Effects of Antibiotics on Dental Implants: A Review

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Abstract

There are many reasons for dental implant failure, the development of bacteremia is concern for dentists. This is due to the possibility of unfavorable result such as implant loss or the need for re-treatment. In general, antibiotic prophylaxis is recommended for high risk patients such as individuals with an immunodeficiency, infectious endocarditis, or previous prosthetic instrumentation. However regarding clinically healthy, low and moderate risk individuals the use of antibiotics in implant dentistry is controversial. Another major concern regarding the over prescription of antibiotics is the selection of antibiotic resistant bacteria. A better understanding of the efficacy of prophylactic treatments regarding dental implantation is crucial. Thus a literature review and comparison of survival rates of dental implants with regimens of no, pre or post prophylaxis was performed using systematic literature review using reliable electronic databases. Retrospective or prospective controlled studies were examined for the influence of preoperative and/or postoperative or no antibiosis on dental implant success rate. Of the 11406 implants used in this literature review, cases with no antibiotics had a 92 % success rate, cases with pre-op antibiotic alone had a 96% success rate, cases with post-op antibiotic alone had a 97% success rate and cases with both pre and post-op antibiotic had a success rate of 96%. Thus, the results from this literature review show a > 90% success rate when antibiotics are used compared to when they are not used. Thus, no benefit is seen from the use of antibiotic prophylaxis in low and moderate risk dental implant patients.

Keywords

Dental implants; Pre-operative prophylactics; Post-operative prophylactics; Success rate

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Most cited references 32

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Prevention of bacterial endocarditis. Recommendations by the American Heart Association.

Abigail P. Ferrieri, C Hutto, J Newburger … (1997)

To update recommendations issued by the American Heart Association last published in 1990 for the prevention of bacterial endocarditis in individuals at risk for this disease. An ad hoc writing group appointed by the American Heart Association for their expertise in endocarditis and treatment with liaison members representing the American Dental Association, the Infectious Diseases Society of America, the American Academy of Pediatrics, and the American Society for Gastrointestinal Endoscopy. The recommendations in this article reflect analyses of relevant literature regarding procedure-related endocarditis, in vitro susceptibility data of pathogens causing endocarditis, results of prophylactic studies in animal models of endocarditis, and retrospective analyses of human endocarditis cases in terms of antibiotic prophylaxis usage patterns and apparent prophylaxis failures. MEDLINE database searches from 1936 through 1996 were done using the root words endocarditis, bacteremia, and antibiotic prophylaxis. Recommendations in this document fall into evidence level III of the US Preventive Services Task Force categories of evidence. The recommendations were formulated by the writing group after specific therapeutic regimens were discussed. The consensus statement was subsequently reviewed by outside experts not affiliated with the writing group and by the Science Advisory and Coordinating Committee of the American Heart Association. These guidelines are meant to aid practitioners but are not intended as the standard of care or as a substitute for clinical judgment. Major changes in the updated recommendations include the following: (1) emphasis that most cases of endocarditis are not attributable to an invasive procedure; (2) cardiac conditions are stratified into high-, moderate-, and negligible-risk categories based on potential outcome if endocarditis develops; (3) procedures that may cause bacteremia and for which prophylaxis is recommended are more clearly specified; (4) an algorithm was developed to more clearly define when prophylaxis is recommended for patients with mitral valve prolapse; (5) for oral or dental procedures the initial amoxicillin dose is reduced to 2 g, a follow-up antibiotic dose is no longer recommended, erythromycin is no longer recommended for penicillin-allergic individuals, but clindamycin and other alternatives are offered; and (6) for gastrointestinal or genitourinary procedures, the prophylactic regimens have been simplified. These changes were instituted to more clearly define when prophylaxis is or is not recommended, improve practitioner and patient compliance, reduce cost and potential gastrointestinal adverse effects, and approach more uniform worldwide recommendations.

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Surgical determinants of clinical success of osseointegrated oral implants: a review of the literature.

L Sennerby, Eveline Roos (2015)

This article reviews the current knowledge about the influence of surgical factors on implant failure in routine cases and in those where implants have been used in conjunction with bone augmentation procedures. Clinical reports published in major scientific journals served as the basis for this review. With few exceptions, most clinical reports were on screw-shaped titanium implants. High failure rates are associated with poor bone quality and the use of short implants in the athrophic maxilla, irradiation, and bone-grafting procedures of the athrophic maxilla. Evidence for high long-term failure rates of press-fit cylinders was found. Moreover, limited clinical experience, lack of preoperative antibiotics, and smoking may lead to higher failure rates. There is a need for further research to increase the success rates in the severely resorbed maxilla. Because of a lack of proper documentation with respect to the great majority of currently used oral implant designs, the influence of different factors and their long-term results remain unknown.

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The microbiota of osseointegrated implants in patients with a history of periodontal disease.

M Marxer, Ninian Lang, T Gaberthüel … (1995)

The purpose of this study was to determine the presence of suspected periodontal pathogens in the peri-implant microflora of osseointegrated implants exposed 3 and 6 months to the oral environment of patients previously treated for periodontal disease. Subgingival microbial samples were taken in the deepest residual pocket of each quadrant in 10 patients before placement of ITI implants and in 10 patients before abutment connection of Brånemark implants. The samples were cultured using continuous anaerobic techniques. 4 patients were positive for P. gingivalis, 13 for P. intermedia, 2 for A. actinomycetemcomitans, 16 for Fusobacterium, 7 for C. rectus and 12 showed microscopic evidence of spirochetes. After 3 and 6 months exposure of the implants to the oral environment, one sample was obtained from the peri-implant sulcus in each patient. P. gingivalis was found in 2 patients in the peri-implant samples after 3 and 6 months. 6 peri-implant samples were positive for P. intermedia after 3 months, 7 after 6 months. Fusobacterium was present in 13 peri-implant samples after 3, and in 12 samples after 6 months. 4 patients showed evidence of for C. rectus after 3 months, 2 after 6 months. Spirochetes were seen in 3 peri-implant samples after 3 and in 5 after 6 months. None of the implants were found to be colonized by A. actinomycetemcomitans, although the organism was detected on teeth in 1 individual. Similar distribution patterns were noted for ITI and Brånemark type implants.(ABSTRACT TRUNCATED AT 250 WORDS)

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Author and article information

Journal

Journal ID (nlm-ta): J Clin Med Res

Journal ID (publisher-id): Elmer Press

Title: Journal of Clinical Medicine Research

Publisher: Elmer Press

ISSN (Print): 1918-3003

ISSN (Electronic): 1918-3011

Publication date (Print): February 2012

Publication date (Electronic): 17 January 2012

Volume: 4

Issue: 1

Pages: 1-6

Affiliations

[a ]Schulich School of Medicine & Dentistry, University of Western Ontario, Canada

[b ]Assistant Director-Clinical Affairs, Chair-Restorative Dentistry, Schulich School of Medicine & Dentistry, University of Western Ontario, Canada

[c ]Imaging Research Laboratories, Robarts Research Institute, London, Ontario, Canada

[d ]Medical Biophysics, The University of Western Ontario, Canada

Author notes

[e ]Corresponding author: Nabeel Ahmad, Schulich School of Medicine & Dentistry University of Western Ontario,Room 0148, Dental Sciences Building, LONDON, ON. N6A 5C1, Canada. Email: naahmad3@ 123456gmail.com

Article

DOI: 10.4021/jocmr658w

PMC ID: 3279494

PubMed ID: 22383920

SO-VID: 0126fc42-5271-4fe9-9fd1-dab89bac975a

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Effects of Antibiotics on Dental Implants: A Review

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Most cited references 32

Prevention of bacterial endocarditis. Recommendations by the American Heart Association.

Surgical determinants of clinical success of osseointegrated oral implants: a review of the literature.

The microbiota of osseointegrated implants in patients with a history of periodontal disease.

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