ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title A Regimen of Postoperative Antibiotics and Chlorhexidine Rinses Can Increase The Success Rate of Implant Osseointegration Following Ridge Preservation
Clinical Question In patients undergoing implant placement following ridge preservation, does the use of post operative antibiotics and chlorhexidine rinse increase the success rate of implant osseointegration compared to no antibiotic/chlorhexidine use?
Clinical Bottom Line Both pre- and postoperative antibiotics and chlorhexidine use increase the success rate of implant osseointegration following bone graft placement.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 14676756Lindeboom/200320 patients undergoing a graft procedureRandomized Controlled Trial
Key resultsNone of the patients that received the 2 grams of pheneticillin one hour before surgery developed infection. In the patients receiving the placebo, two developed an infection in the receptor and donor sites and one in the donor site alone. All patients were prescribed postoperative analgesics and 0.2% chlorhexidine rinse. (P<.05)
#2) 24183737El-Kholey/201480 patients undergoing implant placementRandomized Controlled Trial
Key resultsTwo groups received either a preoperative single dose of 1g amoxicillin and no postoperative administration. In the second group, the patients were given 1g of amoxicillin preoperative and then continued the regimen for 3 days postoperatively. The sites were evaluated at 3 days, 7 days, 12 days post operation for “pain, swelling, wound dehiscence, and pus formation.“ All patients were given 12% chlorhexidine rinse pre and post operatively for 5 days, as well as 500mg of paracetamol 4 times daily as needed. All implants integrated successfully and there was no statistically significant difference between pre and postoperative administration of antibiotics (p=1.0).
Evidence Search "Dental Implants"[Mesh] AND "Anti-Bacterial Agents"[Mesh] (((((("Alveolar Ridge Augmentation*/methods"[MAJR]) AND "Anti-Bacterial Agents/therapeutic use"[MAJR]) AND "Bone Transplantation*/methods"[MAJR]) AND "Maxilla/surgery"[MeSH Terms]) AND "Penicillins"[MAJR]) AND "Surgical Wound Infection/prevention and control"[MeSH Terms]) AND "Antibiotic Prophylaxis"[MAJR]
Comments on
The Evidence
Validity: The cited articles are both randomized control trials, one was double blind (Lindeboom, van den Akker), while the other (El-Kholey) was single blind. The groups were similar at the start and all were treated equally. Compliance was seen in the two studies as well as no recall bias. No funding bias was reported.
Applicability The subjects are representative of the patient pool (variations in age and health) and the treatment options are easily attainable. The results were very promising, even though the sample sizes were small in scale, and at the very least laid the foundation for further research on the subject.
Specialty/Discipline (General Dentistry) (Oral Surgery) (Periodontics) (Prosthodontics)
Keywords Antibiotics Chlorhexidine Implants Bone Graft
ID# 3080
Date of submission: 04/05/2016spacer
E-mail grantmr@livemail.uthscsa.edu
Author Michael Grant
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Kevin Gureckis, DMD
Faculty mentor/Co-author e-mail gureckis@uthscsa.edu
Basic Science Rationale
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