Effect of systemic antibiotics on clinical and patient-centered outcomes of implant therapy: preliminary dataanalysis

Abstract

The use of antibiotics as prophylaxis against postsurgical infection has been propagated. However, in the field of oral implant dentistry, the use of systemic antibiotics remains a controversial issue, with various antibiotic regimens being advocated. The aims of this multi-center randomized clinical trial were to determine the effect of various systemic antibiotic prophylaxis regimens on patient-centered outcomes and perceptions, postsurgical complications in patients undergoing standard oral implant therapy.

In this preliminary study, 107 medically healthy adults who were consecutively admitted to 5 study centers for standard oral implant therapy were randomly assigned to one of the 4 groups (3 test and 1 control groups). Pre-operative antibiotics of 2 g amoxicillin 1 hour prior to standard implant placement were prescribed to test group 1 (positive control), post-operative antibiotics of 2g amoxicillin following implant placement for test group 2, and pre-operative antibiotics of 2g amoxicillin 1 hour prior to standard implant placement and 500mg three times daily on days 2 through 3 after standard implant placement for test group 3. The control group was given a placebo tablet of 2g 1 hour prior to standard implant placement without any antibiotics. Subjects were examined clinically by blinded examiners at 1 week, 2 weeks, 4 weeks and 8 weeks from implant installation for post-operative complications. In addition, Visual Analogue Scales (VAS) on pain, swelling, bruising and bleeding were obtained from the patients from Day 1 through Day 7 and 14.

From the results of this preliminary study, in standard single implant placement with non-submerged healing, the postoperative complications (Flap closure, Swelling, Pain, Suppuration and Implant stability) and patient-centered outcomes (VAS of bleeding, pain, swelling and bruising) will neither be affected by using antibiotics prophylaxis in different regimens nor not using antibiotics prophylaxis.

It should be reiterated that dental practitioners should be cautious when using antibiotics as a prevention of postoperative infection in dental implant therapy. The indiscriminate use of antibiotics will eventually lead to more serious consequences including allergy and the development of resistance strains.