This review of antibiotic prophylactic treatments in relation to the risk of developing dry socket (DS) and site-specific infection (SSI) after lower third molar extraction included 16 RCTs. Antibiotic did reduce the risk of DS and SSI in health patients but the number needed to treat (NNT) was high so the use should be considered only after a careful assessment of an individual patient’s risk.
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This review comparing short (3–5 days) or longer courses (≥7 days) of antibiotics for the treatment of dental infections in general practice only included one small RCTs. No differences were seen between short an dlong courses but the findings should be interpreted cautiously becaise of the limited data available.
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This review of whether metronidazole used as monotherapy or in addition to a β-lactam antibiotic offers any additional benefit over β-lactam monotherapy in non- periodontal dental infections includes 3 RCTs. The findings suggest that metronidazole does not provide superior clinical results compared to β-lactam antibiotics for the treatment of non-periodontal dental infections. However the evidence is limited and of low quality.
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This review and infection of dry socket after third molar surgery identified 58 RCTs of whihc 34 contributed to a meta-analyses. The findings indicated that metronidazle and amoxicillin did reduce infection but the findings were of low certainty.
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This review of whether amoxicillin and metronidazole used as an adjunct to full-mouth scaling and root planing improved clinical outcomes included 11 RCTs. While the findings indicate significant improvements in clinical attachment level and pocket probing depth they may not be clinically important.
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This review of the efficacy of antimicrobials adjunctive to scaling and root planing (SRP) in the treatment of chronic periodontitis. 21 RCTs were included with the findings showing that amoxicillin and metronidazole had the largest statistical benefit. Whether this benefit is a clinically important benefit is a wider question.
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This Cochrane review of the effects of systemic antimicrobials as an adjunct to scaling and root planing (SRP) for the non-surgical treatment of patients with periodontitis identified 45 RCTs. However the evidence is of very low certainty to inform tclinicians and patients if adjunctive antibiotics are beneficial.
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Two small RCTs at high risk of bias were included in this Cochrane systematic review looking at the effects of periodontal therapy for primary or secondary prevention of CVD in people with chronic periodontitis.
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This new guideline from the American Dental Association is about the the appropriate use of systemic antibiotics for the urgent management of symptomatic irreversible pulpitis with or without symptomatic apical pulpitis, pulp necrosis and symptomatic apical periodontitis and pulp necrosis and localized acute apical abscess.
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This review of the the effectiveness of different antibiotic protocols to prevent early dental implant failure includes 9 RCTs showing that antibiotics were protective against early implant failures.
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