Systematic reviews and meta-analyses have suggested that a prophylactic loading dose of antibiotic can reduce implant failure rates in healthy adults.55,56,62,63 It is estimated that for every 24-55 implant patients (mean 33 patients) undergoing dental implant placement who receive antibiotic prophylaxis prior to surgery, one implant failure is prevented.55,62 Within reviews of antibiotic benefits, the overall benefit is often calculated for the population based upon number needed to treat (NNT). This figure describes the overall number of patients who when treated with antibiotic prophylaxis would experience one less implant failure. The NNT can then be compared to the overall prevalence of adverse events for individual antibiotics to determine the suitability and benefits of individual antibiotic type/dosage for use as pre-treatment antibiotic prophylaxis. Based upon these findings, some authorities have recommended that an antibiotic prophylaxis regimen of 2.0 gm amoxicillin administered 1-hour prior to implant surgery in a healthy, non-allergic patient would be beneficial to provide a clinically significant reduction in implant failure rates.56,62 For individuals receiving adjunctive therapies with implant placement, including bone and/or soft tissue grafting, clinicians should adjust prescribing patterns to the individualized clinical scenario.
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