Antibiotics play a significant role in both non-surgical and surgical periodontal therapy. However, with the rise of antimicrobial resistance, the necessity of prescribing antibiotics has become a topic of debate among many clinicians. This literature-based narrative review aims to assess the necessity of systemic antibiotics in periodontal surgical therapy. Administration of antibiotics in the prevention of postoperative infection in periodontal surgery is not justified in systemically healthy patients. Similarly, the role of antibiotics in improving clinical and radiographic outcomes in regenerative periodontal therapy is also not justified in systemically healthy patients. Thus, the usage of systemic antibiotics in periodontal surgical therapy cannot be universally justified. The clinicians must consider the available literature evidence, factors related to the patient’s systemic health, and the complexity of the surgery before prescribing antibiotics to prevent antimicrobial resistance.
