There is still no accordance on the antibiotic prophylaxis regimen to prevent failures or postoperative infections in healthy patients undergoing standard implant surgery.
Some authors proposed single-dose administration preoperatively; others suggested the preoperative dose, followed by postoperative administration twice a day; others suggested only postoperative administration.
Considering the growing problem of antimicrobial resistance with progressive loss of antibiotic efficacy and the increasing number of dental implants placed every year, it is mandatory to identify a common strategy on antibiotic prescription.
The aim of the present systematic review was to evaluate if an antibiotic prophylaxis regimen reduces early implant failure and postoperative infection in healthy patients undergoing implant surgery.
Materials and methods
An electronic database search (MEDLINE/PubMed, Scopus, Web of Science, Cochrane Library) until June 30, 2019 was performed. Studies were included if the following inclusion criteria were met: Randomized clinical trials (RCTs).
At least 20 patients included
Antibiotic therapy clearly described
The following studies were also excluded:
• Studies on mini-implants and/or orthodontic mini screws
• Studies without a placebo or “no-antibiotic” group
• Studies including patients for whom prophylaxis was prescribed due to their medical history (eg, endocarditis)
• Studies investigating local antibiotic therapy
Results
A total of nine studies including 1,984 patients and 3,588 implants were selected: 885 patients (1,617 implants) received no antibiotics or placebo therapy before the implant surgery; 1,099 patients (1,971 implants) were placed with an antibiotic therapy.
Different antibiotic prophylactic therapies were applied:
- Placebo or no antibiotic ;
- 3 g amoxicillin before surgery;
- 2 g amoxicillin or 600 mg clindamycin before surgery;
- 2 g amoxicillin postsurgery;
- 2 g amoxicillin before surgery and 1 × 2 × 7 postsurgery;
- Amoxicillin 1×2×7 postsurgery
The most used was 2 gr of amoxicillin before surgery (791 patients and 1,533 implants).
A meta-analysisand a trial sequential analysis (TSA) were performed for the outcome early implant failure at both implant level and patient level.
The percentage of implant failure was 1.82 and 7.24 at the patient level in the antibiotics and no-antibiotics groups, respectively. The percentage of implant failure was 1.22 and 4.19 at the implant level in the antibiotics and no-antibiotics groups, respectively.
Seventy-one implants failed in 46 patients in the placebo/ no-antibiotic groups, and 23 implants failed in 20 patients in the 2 g of amoxicillin before implant surgery. Zero failures were detected in the other groups.
Conclusions
This systematic review and meta-analysis indicates that an antibiotic prophylaxis administered before or after the surgery prevents early implant failures in healthy patients. No information can be provided on peri-implant infections. Limitations of the present study are represented by the high heterogeneity of the included studies and different antibiotic protocols used.
For additional information: The Use of Antibiotics in Implant Therapy: A Systematic Review and Meta-Analysis with Trial Sequential Analysis on Early Implant Failure.
Endodontics 13 March 2024
Removal of fiber endocanal posts: guided technique vs conventional freehand technique
When due to periapical pathologies there is a need to provide root canal retreatment in teeth treated endodontically and reconstructed with a post, the first step is the removal of the post in order...
Today, Dr. Carol Anne Murdoch-Kinch (at right) returned to IUSD as dean. She had been serving as IU interim chancellor since June 2023. She comes back to IUSD as Dr. Latha Ramchand begins her term as...
MouthWatch, LLC, a leader in innovative intraoral imaging and teledentistry solutions, will showcase its intraoral cameras and teledentistry software at booth #418 during the upcoming American Dental...
Market 13 March 2024
Dentsply Sirona Advocates for More Inclusive Measures on International Women’s Day
Today is International Women’s Day. Dentsply Sirona, the world’s largest manufacturer of professional dental products and technologies, actively advocates for a greater focus on women’s...
This week, from March 7th to 9th, the 2024 Annual Meeting of the Academy of Osseointegration (AO) will commence at the Convention Center in Charlotte, North Carolina.