Premium
Should Perioperative Antibiotics Be Prescribed Prophylactically for Uncomplicated Single Implant Surgeries?
Author(s) -
Reddy Caitlin M.,
Brock Adam W.,
Coleman Brandon G.,
Erley Kenneth J.,
Johnson Thomas M.
Publication year - 2017
Publication title -
clinical advances in periodontics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.182
H-Index - 2
eISSN - 2163-0097
pISSN - 2573-8046
DOI - 10.1902/cap.2017.160040
Subject(s) - medicine , implant , antibiotics , dentistry , adverse effect , perioperative , implant failure , dental implant , surgery , intensive care medicine , microbiology and biotechnology , biology
Type of Case: A 32‐year‐old female presents missing tooth #5 and requesting replacement with a dental implant. She has an unremarkable medical history. The tooth #5 site is a healed ridge with adequate bone to support an implant without additional augmentation. Clinical Approach #1 (CMR and TMJ): This approach involves routine implant surgery with placement of a healing abutment. Preoperative management includes 2 g amoxicillin 1 hour prior to the procedure and postoperative pain medication. The rationale for use of an antibiotic is to decrease the risk of infection and implant failure and to reduce peri‐implant inflammation during early healing. The desired effect of the antibiotic is to minimize or eliminate the negative effects of bacteria in the wound site and on the implant surface during healing. This clinical approach is recommended to protect the investment of resources and time by the patient and dental team for optimal treatment outcomes. Clinical Approach #2 (AWB, BGC, and KJE): This approach involves routine implant surgery with placement of a healing abutment. Postoperative management includes pain medications without antibiotic use. The rationale for avoidance of antibiotics is to eliminate risk of an adverse drug reaction such as urticaria, anaphylaxis, or gastrointestinal disturbances. Because the evidence justifying antibiotic coverage is considered to be weak, clinicians are advised to consider withholding antibiotic prescriptions for routine implant placement as a means of risk mitigation for the patient and public health in general.