Oral antibiotics not beneficial for replantation of avulsed teeth: study

At present, there is no clear consensus on whether systemic antibiotics should be administered at replantation of an avulsed permanent tooth. This systematic review and meta-analysis assessed the evidence on the effectiveness and harms of the administration of systemic antibiotics at replantation of avulsed permanent teeth.

In August 2020 a systematic literature search was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, for systematic reviews, randomized controlled trials (RCT) and observational controlled studies in MEDLINE, PreMedline, Embase, and the Cochrane databases.

The population of interest were medically fit patients with a replanted avulsed tooth. The main outcomes were tooth survival, periodontal healing, pulpal revascularization as well as (severe) adverse events. These outcomes were compared in patients who did and who did not receive systemic antibiotics. The GRADE methodology was used to assess the quality of evidence.

The Results of the study are:

• The search yielded no RCTs, and none of the 7 included observational studies had the prime intent to investigate the effectiveness or harms of antibiotics.
• According to GRADE, the overall level of evidence was very low.
• The meta-analyses showed non-significant associations between the administration of systemic antibiotics on the one hand and tooth survival, periodontal healing, and pulpal revascularization on the other hand.

Thus, currently, there is no high-quality evidence to support the use of systemic antibiotics for the replantation of avulsed permanent teeth. Hence, their routine use cannot be recommended in medically fit patients. Well-designed RCTs should be a priority on the research agenda.

Reference:

Jolyce Bourgeois, Joana Christina Carvalho, Mieke De Bruyne, Dominique Declerck, Anouk Eloot, Roos Leroy, Antibiotics at replantation of avulsed permanent teeth? A systematic review, Journal of Evidence-Based Dental Practice, Volume 22, Issue 2, 2022, 101706, ISSN 1532-3382, https://doi.org/10.1016/j.jebdp.2022.101706.