title: Effects of Antibiotics on Bone and Soft-Tissue Healing Following Immediate Single-Tooth Implant Placement Into Sites With Apical Pathology.
abstract: Overprescription of antibiotics can cause bacterial resistance problems, leading to life-threatening illnesses and public health crises. Clinicians often believe antibiotics can prevent dental implant failure and postoperative complications. In conjunction with implant surgery, antibiotics are therefore routinely prescribed for all cases. In this double-blind, randomized controlled trial, the effects of antibiotics on the clinical outcomes of immediate implant placement upon replacing a tooth with an apical pathology were examined to compare antibiotics (n = 10) and placebo (n = 10). In each subject, a tooth with a chronic apical lesion was extracted, thoroughly curetted, irrigated, and replaced with single implant with a screw-retained custom provisional abutment/crown. Postoperative pain/discomfort was measured at 1- and 4-week postsurgical follow-up visits using visual analog scales. Facial alveolar bone and soft-tissue changes were measured using pre- and postoperative cone-beam computerized tomography and impressions. We found survival rates of 100% (antibiotics) and 78% (control). However, there was no statistical difference in means for any clinical outcome (t tests with Bonferroni adjustment for multiple testing), except for midfacial soft-tissue changes: 0.43 mm (SD, 0.76) in the antibiotics group and 1.70 mm (SD, 1.06) in the placebo group (t15 = -2.89, P = .011). The average change of the midfacial alveolar plate was 0.62 mm (SD, 0.46) and 1.34 mm (SD, 0.91) for the antibiotic and placebo groups, respectively, which did not significantly differ statistically. No significant correlation (Spearman correlation) existed between the changes in facial alveolar bone and the facial gingival margin. Antibiotics appear to have little effect on immediate implant treatment outcomes.
authors: 1  Department of Endodontics, School of Dentistry, University of North Carolina, Chapel Hill, NC.
authors: Bashir
authors: B
authors: Hosseini
authors: 2  Department of Prosthodontics, School of Dentistry, University of North Carolina, Chapel Hill, NC.
authors: Warren C
authors: WC
authors: Byrd
authors: 3  Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC.
authors: John S
authors: JS
authors: Preisser
authors: 1  Department of Endodontics, School of Dentistry, University of North Carolina, Chapel Hill, NC.
authors: Asma
authors: A
authors: Khan
authors: 1  Department of Endodontics, School of Dentistry, University of North Carolina, Chapel Hill, NC.
authors: Derek
authors: D
authors: Duggan
authors: 1  Department of Endodontics, School of Dentistry, University of North Carolina, Chapel Hill, NC.|4  Department of Pharmacology, School of Medicine, University of North Carolina, Chapel Hill, NC.
authors: Sompop
authors: S
authors: Bencharit
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003442:Crowns; D019250:Dental Implants, Single-Tooth; D019094:Dental Prosthesis, Implant-Supported; D019232:Dental Restoration Failure; D003794:Dental Restoration, Temporary; D004311:Double-Blind Method; D005500:Follow-Up Studies; D006801:Humans; D057893:Immediate Dental Implant Loading; D014081:Tooth Extraction; D016896:Treatment Outcome; D014945:Wound Healing
chemical_list: D000900:Anti-Bacterial Agents
keywords: antibiotics; apical infection; dental implants; immediate placement; immediate restoration; randomized controlled trial