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Blyleven GM, Johnson TM, Inouye KA, Stancoven BW, Lincicum AR. Factors influencing intraoperative and postoperative complication occurrence: A series of 1135 periodontal and implant-related surgeries. Clin Exp Dent Res 2024; 10:e849. [PMID: 38345517 PMCID: PMC10847704 DOI: 10.1002/cre2.849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 12/13/2023] [Accepted: 01/15/2024] [Indexed: 02/15/2024] Open
Abstract
OBJECTIVES In periodontology, it is widely recognized that evidence characterizing the incidence and effect of treatment complications is lacking. The objective of this study was to assess the influence of operator-, procedure-, patient-, and site-associated factors on intraoperative and postoperative complication occurrence. MATERIAL AND METHODS A single investigator reviewed records of patients treated by eight periodontics residents from July 2018 through June 2022. For each procedure, the investigator recorded each intraoperative and postoperative complication or indicated that no complication had occurred. These outcomes were analyzed against a panel of explanatory covariates. In addition, the severity of each postoperative complication was assessed using a standardized grading system. RESULTS A total of 1135 procedures were included in the analysis. Intraoperative and postoperative complications were identified in 2.8% and 15.2% of procedures, respectively. The most common intraoperative complications were Schneiderian membrane perforation (1.3%) and gingival flap perforation/tear (1%), and the most common postoperative complications were dentin hypersensitivity (2.6%), excessive pain (2.5%), and infection (2.2%). Subepithelial connective tissue graft (odds ratio [OR]: 3.2, 95% confidence interval [CI]: 1.6, 6.1; p < .001), guided bone regeneration (OR: 3.0, 95% CI: 1.4, 6.5; p = .004), and guided bone regeneration with implant placement (OR: 3.1, 95% CI: 1.3, 7.6; p = .011) were associated with higher odds of postoperative complication, whereas lateral sinus elevation (OR: 102.5, 95% CI: 12.3, 852.9; p < .001), transalveolar sinus elevation (OR: 22.4, 95% CI: 2.2, 224.5; p = .008), open flap debridement (OR: 36.4, 95% CI: 3.0, 440.7; p = .005), and surgically facilitated orthodontic therapy (OR: 20.5, 95% CI: 1.2, 358.4; p = .039) were associated with higher odds of intraoperative complication occurrence. CONCLUSIONS Consistent with previous reports, procedure type appears to be the predominant factor driving complication occurrence. As analyses of treatment complications increase, individualized risk-benefit assessments will become progressively meaningful for patients.
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Affiliation(s)
- Gary M. Blyleven
- Department of PeriodonticsArmy Postgraduate Dental School, Postgraduate Dental College, Uniformed Services University of the Health Sciences, Fort EisenhowerAugustaGeorgiaUSA
| | - Thomas M. Johnson
- Department of PeriodonticsArmy Postgraduate Dental School, Postgraduate Dental College, Uniformed Services University of the Health Sciences, Fort EisenhowerAugustaGeorgiaUSA
| | - Kimberly Ann Inouye
- Department of PeriodonticsArmy Postgraduate Dental School, Postgraduate Dental College, Uniformed Services University of the Health Sciences, Fort EisenhowerAugustaGeorgiaUSA
| | - Brian W. Stancoven
- Department of PeriodonticsArmy Postgraduate Dental School, Postgraduate Dental College, Uniformed Services University of the Health Sciences, Fort EisenhowerAugustaGeorgiaUSA
| | - Adam R. Lincicum
- Department of PeriodonticsArmy Postgraduate Dental School, Postgraduate Dental College, Uniformed Services University of the Health Sciences, Fort EisenhowerAugustaGeorgiaUSA
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Salgado-Peralvo AO, Garcia-Sanchez A, Kewalramani N, Barone A, Martínez-González JM, Velasco-Ortega E, López-López J, Kaiser-Cifuentes R, Guerra F, Matos-Garrido N, Moreno-Muñoz J, Núñez-Márquez E, Ortiz-García I, Jiménez-Guerra Á, Monsalve-Guil L. Consensus Report on Preventive Antibiotic Therapy in Dental Implant Procedures: Summary of Recommendations from the Spanish Society of Implants. Antibiotics (Basel) 2022; 11:antibiotics11050655. [PMID: 35625298 PMCID: PMC9138127 DOI: 10.3390/antibiotics11050655] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 05/11/2022] [Accepted: 05/12/2022] [Indexed: 12/10/2022] Open
Abstract
Current patterns of preventive antibiotic prescribing are encouraging the spread of antimicrobial resistance. Recently, the Spanish Society of Implants (SEI) developed the first clinical practice guidelines published to date, providing clear guidelines on how to prescribe responsible and informed preventive antibiotic therapy (PAT) based on the available scientific evidence on dental implant treatments (DIs). The present document aims to summarise and disseminate the recommendations established by this expert panel. These were based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Studies were analysed using the Scottish Intercollegiate Guidelines Network (SIGN) checklist templates and ranked according to their level of evidence. They were then assigned a level of recommendation using the Grading of Recommendations, Assessment, Development and Evaluation system (GRADE). Guidelines were established on the type of PAT, antibiotic and dosage of administration in the placement of DIs without anatomical constraints, in bone augmentation with the placement of DIs in one or two stages, placement of immediate DIs, sinus elevations, implant prosthetic phase, as well as recommendations in patients allergic to penicillin. Therefore, the PAT must be adapted to the type of implant procedure to be performed.
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Affiliation(s)
- Angel-Orión Salgado-Peralvo
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University of Madrid, 28040 Madrid, Spain;
- Science Committee for Antibiotic Research of Spanish Society of Implants (SEI—Sociedad Española de Implantes), 28020 Madrid, Spain; (N.K.); (A.B.); (E.V.-O.); (J.L.-L.); (R.K.-C.); (F.G.); (N.M.-G.); (J.M.-M.); (E.N.-M.); (I.O.-G.); (L.M.-G.)
- Correspondence: (A.-O.S.-P.); (Á.J.-G.)
| | - Alvaro Garcia-Sanchez
- Department of Oral Health and Diagnostic Sciences, School of Dental Medicine, University of Connecticut Health, Farmington, CT 06030, USA;
| | - Naresh Kewalramani
- Science Committee for Antibiotic Research of Spanish Society of Implants (SEI—Sociedad Española de Implantes), 28020 Madrid, Spain; (N.K.); (A.B.); (E.V.-O.); (J.L.-L.); (R.K.-C.); (F.G.); (N.M.-G.); (J.M.-M.); (E.N.-M.); (I.O.-G.); (L.M.-G.)
- Department of Nursery and Stomatology, Faculty of Dentistry, Rey Juan Carlos University, 28922 Madrid, Spain
| | - Antonio Barone
- Science Committee for Antibiotic Research of Spanish Society of Implants (SEI—Sociedad Española de Implantes), 28020 Madrid, Spain; (N.K.); (A.B.); (E.V.-O.); (J.L.-L.); (R.K.-C.); (F.G.); (N.M.-G.); (J.M.-M.); (E.N.-M.); (I.O.-G.); (L.M.-G.)
- Department of Surgical, Medical and Molecular Pathology and Critical Areas, Faculty of Dentistry, University of Pisa, 56126 Pisa, Italy
| | - Jose-María Martínez-González
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University of Madrid, 28040 Madrid, Spain;
- Science Committee for Antibiotic Research of Spanish Society of Implants (SEI—Sociedad Española de Implantes), 28020 Madrid, Spain; (N.K.); (A.B.); (E.V.-O.); (J.L.-L.); (R.K.-C.); (F.G.); (N.M.-G.); (J.M.-M.); (E.N.-M.); (I.O.-G.); (L.M.-G.)
| | - Eugenio Velasco-Ortega
- Science Committee for Antibiotic Research of Spanish Society of Implants (SEI—Sociedad Española de Implantes), 28020 Madrid, Spain; (N.K.); (A.B.); (E.V.-O.); (J.L.-L.); (R.K.-C.); (F.G.); (N.M.-G.); (J.M.-M.); (E.N.-M.); (I.O.-G.); (L.M.-G.)
- Department of Stomatology, Faculty of Dentistry, University of Seville, 41009 Seville, Spain
| | - José López-López
- Science Committee for Antibiotic Research of Spanish Society of Implants (SEI—Sociedad Española de Implantes), 28020 Madrid, Spain; (N.K.); (A.B.); (E.V.-O.); (J.L.-L.); (R.K.-C.); (F.G.); (N.M.-G.); (J.M.-M.); (E.N.-M.); (I.O.-G.); (L.M.-G.)
- Department of Odontostomatology, Faculty of Dentistry, University of Barcelona, 08907 Barcelona, Spain
| | - Rodrigo Kaiser-Cifuentes
- Science Committee for Antibiotic Research of Spanish Society of Implants (SEI—Sociedad Española de Implantes), 28020 Madrid, Spain; (N.K.); (A.B.); (E.V.-O.); (J.L.-L.); (R.K.-C.); (F.G.); (N.M.-G.); (J.M.-M.); (E.N.-M.); (I.O.-G.); (L.M.-G.)
- Faculty of Dentistry, Finis Terrae University, Santiago de Chile 7501015, Chile
| | - Fernando Guerra
- Science Committee for Antibiotic Research of Spanish Society of Implants (SEI—Sociedad Española de Implantes), 28020 Madrid, Spain; (N.K.); (A.B.); (E.V.-O.); (J.L.-L.); (R.K.-C.); (F.G.); (N.M.-G.); (J.M.-M.); (E.N.-M.); (I.O.-G.); (L.M.-G.)
- Faculty of Dental Medicine, University of Coimbra, 3000-075 Coimbra, Portugal
| | - Nuno Matos-Garrido
- Science Committee for Antibiotic Research of Spanish Society of Implants (SEI—Sociedad Española de Implantes), 28020 Madrid, Spain; (N.K.); (A.B.); (E.V.-O.); (J.L.-L.); (R.K.-C.); (F.G.); (N.M.-G.); (J.M.-M.); (E.N.-M.); (I.O.-G.); (L.M.-G.)
- Department of Stomatology, Faculty of Dentistry, University of Seville, 41009 Seville, Spain
| | - Jesús Moreno-Muñoz
- Science Committee for Antibiotic Research of Spanish Society of Implants (SEI—Sociedad Española de Implantes), 28020 Madrid, Spain; (N.K.); (A.B.); (E.V.-O.); (J.L.-L.); (R.K.-C.); (F.G.); (N.M.-G.); (J.M.-M.); (E.N.-M.); (I.O.-G.); (L.M.-G.)
- Department of Stomatology, Faculty of Dentistry, University of Seville, 41009 Seville, Spain
| | - Enrique Núñez-Márquez
- Science Committee for Antibiotic Research of Spanish Society of Implants (SEI—Sociedad Española de Implantes), 28020 Madrid, Spain; (N.K.); (A.B.); (E.V.-O.); (J.L.-L.); (R.K.-C.); (F.G.); (N.M.-G.); (J.M.-M.); (E.N.-M.); (I.O.-G.); (L.M.-G.)
- Department of Stomatology, Faculty of Dentistry, University of Seville, 41009 Seville, Spain
| | - Iván Ortiz-García
- Science Committee for Antibiotic Research of Spanish Society of Implants (SEI—Sociedad Española de Implantes), 28020 Madrid, Spain; (N.K.); (A.B.); (E.V.-O.); (J.L.-L.); (R.K.-C.); (F.G.); (N.M.-G.); (J.M.-M.); (E.N.-M.); (I.O.-G.); (L.M.-G.)
- Department of Stomatology, Faculty of Dentistry, University of Seville, 41009 Seville, Spain
| | - Álvaro Jiménez-Guerra
- Science Committee for Antibiotic Research of Spanish Society of Implants (SEI—Sociedad Española de Implantes), 28020 Madrid, Spain; (N.K.); (A.B.); (E.V.-O.); (J.L.-L.); (R.K.-C.); (F.G.); (N.M.-G.); (J.M.-M.); (E.N.-M.); (I.O.-G.); (L.M.-G.)
- Department of Stomatology, Faculty of Dentistry, University of Seville, 41009 Seville, Spain
- Correspondence: (A.-O.S.-P.); (Á.J.-G.)
| | - Loreto Monsalve-Guil
- Science Committee for Antibiotic Research of Spanish Society of Implants (SEI—Sociedad Española de Implantes), 28020 Madrid, Spain; (N.K.); (A.B.); (E.V.-O.); (J.L.-L.); (R.K.-C.); (F.G.); (N.M.-G.); (J.M.-M.); (E.N.-M.); (I.O.-G.); (L.M.-G.)
- Department of Stomatology, Faculty of Dentistry, University of Seville, 41009 Seville, Spain
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Salgado-Peralvo AO, Kewalramani N, Peña-Cardelles JF, Mateos-Moreno MV, Monsalve-Guil L, Jiménez-Guerra Á, Ortiz-García I, Velasco-Ortega E. Preventive Antibiotic Prescribing Habits among Professionals Dedicated to Oral Implantology: An Observational Study. Antibiotics (Basel) 2021; 10:antibiotics10030301. [PMID: 33799411 PMCID: PMC7999193 DOI: 10.3390/antibiotics10030301] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 03/05/2021] [Accepted: 03/12/2021] [Indexed: 12/11/2022] Open
Abstract
The prescription of preventive antibiotics (PA) in oral implantology is a controversial issue. The study aimed to determine the prescribing habits of PA in professionals dedicated to oral implantology in various treatments in healthy and at-risk patients. This is a cross-sectional observational study based on the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines. An electronic survey consisting of 4 blocks of questions was sent to members of the Spanish Society of Implants. The data were analyzed using descriptive analysis. A total of 303 participants (20.8%) responded to the questionnaire. One percent never prescribed PA, 55.4% prescribed them always, and 43.6% prescribed them sometimes. Ninety-six percent administered them preoperatively, while 92.4% administered them postoperatively. The most commonly used antibiotic is amoxicillin followed by amoxicillin with clavulanic acid (875/125 mg). Clindamycin is the most commonly administered antibiotic in patients with allergies. Professionals dedicated to oral implantology frequently prescribe PA in both healthy and at-risk patients, especially perioperatively. Immediate implant placement, sinus lifts, bone regeneration, and multiple implant placement are the treatments in which PA are most commonly prescribed, as well as in patients with heart valve prostheses or a history of bacterial endocarditis and immunodeficiency.
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Affiliation(s)
- Angel Orión Salgado-Peralvo
- Department of Stomatology, University of Seville, 41009 Seville, Spain; (L.M.-G.); (Á.J.-G.); (I.O.-G.); (E.V.-O.)
- Science Committee for Antibiotic Research of Spanish Society of Implants (SEI–Sociedad Española de Implantes), 28020 Madrid, Spain; (J.F.P.-C.); (M.V.M.-M.)
- Correspondence:
| | - Naresh Kewalramani
- Department of Nursery and Stomatology, Rey Juan Carlos University, 28922 Madrid, Spain;
| | - Juan Francisco Peña-Cardelles
- Science Committee for Antibiotic Research of Spanish Society of Implants (SEI–Sociedad Española de Implantes), 28020 Madrid, Spain; (J.F.P.-C.); (M.V.M.-M.)
- Department of Basic Health Sciences, Rey Juan Carlos University, 28922 Madrid, Spain
| | - María Victoria Mateos-Moreno
- Science Committee for Antibiotic Research of Spanish Society of Implants (SEI–Sociedad Española de Implantes), 28020 Madrid, Spain; (J.F.P.-C.); (M.V.M.-M.)
- Department of Clinical Specialties, Faculty of Dentistry, Complutense University of Madrid, 28040 Madrid, Spain
| | - Loreto Monsalve-Guil
- Department of Stomatology, University of Seville, 41009 Seville, Spain; (L.M.-G.); (Á.J.-G.); (I.O.-G.); (E.V.-O.)
- Science Committee for Antibiotic Research of Spanish Society of Implants (SEI–Sociedad Española de Implantes), 28020 Madrid, Spain; (J.F.P.-C.); (M.V.M.-M.)
| | - Álvaro Jiménez-Guerra
- Department of Stomatology, University of Seville, 41009 Seville, Spain; (L.M.-G.); (Á.J.-G.); (I.O.-G.); (E.V.-O.)
- Science Committee for Antibiotic Research of Spanish Society of Implants (SEI–Sociedad Española de Implantes), 28020 Madrid, Spain; (J.F.P.-C.); (M.V.M.-M.)
| | - Iván Ortiz-García
- Department of Stomatology, University of Seville, 41009 Seville, Spain; (L.M.-G.); (Á.J.-G.); (I.O.-G.); (E.V.-O.)
- Science Committee for Antibiotic Research of Spanish Society of Implants (SEI–Sociedad Española de Implantes), 28020 Madrid, Spain; (J.F.P.-C.); (M.V.M.-M.)
| | - Eugenio Velasco-Ortega
- Department of Stomatology, University of Seville, 41009 Seville, Spain; (L.M.-G.); (Á.J.-G.); (I.O.-G.); (E.V.-O.)
- Science Committee for Antibiotic Research of Spanish Society of Implants (SEI–Sociedad Española de Implantes), 28020 Madrid, Spain; (J.F.P.-C.); (M.V.M.-M.)
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Preventive antibiotic therapy in bone augmentation procedures in oral implantology: A systematic review. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2021; 123:74-80. [PMID: 33493687 DOI: 10.1016/j.jormas.2021.01.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 01/11/2021] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Since the beginning of Oral Implantology, preventive antibiotic therapy has been routinely prescribed. However, at present, due to the growing appearance of antimicrobial resistance, its use has been questioned, generating a great debate and an emerging controversy. The present systematic review aims to analyze the scientific literature to determine whether the preventive prescription of antibiotics in augmentation procedures with the insertion of implants in one or two phases decreases the incidence of postoperative infections and/or the survival rate of the implants. MATERIAL AND METHODS The MEDLINE database was searched (via PubMed) with the following keywords: (bone grafting OR alveolar ridge augmentation OR bone graft augmentation OR guided bone regeneration OR bone block) AND (dental implants OR dental implant OR oral implantology) AND (antibiotic prophylaxis OR antibiotics). The criteria used were those described by the PRISMA® Statement. The search was limited to randomised clinical trials, systematic reviews and meta-analyses published in the last 15 years (2005-2020). RESULTS After reading the titles and abstracts of the resulting articles, only one systematic review meeting the described criteria and 4 randomised clinical trials were included. CONCLUSIONS Prescription of 2 or 3 g of amoxicillin one hour before surgery is recommended to reduce the early failure rate of one-stage implants and to decrease the bacterial load of grafted bone particles in bone augmentation procedures with one or two-stage implants.
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Kim AS, Abdelhay N, Levin L, Walters JD, Gibson MP. Antibiotic prophylaxis for implant placement: a systematic review of effects on reduction of implant failure. Br Dent J 2020; 228:943-951. [PMID: 32591710 PMCID: PMC7319948 DOI: 10.1038/s41415-020-1649-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Introduction Despite excellent reviews in the past several years, the use of antibiotics as prophylaxis for implant placement remains controversial.Aim To assess the literature on the efficacy of prophylactic antibiotics prescribed prior to and immediately following implant surgery (PIFS).Outcomes Whether administration of antibiotics reduced implant failure and post-operative complications.Design Databases searched were PubMed and Medline via Ovid (1946 to February 2018), Cochrane Library (Wiley) and Google Scholar.Materials and methods Quality assessment, meta-analysis with a forest plot and incorporated assessment of heterogeneity. A two-tailed paired t-test was performed, analysing differences in mean failure rates between groups.Results Fourteen publications were collected; 5,334 implants were placed with pre-operative antibiotics, 82 implants with antibiotics PIFS and 3,862 placed with no antibiotics. The overall risk ratio (RR) was 0.47 (95% CI 0.39-0.58), with the implant failure rates significantly affected by pre-operative intervention (Z = 7.00, P <0.00001). The number needed to treat (NNT) was 35 (95% CI 26.3-48.2). The difference between mean failure rates was statistically significant (P = 0.0335).Conclusion Administering prophylactic antibiotics reduced the risk of implant failures. Further investigations are recommended to establish a standardised protocol for the proper use of antibiotic regimen.
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Affiliation(s)
- Andy Seongju Kim
- Department of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Canada
| | - Nancy Abdelhay
- Department of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Canada
| | - Liran Levin
- Division of Periodontology, Department of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Canada
| | - John D Walters
- Division of Periodontology, College of Dentistry, The Ohio State University, USA
| | - Monica P Gibson
- Division of Periodontology, Department of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Canada.
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Escalante MG, Eubank TD, Leblebicioglu B, Walters JD. Comparison of Azithromycin and Amoxicillin Before Dental Implant Placement: An Exploratory Study of Bioavailability and Resolution of Postoperative Inflammation. J Periodontol 2015; 86:1190-200. [PMID: 26252749 DOI: 10.1902/jop.2015.150024] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Studies suggest that a single prophylactic dose of amoxicillin reduces early implant complications, but it is unclear whether other antibiotics are also effective. This study compared the local antimicrobial and anti-inflammatory effects resulting from a single dose of azithromycin or amoxicillin before surgical placement of one-stage dental implants. METHODS Healthy adult patients requiring one-stage dental implant placement were allocated randomly to receive either 2 g amoxicillin (n = 7) or 500 mg azithromycin (n = 6) before surgery. Peri-implant crevicular fluid (PICF) samples from the new implant and gingival crevicular fluid (GCF) from adjacent teeth were sampled on postoperative days 6, 13, and 20. Inflammatory mediators in the samples were analyzed by immunoassay, and antibiotic levels were measured by bioassay. RESULTS On day 6, azithromycin concentrations in GCF and PICF were 3.39 ± 0.73 and 2.77 ± 0.90 μg/mL, respectively, whereas amoxicillin was below the limit of detection. During early healing, patents in the azithromycin group exhibited a significantly greater decrease in GCF volume (P = 0.03, analysis of variance). At specific times during healing, the azithromycin group exhibited significantly lower levels of interleukin (IL)-6 and IL-8 in GCF than the amoxicillin group and exhibited significantly lower levels of granulocyte colony stimulating factor, IL-8, macrophage inflammatory protein-1β, and interferon-gamma-inducible protein-10 in PICF. CONCLUSIONS Azithromycin was available at the surgical site for a longer period of time than amoxicillin, and patients taking azithromycin exhibited lower levels of specific proinflammatory cytokines and chemokines in GCF and PICF. Thus, preoperative azithromycin may enhance resolution of postoperative inflammation to a greater extent than amoxicillin.
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Affiliation(s)
- Mariana Gil Escalante
- Division of Periodontology, College of Dentistry, The Ohio State University Wexner Medical Center, Columbus, OH
| | - Tim D Eubank
- Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine; Department of Internal Medicine; The Ohio State University Wexner Medical Center
| | - Binnaz Leblebicioglu
- Division of Periodontology, College of Dentistry, The Ohio State University Wexner Medical Center, Columbus, OH
| | - John D Walters
- Division of Periodontology, College of Dentistry, The Ohio State University Wexner Medical Center, Columbus, OH
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Datta R, Grewal Y, Batth JS, Singh A. Current Trend of Antimicrobial Prescription for Oral Implant Surgery Among Dentists in India. J Maxillofac Oral Surg 2014; 13:503-7. [PMID: 26225019 PMCID: PMC4518808 DOI: 10.1007/s12663-013-0567-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2013] [Accepted: 08/07/2013] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES The aim of our study was to evaluate antimicrobial prescription behaviour amongst dentists performing oral implant surgery in India. STUDY DESIGN Dentists performing oral implant surgery from different parts of India were personally approached during various national events such as conferences and academic meetings and information regarding their prescription habits for antimicrobial agents in routine oral implant surgery was collected using a structured questionnaire. RESULTS Out of a total sample of 332 dentists, 85.5 % prescribed 17 different groups or combinations of antibiotics routinely for oral implant surgery in the normal healthy patient. Majority preferred the peri-operative protocol of drug therapy (72.2 %) with variable and prolonged duration of therapy after surgery, ranging from 3 to 10 days. An antimicrobial mouthwash was routinely prescribed by all the doctors (14.5 %) not in favour of prescribing antimicrobials in a normal healthy patient. CONCLUSIONS Our findings suggest that there is a trend of antimicrobial agent misuse by dentists performing oral implant surgery in India, both in terms of drugs used and the protocols prescribed. The majority of these dentists prescribed a variety of antimicrobial agents for prolonged durations routinely even in the normal, healthy patients.
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Affiliation(s)
- Rahul Datta
- />Rayat Bahra Dental College and Hospital, Mohali, Punjab India
- />H No 416, Sector 37 A, Chandigarh, 160036 India
| | - Yasmin Grewal
- />Rayat Bahra Dental College and Hospital, Mohali, Punjab India
| | - J. S. Batth
- />Gian Sagar Dental College and Hospital, Rajpura, Punjab India
| | - Amandeep Singh
- />Gian Sagar Medical College and Hospital, Rajpura, Punjab India
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Patients who received preoperative antibiotics showed fewer early implant failures. J Am Dent Assoc 2014; 145:1068-70. [DOI: 10.14219/jada.2014.72] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Current evidence regarding prophylactic antibiotics in head and neck and maxillofacial surgery. BIOMED RESEARCH INTERNATIONAL 2014; 2014:879437. [PMID: 25110703 PMCID: PMC4119728 DOI: 10.1155/2014/879437] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Revised: 02/19/2014] [Accepted: 06/16/2014] [Indexed: 11/18/2022]
Abstract
Antibiotic prophylaxis is commonly used to decrease the rate of infections in head and neck surgery. The aim of this paper is to present the available evidence regarding the application of antibiotic prophylaxis in surgical procedures of the head and neck region in healthy patients. A systemic literature review based on Medline and Embase databases was performed. All reviews and meta-analyses based on RCTs in English from 2000 to 2013 were included. Eight out of 532 studies fulfilled all requirements. Within those, only seven different operative procedures were analyzed. Evidence exists for the beneficial use of prophylactic antibiotics for tympanostomy, orthognathic surgery, and operative tooth extractions. Unfortunately, little high-level evidence exists regarding the use of prophylactic antibiotics in head and neck surgery. In numerous cases, no clear benefit of antibiotic prophylaxis has been shown, particularly considering their potential adverse side effects. Antibiotics are often given unnecessarily and are administered too late and for too long. Furthermore, little research has been performed on the large number of routine cases in the above-mentioned areas of specialization within the last few years, although questions arising with respect to the treatment of high-risk patients or of specific infections are discussed on a broad base.
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Marković A, Čolić S, Šćepanović M, Mišić T, Ðinić A, Bhusal DS. A 1-Year Prospective Clinical and Radiographic Study of Early-Loaded Bone Level Implants in the Posterior Maxilla. Clin Implant Dent Relat Res 2014; 17:1004-13. [DOI: 10.1111/cid.12201] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Aleksa Marković
- Department of Oral Surgery; School of Dentistry; University of Belgrade; Belgrade Serbia
| | - Snježana Čolić
- Department of Oral Surgery; School of Dentistry; University of Belgrade; Belgrade Serbia
| | - Miodrag Šćepanović
- Department of Prosthodontics; School of Dentistry; University of Belgrade; Belgrade Serbia
| | - Tijana Mišić
- Department of Oral Surgery; School of Dentistry; University of Belgrade; Belgrade Serbia
| | - Ana Ðinić
- Department of Oral Surgery; School of Dentistry; University of Belgrade; Belgrade Serbia
| | - Dinesh Sharma Bhusal
- Department of Oral Surgery; School of Dentistry; University of Belgrade; Belgrade Serbia
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Silver nanoparticles and mitochondrial interaction. Int J Dent 2013; 2013:312747. [PMID: 24101927 PMCID: PMC3786470 DOI: 10.1155/2013/312747] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Revised: 07/10/2013] [Accepted: 07/31/2013] [Indexed: 11/25/2022] Open
Abstract
Nanotechnology has gone through a period of rapid growth, thus leading to the constant increase in the application of engineered nanomaterials in daily life. Several different types of nanoparticles have been engineered to be employed in a wide array of applications due to their high surface to volume ratio that leads to unique physical and chemical properties. So far, silver nanoparticles (AgNps) have been used in many more different medical devices than any other nanomaterial, mainly due to their antimicrobial properties. Despite the promising advantages posed by using AgNps in medical applications, the possible health effects associated with the inevitable human exposure to AgNps have raised concerns as to their use since a clear understanding of their specific interaction with biological systems has not been attained yet. In light of such consideration, aim of the present work is the morphological analysis of the intracellular behavior of AgNps with a diameter of 10 nm, with a special attention to their interaction with mitochondria.
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Esposito M, Grusovin MG, Worthington HV. Interventions for replacing missing teeth: antibiotics at dental implant placement to prevent complications. Cochrane Database Syst Rev 2013; 2013:CD004152. [PMID: 23904048 PMCID: PMC6786879 DOI: 10.1002/14651858.cd004152.pub4] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Some dental implant failures may be due to bacterial contamination at implant insertion. Infections around biomaterials are difficult to treat, and almost all infected implants have to be removed. In general, antibiotic prophylaxis in surgery is only indicated for patients at risk of infectious endocarditis; with reduced host-response; when surgery is performed in infected sites; in cases of extensive and prolonged surgical interventions; and when large foreign materials are implanted. A variety of prophylactic systemic antibiotic regimens have been suggested to minimise infections after dental implant placement. More recent protocols recommended short-term prophylaxis, if antibiotics have to be used. Adverse events may occur with the administration of antibiotics, and can range from diarrhoea to life-threatening allergic reactions. Another major concern associated with the widespread use of antibiotics is the selection of antibiotic-resistant bacteria. The use of prophylactic antibiotics in implant dentistry is controversial. OBJECTIVES To assess the beneficial or harmful effects of systemic prophylactic antibiotics at dental implant placement versus no antibiotic or placebo administration and, if antibiotics are beneficial, to determine which type, dosage and duration is the most effective. SEARCH METHODS We searched the Cochrane Oral Health Group's Trials Register (to 17 June 2013), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2013, Issue 5), MEDLINE via OVID (1946 to 17 June 2013) and EMBASE via OVID (1980 to 17 June 2013). There were no language or date restrictions placed on the searches of the electronic databases. SELECTION CRITERIA Randomised controlled clinical trials (RCTs) with a follow-up of at least three months, that compared the administration of various prophylactic antibiotic regimens versus no antibiotics to people undergoing dental implant placement. Outcome measures included prosthesis failures, implant failures, postoperative infections and adverse events (gastrointestinal, hypersensitivity, etc). DATA COLLECTION AND ANALYSIS Screening of eligible studies, assessment of the risk of bias of the trials and data extraction were conducted in duplicate and independently by two review authors. Results were expressed as risk ratios (RRs) using a random-effects model for dichotomous outcomes with 95% confidence intervals (CIs). Heterogeneity, including both clinical and methodological factors, was to be investigated. MAIN RESULTS Six RCTs with 1162 participants were included: three trials compared 2 g of preoperative amoxicillin versus placebo (927 participants), one compared 3 g of preoperative amoxicillin versus placebo (55 participants), one compared 1 g of preoperative amoxicillin plus 500 mg four times a day for two days versus no antibiotics (80 participants), and one compared four groups: (1) 2 g of preoperative amoxicillin; (2) 2 g of preoperative amoxicillin plus 1 g twice a day for seven days; (3) 1 g of postoperative amoxicillin twice a day for seven days, and (4) no antibiotics (100 participants). The overall body of evidence was considered to be of moderate quality. The meta-analyses of the six trials showed a statistically significant higher number of participants experiencing implant failures in the group not receiving antibiotics (RR 0.33; 95% CI 0.16 to 0.67, P value 0.002, heterogeneity: Tau(2) 0.00; Chi(2) 2.87, df = 5 (P value 0.57); I(2) 0%). The number needed to treat for one additional beneficial outcome (NNTB) to prevent one person having an implant failure is 25 (95% CI 14 to 100), based on an implant failure rate of 6% in participants not receiving antibiotics. There was borderline statistical significance for prosthesis failures (RR 0.44; 95% CI 0.19 to 1.00), with no statistically significant differences for infections (RR 0.69; 95% CI 0.36 to 1.35), or adverse events (RR 1; 95% CI 0.06 to 15.85) (only two minor adverse events were recorded, one in the placebo group). No conclusive information can be derived from the only trial that compared three different durations of antibiotic prophylaxis since no event (implant/prosthesis failures, infections or adverse events) occurred in any of the 25 participants included in each study group. There were no trials that evaluated different antibiotics or different antibiotic dosages. AUTHORS' CONCLUSIONS Scientific evidence suggests that, in general, antibiotics are beneficial for reducing failure of dental implants placed in ordinary conditions. Specifically 2 g or 3 g of amoxicillin given orally, as a single administration, one hour preoperatively significantly reduces failure of dental implants. No significant adverse events were reported. It might be sensible to suggest the use of a single dose of 2 g prophylactic amoxicillin prior to dental implant placement. It is still unknown whether postoperative antibiotics are beneficial, and which antibiotic is the most effective.
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Affiliation(s)
- Marco Esposito
- Cochrane Oral Health Group, School of Dentistry, The University of Manchester, Manchester, UK.
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14
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Robles Raya P, de Frutos Echaniz E, Moreno Millán N, Mas Casals A, Sánchez Callejas A, Morató Agustí ML. [I'm going to the dentist: antibiotic as a prevention or as a treatment?]. Aten Primaria 2013; 45:216-21. [PMID: 23182318 PMCID: PMC6985532 DOI: 10.1016/j.aprim.2012.10.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2012] [Revised: 10/04/2012] [Accepted: 10/05/2012] [Indexed: 10/27/2022] Open
Abstract
Odontogenic infections account for 10% of all antibiotic prescriptions in Spain. Despite the frequency and importance of these infections, there is often confusion between prophylaxis and treatment. The oral cavity is a complex ecosystem made up of over 500 bacterial species. It is essential to take the medical history, examine each infection, and know about previous illnesses that could change our therapeutic and/or prophylactic attitude. The use of prophylaxis with antibiotics in patients at risk of infective endocarditis has been accepted for many years. Nowadays this is being restricted, and in many cases the risks of taking preventive antibiotics outweigh its benefits. There are no serious studies to determine the best antibiotic and its dosage, thus the Spanish consensus guidelines have to be followed. It is not known how the misuse of antibiotics influences bacterial resistance, not only on pathogen strains, but also on the common oral flora.
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Affiliation(s)
| | | | | | | | | | - M. Luisa Morató Agustí
- Grupo de Trabajo en Prevención de las Enfermedades Infecciosas, Sociedad Catalana de Medicina de Familia y Comunitaria (CAMFIC), Barcelona, España
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Ramu C, Padmanabhan TV. Indications of antibiotic prophylaxis in dental practice- review. Asian Pac J Trop Biomed 2012; 2:749-54. [PMID: 23570007 PMCID: PMC3609373 DOI: 10.1016/s2221-1691(12)60222-6] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2012] [Revised: 01/22/2012] [Accepted: 03/14/2012] [Indexed: 11/24/2022] Open
Abstract
Antibiotics are frequently used in dental practice. Clinical and bacteriological epidemiological factors determine the indications of antibiotics in dentistry. Antibiotics are used in addition to appropriate treatment to aid the host defences in the elimination of remaining bacteria. It is indicated when there is evidence of clinical sign involvement and spread of infection. Antibiotics are prescribed in dental practice for treating odontoge nic infections, non-odontogenic infections, as prophylaxis against focal and local infection. Special care needs to be addressed to patients with organ transplants, poorly controlled diabetes and pregnancy. Antibiotics should be used only as an adjunct to dental treatment and never alone as the first line of care. The present paper reviews the indications of antibiotics in dental practice.
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Affiliation(s)
- C Ramu
- *Corresponding author: Dr. C Ramu, MDS, Senior lecturer, Department of Prosthodontics, Faculty of Dental Sciences, Sri Ramachandra University,Porur, Chennai-600116, India. Tel: +919442322777 E-mail:
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Does the Use of Prophylactic Antibiotics Decrease Implant Failure? Oral Maxillofac Surg Clin North Am 2011; 23:547-50, vi. [DOI: 10.1016/j.coms.2011.07.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Sharaf B, Jandali-Rifai M, Susarla SM, Dodson TB. Do Perioperative Antibiotics Decrease Implant Failure? J Oral Maxillofac Surg 2011; 69:2345-50. [DOI: 10.1016/j.joms.2011.02.095] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2010] [Revised: 02/01/2011] [Accepted: 02/18/2011] [Indexed: 11/29/2022]
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Evidence for Survival of Implants Placed into Infected Sites is Limited. J Evid Based Dent Pract 2011; 11:95-6. [DOI: 10.1016/j.jebdp.2011.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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