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Karagah A, Tabrizi R, Mohammadhosseinzade P, Mirzadeh M, Tofangchiha M, Lajolo C, Patini R. Effect of Sinus Floor Augmentation with Platelet-Rich Fibrin Versus Allogeneic Bone Graft on Stability of One-Stage Dental Implants: A Split-Mouth Randomized Clinical Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159569. [PMID: 35954926 PMCID: PMC9367838 DOI: 10.3390/ijerph19159569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 07/31/2022] [Accepted: 08/02/2022] [Indexed: 02/04/2023]
Abstract
Rehabilitation of an edentulous posterior maxilla with dental implants is challenging, and sinus floor augmentation could be considered as an important surgical procedure for bone augmentation in this region before implant placement. Platelet-rich fibrin (PRF) is a new-generation platelet concentrate with simplified processing: its application in sinus floor augmentation has been widely investigated in literature. However, the biological properties and actual efficacy of this product remain controversial. This study assessed the effect of sinus floor augmentation with PRF versus freeze-dried bone allograft (FDBA) on stability of one-stage dental implants. This split-mouth randomized clinical trial evaluated 10 patients who required bilateral sinus floor augmentation. PRF and L-PRF membrane were used in one quadrant while FDBA and collagen membrane were used in the other quadrant. Implant stability was assessed by resonance frequency analysis (RFA) immediately, and 2, 4, and 6 months after implant placement. The implant stability quotient (ISQ) was compared over time and between the two groups using repeated measures ANOVA and independent sample t-test. The mean ISQ significantly increased over time in both groups (p < 0.001). The increase was greater in the PRF group (p < 0.05). Within the limitations of this study, PRF yielded superior results compared with FDBA regarding the stability of one-stage dental implants.
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Affiliation(s)
- Aida Karagah
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Qazvin University of Medical Sciences, Qazvin 34199-15315, Iran
| | - Reza Tabrizi
- Department of Oral and Maxillofacial Surgery, Shahid Beheshti University of Medical Sciences, Tehran 11151-19857, Iran
| | | | - Monirsadat Mirzadeh
- Metabolic Diseases Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin 34199-15315, Iran
| | - Maryam Tofangchiha
- Department of Oral and Maxillofacial Radiology, Dental Caries Prevention Research Center, Qazvin University of Medical Sciences, Qazvin 34199-15315, Iran
- Correspondence: (M.T.); (C.L.); Tel.: +98-9121825156 (M.T.); +39-0630154286 (C.L.); Fax: +98-2833353066 (M.T)
| | - Carlo Lajolo
- Department of Head, Neck and Sense Organs “Fondazione Policlinico Universitario A. Gemelli-IRCCS”, School of Dentistry, Catholic University of Sacred Heart, 00168 Rome, Italy
- Correspondence: (M.T.); (C.L.); Tel.: +98-9121825156 (M.T.); +39-0630154286 (C.L.); Fax: +98-2833353066 (M.T)
| | - Romeo Patini
- Department of Head, Neck and Sense Organs “Fondazione Policlinico Universitario A. Gemelli-IRCCS”, School of Dentistry, Catholic University of Sacred Heart, 00168 Rome, Italy
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Bedeloğlu E, Yalçın M, Koyuncuoğlu CZ. Is Perioperative Antibiotic Necessary in Straightforward Implant Placement Procedures? J ORAL IMPLANTOL 2021; 47:135-139. [PMID: 32663852 DOI: 10.1563/aaid-joi-d-19-00282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The purpose of this nonrandom retrospective cohort study was to evaluate the impact of perioperative antibiotic on early outcomes, including postoperative pain, swelling, bleeding, and cyanosis, in patients undergoing dental implant placement before prosthetic loading. Seventy-five patients (45 men, 30 women) who had completed dental implant placement were included in the study. Patients who used perioperative antibiotics comprised the experimental group, and those who did not comprised the control group. The experimental group received 2 g amoxicillin + clavulanic acid 1 hour before surgery and 1 g amoxicillin + clavulanic acid twice a day for 5 days after surgery. The control group received no perioperative antibiotic therapy. Data on pain, swelling, bleeding, cyanosis, flap dehiscence, suppuration, and implant failure were analyzed on postoperative days 2, 7, and 14 and at week 12. No statistically significant difference was detected between the 2 groups with regard to pain and swelling on postoperative days 2, 7, and 14 and week 12 (P > .05), while the severity of pain and swelling were greater on day 2 than on days 7 and 14 and week 12 in both groups (P = .001 and P < .05, respectively). Similarly, no significant difference was found between the 2 groups with regard to postoperative bleeding and cyanosis. Although flap dehiscence was more severe on day 7 in the experimental group, no significant difference was found between the 2 groups with regard to the percentage of flap dehiscence assessed at other time points. Within the limitations of the study, it has been demonstrated that antibiotic use has no effect on implant failure rates in dental implant surgery with a limited number of implants. We conclude that perioperative antibiotic use may not be required in straightforward implant placement procedures. Further randomized controlled clinical studies with more patients and implants are needed to substantiate our findings.
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Affiliation(s)
- Elçin Bedeloğlu
- Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Istanbul Aydın University, Istanbul, Turkey
| | - Mustafa Yalçın
- Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Gaziantep University, Gaziantep, Turkey
| | - Cenker Zeki Koyuncuoğlu
- Faculty of Dentistry, Department of Periodontology, İstanbul Aydın University, Istanbul Turkey
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Klinge A, Khalil D, Klinge B, Lund B, Naimi-Akbar A, Tranaeus S, Hultin M. Prophylactic antibiotics for staged bone augmentation in implant dentistry. Acta Odontol Scand 2020; 78:64-73. [PMID: 31483177 DOI: 10.1080/00016357.2019.1656819] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Background: The objective of the study was to assess the effect of prophylactic antibiotics on the outcome of bone augmentation and subsequent dental implant placement by combining the recommended quality assessment methods for systematic reviews and primary studies.Materials and methods: This is a complex systematic review in which systematic reviews as well as primary studies are scrutinised. A search of Medline (OVID), The Cochrane Library (Wiley) and EMBASE, PubMed and Health technology assessment (HTA) organisations as-well as a complementary hand-search was carried out. Selected primary studies were assessed using GRADE. Each study was reviewed by three authors independently.Results: Abstract screening yielded six potential systematic reviews allocated for full-text inspection. A total of ten primary studies were read in full-text. No relevant systematic reviews regarding the topic of this article were found. The quality assessment resulted in two primary studies with a moderate risk of bias. Of the two studies with a moderate risk of bias, one compared a single dose of clindamycin 600 mg preoperatively with the same preoperative dose followed by four doses of 300 mg every 6 h. The second study compared a single dose prophylaxis of two different types of antibiotic compounds.Conclusion: In conclusion, the scientific evidence regarding the use of antibiotic prophylaxis for reducing the risk of infection in conjunction with bone augmentation procedures during dental implant placement is very limited. The infection rate as compared to nonusage of prophylactic antibiotics, selection of the most suitable compound, and the optimal duration of prophylactic treatment is still unknown.
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Affiliation(s)
- Anna Klinge
- Department of Oral and Maxillofacial Surgery and Oral Medicine, Malmö University, Malmö, Sweden
| | - Dalia Khalil
- Department of Dental Medicine, Division of Periodontology, Karolinska Institutet, Stockholm, Sweden
| | - Björn Klinge
- Department of Dental Medicine, Division of Periodontology, Karolinska Institutet, Stockholm, Sweden
- Department of Periodontology, Malmö University, Malmö, Sweden
- Health Technology Assessment-Odontology (HTA-O), Malmö University, Malmö, Sweden
| | - Bodil Lund
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
- Department of Oral and Maxillofacial Surgery, Haukeland University Hospital, Bergen, Norway
| | - Aron Naimi-Akbar
- Health Technology Assessment-Odontology (HTA-O), Malmö University, Malmö, Sweden
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Sofia Tranaeus
- Health Technology Assessment-Odontology (HTA-O), Malmö University, Malmö, Sweden
- Department of Dental Medicine, Division of Cariology, Karolinska Institutet, Stockholm, Sweden
| | - Margareta Hultin
- Department of Dental Medicine, Division of Periodontology, Karolinska Institutet, Stockholm, Sweden
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Braun RS, Chambrone L, Khouly I. Prophylactic antibiotic regimens in dental implant failure: A systematic review and meta-analysis. J Am Dent Assoc 2019; 150:e61-e91. [PMID: 31010572 DOI: 10.1016/j.adaj.2018.10.015] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 10/17/2018] [Accepted: 10/22/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND In this systematic review and meta-analysis, the authors examine the efficacy of antibiotic prophylaxis (AP) and specific antibiotic regimens for prevention of dental implant failure in patients who are healthy overall. TYPES OF STUDIES REVIEWED The authors independently conducted electronic database and manual searches to identify randomized controlled trials (RCTs). The authors selected articles on the basis of eligibility criteria and assessed for risk of bias by using the Cochrane Handbook. Implant failure was the primary outcome studied; perimucositis or implantitis, prosthetic failure, and adverse events were secondary outcomes studied. The authors conducted random effects meta-analysis for risk ratios of dichotomous data and used OpenMeta[Analyst] (Center for Evidence Synthesis, Brown School of Public Health) for qualitative assessment of administration schedules. RESULTS With duplicates removed, the authors screened 1,022 abstracts, reviewed 21 full-text articles, and included 8 RCTs that included 2,869 implants in 1,585 patients. Meta-analysis results indicated that AP resulted in a statistically significantly lower number of implant failures for all regimens combined (implant, P = .005; patient, P = .002), as well as preoperative (implant, P = .01; patient, P = .007), pre- and postoperative (implant, P = .04), and postoperative AP only (implant, P = .02), compared with no antibiotics. The authors found no statistically significant differences in analysis of comparative antibiotic treatments or secondary outcomes. The authors identified confounding variables. CONCLUSIONS AND PRACTICAL IMPLICATIONS Although meta-analysis results suggested that AP may reduce implant failure, definitive conclusions cannot be achieved yet. The overall nonsignificant differences reported in individual trials, limitations discussed, implant infection outcomes, and antibiotic-associated risks must be considered. Thus, the results for implant failure outcomes may not warrant the indiscriminate use of antibiotics in patients who are healthy who are receiving dental implants. Investigators must conduct large-scale RCTs to determine the efficacy of AP and various regimens, independent of confounding variables.
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Khouly I, Braun RS, Chambrone L. Antibiotic prophylaxis may not be indicated for prevention of dental implant infections in healthy patients. A systematic review and meta-analysis. Clin Oral Investig 2019; 23:1525-1553. [DOI: 10.1007/s00784-018-2762-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 10/17/2018] [Indexed: 01/23/2023]
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Pattern of Antibiotic Prescription for Oral Implant Treatment Among Dentists in Saudi Arabia. IMPLANT DENT 2018; 27:317-323. [DOI: 10.1097/id.0000000000000748] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Lund B, Hultin M, Tranaeus S, Naimi-Akbar A, Klinge B. Complex systematic review - Perioperative antibiotics in conjunction with dental implant placement. Clin Oral Implants Res 2015; 26 Suppl 11:1-14. [PMID: 26080862 DOI: 10.1111/clr.12637] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2015] [Indexed: 12/25/2022]
Abstract
OBJECTIVES The aim of this study was to revisit the available scientific literature regarding perioperative antibiotics in conjunction with implant placement by combining the recommended methods for systematic reviews and complex systematic reviews. MATERIAL AND METHODS A search of Medline (OVID), The Cochrane Library (Wiley), EMBASE, PubMed and Health technology assessment (HTA) organizations was performed, in addition to a complementary hand-search. Selected systematic reviews and primary studies were assessed using GRADE and AMSTAR, respectively. A meta-analysis was performed. RESULTS The literature search identified 846 papers of which 10 primary studies and seven systematic reviews were included. Quality assessment of the systematic reviews revealed two studies of moderate risk of bias and five with high risk of bias. The two systematic reviews of moderate risk of bias stated divergent numbers needed to treat (NNT) to prevent one patient from implant failure. Four of the primary studies comparing antibiotic prophylaxis with placebo were estimated to be of low, or moderate, risk of bias and subjected to meta-analysis. The NNT was 50 (pooled RR 0.39, 95% CI 0.18, 0.84; P = 0.02). None of these four studies individually show a statistical significant benefit of antibiotic prophylaxis. Furthermore, narrative analysis of the studies eligible for meta-analysis reveals clinical heterogeneity regarding intervention and smoking. CONCLUSION Antibiotic prophylaxis in conjunction with implant placement reduced the risk for implant loss by 2%. However, the sub-analysis of the primary studies suggests that there is no benefit of antibiotic prophylaxis in uncomplicated implant surgery in healthy patient.
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Affiliation(s)
- Bodil Lund
- Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.,Department of Oral and Maxillofacial Surgery, Karolinska University Hospital, Huddinge, Sweden
| | - Margareta Hultin
- Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Sofia Tranaeus
- Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.,Swedish Council on Health Technology Assessment, Stockholm, Sweden.,Department of Periodontology, Faculty of Odontology, Malmo University, Malmo, Sweden
| | - Aron Naimi-Akbar
- Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.,Department of Oral and Maxillofacial Surgery, Karolinska University Hospital, Huddinge, Sweden
| | - Björn Klinge
- Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.,Department of Periodontology, Faculty of Odontology, Malmo University, Malmo, Sweden
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Quirynen M, Herrera D, Teughels W, Sanz M. Implant therapy: 40 years of experience. Periodontol 2000 2014; 66:7-12. [DOI: 10.1111/prd.12060] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2013] [Indexed: 12/30/2022]
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