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 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 effectiveness of locally administered antibiotics in the treatment of peri-implantitis included 12 small studies 7 of which were RCTs. While the findings suggest a small additional benefit with antibiotic use however the clinical importance of this is debatable.
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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 review of amoxicillin & metronidazole as an adjunct to non-surgical periodontal treatment included 18 trials . A small benefit was seen with antibiotic use but no clinically meaningful difference between different doses or duration of amoxicillin-plus-metronidazole at 3 months post-treatment.
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This review of antibiotic prophylaxis for the removal of third molars included 22 RCTs and suggest that antibiotic use lowered the infection risk by 60%. The number pf patients needed to treat to prevent one infection was 14 (95%CI;11-19).
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