title: AICRG, Part III: The influence of antibiotic use on the survival of a new implant design.
abstract: OBJECTIVE
  The American College of Surgeons guidelines suggest that complex oral surgery may benefit from prophylactic antibiotic coverage. The use of preoperative antibiotics, postoperative antibiotics, or both during implant placement is a widely accepted practice in the United States, whereas dentists in other countries rarely use antibiotics.
  
  
  OBJECTIVE
  The purpose of this study was to determine if antibiotic coverage at the time of implant placement improves the survival of the Ankylos implant.
  
  
  METHODS
  As part of a comprehensive, multicentered, multidisciplinary, prospective, independent, international clinical study, designed and coordinated in the United States by the Ankylos Implant Clinical Research Group (AICRG), the use of preoperative (several regimens) and postoperative antibiotics (yes/no) were carefully documented to assess their influence on improving survival. A total of 1500 Ankylos implants were placed and followed for a period of 3 to 5 years. The decision to use antibiotics and the regimen to be employed was made by the treating surgeon. Failure was defined as removal of the implant for any reason. All data were entered into a computerized database for analysis.
  
  
  RESULTS
  The use of preoperative antibiotics produced no significant improvement (P = .21, Fisher's exact test) in survival compared with those placed without antibiotic coverage. There was no significant difference between the regimens defined as AHA-1990, AHA-1997, and Peterson's recommendations.
  
  
  CONCLUSIONS
  The results of this study suggest that there was little or no advantage to providing antibiotic coverage when placing this implant. These findings also suggest that the use of antibiotics for implant placement may not be as beneficial as once believed. If validated by other studies, the elimination of this practice for routine implant placement would represent a small but significant step forward in the reduction of unnecessary antibiotic use.
authors.affiliation: Dental Clinical Research Center, Ankylos Implant Clinical Research Group, Department of Veterans Affairs Medical Center, Ann Arbor, MI 48105, USA.
authors.forename: Harold F
authors.initials: HF
authors.lastname: Morris
authors.forename: Shigeru
authors.initials: S
authors.lastname: Ochi
authors.forename: Richard
authors.initials: R
authors.lastname: Plezia
authors.forename: Harry
authors.initials: H
authors.lastname: Gilbert
authors.forename: C Daniel
authors.initials: CD
authors.lastname: Dent
authors.forename: James
authors.initials: J
authors.lastname: Pikulski
authors.forename: Paul M
authors.initials: PM
authors.lastname: Lambert
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis / Q000706:statistics & numerical data; D001863:Bone Screws; D003758:Dental Implantation, Endosseous; D015921:Dental Implants; D017267:Dental Prosthesis Design; D017268:Dental Prosthesis Retention; D019232:Dental Restoration Failure; D006801:Humans; D011182:Postoperative Care; D011446:Prospective Studies; D013499:Surface Properties
chemical_list: D000900:Anti-Bacterial Agents; D015921:Dental Implants