Retrospective analysis of 736 implants inserted without antibiotic therapy.
OBJECTIVE
The routine use of antibiotics in oral implant treatment seems to be widespread. The principle of antibiotic prophylaxis before oral surgical procedures in patients at risk for endocarditis or in those who are severely immunocompromised is well established. Antibiotic therapy in conjunction with implant surgery in fit patients and its correlation with failure and success rates remains poorly documented, however. The debate regarding overprescription of antibiotics raises the need for a critical evaluation of proper antibiotic coverage in association with implant treatment. The purpose of this study was to retrospectively show and value the outcomes of dental implant treatment without antibiotic prophylaxis.


METHODS
The study included 437 consecutively treated patients, in whom a total of 736 implants were placed. The population received no prophylactic antibiotics, but received anti-inflammatory therapy (nimesulide 100 mg twice daily or Arnica montana 5C 3 times a day) for 3 days postoperatively. Healing was evaluated at second-stage surgery (4 to 6 months postoperatively). Failure was defined as removal of the implant due to either signs of infection or nonosseointegration of the implant, according to the criteria for success described by Albrektsson and Coll in 1988.


RESULTS
The implant survival rate in the sample (96.2%) was no lower than the high success rates published in the literature using various antibiotic regimens.


CONCLUSIONS
Our findings support the results of several recent reviews of minor use of antibiotics in oral surgery. These findings suggest that the use of antibiotics for routine oral implants may not be as beneficial as once believed and that clinicians should look forward to the reduction of their unnecessary use. The use of antibiotic prophylaxis before oral surgical procedures remains a controversial issue, poorly documented in the literature.
Mazzocchi
Alberto
A
Private Practice, Bergamo, Italy. mazzocc@gmail.com
Passi
Luca
L
Moretti
Roberto
R
D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis; D018650:Arnica; D003758:Dental Implantation, Endosseous / Q000379:methods*; D015921:Dental Implants; D019232:Dental Restoration Failure; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016348:Osseointegration / Q000502:physiology; D008517:Phytotherapy; D028321:Plant Preparations / Q000627:therapeutic use; D012189:Retrospective Studies; D013449:Sulfonamides / Q000627:therapeutic use; D013530:Surgical Wound Infection / Q000209:etiology; D016019:Survival Analysis; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology
D000893:Anti-Inflammatory Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D015921:Dental Implants; D028321:Plant Preparations; D013449:Sulfonamides; C012655:nimesulide