The influence of prophylactic antibiotic administration on post-operative morbidity in dental implant surgery. A prospective double blind randomized controlled clinical trial
, , , . The
influence of prophylactic antibiotic administration on post-operative
morbidity in dental implant surgery. A prospective double blind
randomized controlled clinical trial. Clin. Oral Impl. Res. 00, 2013; 1–8.
Abstract
Objectives
A
prospective double-blind randomised controlled trial was conducted to
test the effect of prophylactic antibiotics on post-operative morbidity
and osseointegration of dental implants.
Materials and Methods
Fifty-five
subjects scheduled for implant surgery were enrolled. The patients were
randomly assigned to the antibiotic (test group) and placebo (control
group). Twenty-seven patients (test group) received 3 g amoxicillin one
hour pre-operatively, and 28 patients (control group) received placebo
capsules 1 h pre-operatively. No post-operative antibiotics were
prescribed. Pain diaries and interference with daily activities diaries
were kept by the patients for 1 week post-operatively. Signs of
post-operative morbidity (swelling, bruising, suppuration and wound
dehiscence) were recorded by the principal investigators at day 2 and
day 7 following the operation. Osseointegration was assessed at 2nd
stage surgery or 3–4 months post-operatively.
Results
The
results of this study suggest that the use of prophylactic
pre-operative antibiotics may result in higher dental implant survival
rates (100% vs. 82%). Five implant failures, one in each of five
patients, were reported in the placebo group and none in the antibiotic
group (P = 0.0515). No significant differences were
found for most of the signs of post-operative morbidity 2 and 7 days
post-operatively. Only bruising at 2 days following the operation
appeared to be higher in the placebo group (P = 0.0511). Post-operative pain (P = 0.01) and interference with daily activities (P = 0.01)
appeared to be significantly lower for the antibiotic group after
7 days. Those patients with implant failure reported higher pain (based
on the VAS scores) after 2 days (P = 0.003) and after 7 days (P = 0.0005), higher pain (based on the amount of analgesics used) after 7 days (P = 0.001) and higher interference with daily activities (based on the VAS scores) after 2 days (P = 0.005).
Conclusions
The
use of for dental implant surgery may be justified, as it appears to
improve implant survival in the short term and also results in less
post-operative pain and interference with daily activities. From the
results of this study, it appears that prophylactic antibiotics may also
be beneficial both in terms of implant survival, especially when the
surgical procedure is prolonged due to its difficulty, high number of
implants placed or operator's inexperience.
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