Prophylactic Antibiotic Regimens in Oral Implantology: Rationale and Protocol

Abstract

The use of antimicrobials reduces the incidence of surgical wound infection in oral implantology. Antimicrobial prophylaxis is indicated in all Class 2 (clean-contaminated) surgical procedures, which include sufficient blood levels at the time of bacterial contamination of dental implant and bone graft procedures. Timing and dosage are critical to the efficacy of antibiotics. Antibiotic selection is determined mainly by the bacteria which is most likely to cause an infection from the specific procedure. The authors have developed a classification and protocol that allows the dental practitioner to properly prescribe medication based on procedural, local host and systemic factors.

Current Trend of Antimicrobial Prescription for Oral Implant Surgery Among Dentists in India

“…Only one respondent in the prescriber group added this information to the prescribed antimicrobial protocol. Surgical asepsis and local measures like peri-operative antibacterial mouthwash have received due importance in literature with even those authors that were in favour of antimicrobial prophylaxis recommending the use of an antibacterial mouthwash peri-operatively [35,38,39].…”

An investigation of antibiotic prophylaxis in implant practice in the UK

“…30 They have also suggested that their use reduces the incidence of postoperative infections, peri-implantitis and postoperative pain. This, however, remains a controversial issue with little high quality evidence to support the routine use of prophylactic antimicrobials in the placing of implants.…”

Antibiotic prescription patterns among Swedish dentists working with dental implant surgery: adherence to recommendations

“…Side effects such as interaction with other drugs, gastro‐intestinal tract distress, secondary infection, toxicity, and allergic reactions must also be considered (Lawler et al. ; Resnik & Misch ). The risk of inappropriate use of antibiotics and widespread antibiotic resistance appear to be far more important than possible perceived benefit (Tong & Rothwell ).…”

“…Health authorities have reported on the importance of reducing the total use of antibiotics (Huovinen & Cars 1998) and development of resistant bacterial strains. Side effects such as interaction with other drugs, gastro-intestinal tract distress, secondary infection, toxicity, and allergic reactions must also be considered (Lawler et al 2005;Resnik & Misch 2008). The risk of inappropriate use of antibiotics and widespread antibiotic resistance appear to be far more important than possible perceived benefit (Tong & Rothwell 2000).…”