants) that investigated antibiotics given for different lengths of time was found to be at high risk of bias.

RELATED Dental Implant Problems & Causes of Failure

Back to Press Center


A Center for Dental Excellence is fantastic. They’re understanding and extremely competent. Not only is the dental care itself excellent, but their quality of caring about their patients is unparalleled.... Read more

Haylee J (Aberdeen, FL)

They have the best physicians and hygienists possible. I have never had a cleaning as thoroughly as lily. They also did an amazing job on my Invisalign

Jamal Mustafa

Dr. Gorbatov placed an implant for me, I am extremely happy with the result, I had absolutely no pain during the procedure after few month doctor put a crown, looks... Read more

Sergey Kasatkin (Sunny Isles Beach, FL)

Thank you doctor for my beautiful smile!

V V (Hollywood, FL)

Jessica at the front has helped me tremendously and the Dr has made the large amount of work that I have had done painless

Celeste Clossin (Wellington, FL)

I have been with the dentist for a few years now and love the care I receive. You are taken care of from the front desk person, through your visit!... Read more

Juan Rodriguez (Greenacres, FL)

Well I’ve been going to Dr. Gorbatov since 1996.... Yes ! I’m a loyal. With all the dental issues I’ve had, he’s been able to resolve them and been keeping... Read more

Burke Crump (Wellington, FL)

This is the first time I’m writing a review for anyone. I decided to share as this office and practice deserves the the 5 stars for the 5 stars service... Read more

Oksana Libovych

God bless this dentistry! Nice team, professional doctors. Gorbatov has golden hands

Nanna Stormin

I love this dentist office the service here is very fast and comfortable. The staff is extremely nice and caring. I recommend this dentistry to everyone :)

Анна Anna

Book an Appointment
Skip to content


Fill out email and/or message