Comparison Between Two Different Antibiotic Regimens for the Placement of Dental Implants
Summary
In order to prevent infections and complications, it has been initially established with the dental implant placement protocol that pre- and post-operative antibiotics should be prescribed to the patient receiving dental implants. There have been many antibiotic regimens used in the attempt to minimize the risks of infections and consequently, increasing the survival rate of dental implants placement procedures. However, issues about bacterial resistance have been raised recently concerning the extensive use of antibiotics. The primary objective of this study is to find out whether giving antibiotics before or after implant placement would significantly influence crestal bone loss around dental implants. One study group will receive one dosage of antibiotics before implant placement followed by post-operative intake of antibiotics for 7 days. Another group will receive the antibiotics in one single preoperative dose followed by an identical placebo for 7 days. Questionnaires for pain and interference with daily activities assessment to be filled for the first postoperative week will be distributed to participants. Signs of postoperative morbidity will be recorded at 1 and 3 weeks following the surgery, and both clinical and radiographic data will be collected at 4 months postoperative to assess the implants status. A radiographic follow-up will be done 1 year after the surgery. Peri-implant crevicular fluid levels of 3 known immunological markers for bone loss (MMP-8, sRANKL and OPG) will be measured at 1-, 3- and 16-weeks follow-ups. The findings from this study might allow clinicians to establish the ideal antibiotic regimen with minimal risk exposure to bacterial resistance.
Timeline
- Start
- 2014-07
- Primary completion
- 2017-05-01
- Completion
- 2017-05-01
Publications
- Background Doern GV. Resistance among problem respiratory pathogens in pediatrics. Pediatr Infect Dis J. 1995 May;14(5):420-3. doi: 10.1097/00006454-199505001-00003.
- Background Levy SB. Antibiotic resistance-the problem intensifies. Adv Drug Deliv Rev. 2005 Jul 29;57(10):1446-50. doi: 10.1016/j.addr.2005.04.001.
- Background Arias CA, Murray BE. Antibiotic-resistant bugs in the 21st century--a clinical super-challenge. N Engl J Med. 2009 Jan 29;360(5):439-43. doi: 10.1056/NEJMp0804651. No abstract available.
- Background Bidault P, Chandad F, Grenier D. Risk of bacterial resistance associated with systemic antibiotic therapy in periodontology. J Can Dent Assoc. 2007 Oct;73(8):721-5.
- Background Bingen E, Leclercq R, Fitoussi F, Brahimi N, Malbruny B, Deforche D, Cohen R. Emergence of group A streptococcus strains with different mechanisms of macrolide resistance. Antimicrob Agents Chemother. 2002 May;46(5):1199-203. doi: 10.1128/AAC.46.5.1199-1203.2002.
- Background Guillemot D, Carbon C, Balkau B, Geslin P, Lecoeur H, Vauzelle-Kervroedan F, Bouvenot G, Eschwege E. Low dosage and long treatment duration of beta-lactam: risk factors for carriage of penicillin-resistant Streptococcus pneumoniae. JAMA. 1998 Feb 4;279(5):365-70. doi: 10.1001/jama.279.5.365.
- Background Schrag SJ, Pena C, Fernandez J, Sanchez J, Gomez V, Perez E, Feris JM, Besser RE. Effect of short-course, high-dose amoxicillin therapy on resistant pneumococcal carriage: a randomized trial. JAMA. 2001 Jul 4;286(1):49-56. doi: 10.1001/jama.286.1.49.
- Background Gynther GW, Kondell PA, Moberg LE, Heimdahl A. Dental implant installation without antibiotic prophylaxis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998 May;85(5):509-11. doi: 10.1016/s1079-2104(98)90281-5.
- Background Laskin DM, Dent CD, Morris HF, Ochi S, Olson JW. The influence of preoperative antibiotics on success of endosseous implants at 36 months. Ann Periodontol. 2000 Dec;5(1):166-74. doi: 10.1902/annals.2000.5.1.166.
- Background Kashani H, Dahlin C, Alse'n B. Influence of different prophylactic antibiotic regimens on implant survival rate: a retrospective clinical study. Clin Implant Dent Relat Res. 2005;7(1):32-5. doi: 10.1111/j.1708-8208.2005.tb00044.x.
- Background Esposito M, Worthington HV, Loli V, Coulthard P, Grusovin MG. Interventions for replacing missing teeth: antibiotics at dental implant placement to prevent complications. Cochrane Database Syst Rev. 2010 Jul 7;(7):CD004152. doi: 10.1002/14651858.CD004152.pub3.
- Background Ata-Ali J, Ata-Ali F, Ata-Ali F. Do antibiotics decrease implant failure and postoperative infections? A systematic review and meta-analysis. Int J Oral Maxillofac Surg. 2014 Jan;43(1):68-74. doi: 10.1016/j.ijom.2013.05.019. Epub 2013 Jun 26.
- Background Ireland RS, Palmer NO, Lindenmeyer A, Mills N. An investigation of antibiotic prophylaxis in implant practice in the UK. Br Dent J. 2012 Oct;213(8):E14. doi: 10.1038/sj.bdj.2012.960.
- Background Manz MC. Factors associated with radiographic vertical bone loss around implants placed in a clinical study. Ann Periodontol. 2000 Dec;5(1):137-51. doi: 10.1902/annals.2000.5.1.137.
- Background Arikan F, Buduneli N, Lappin DF. C-telopeptide pyridinoline crosslinks of type I collagen, soluble RANKL, and osteoprotegerin levels in crevicular fluid of dental implants with peri-implantitis: a case-control study. Int J Oral Maxillofac Implants. 2011 Mar-Apr;26(2):282-9.
- Background Tsoukaki M, Kalpidis CD, Sakellari D, Tsalikis L, Mikrogiorgis G, Konstantinidis A. Clinical, radiographic, microbiological, and immunological outcomes of flapped vs. flapless dental implants: a prospective randomized controlled clinical trial. Clin Oral Implants Res. 2013 Sep;24(9):969-76. doi: 10.1111/j.1600-0501.2012.02503.x. Epub 2012 Jun 18.
- Background Rakic M, Lekovic V, Nikolic-Jakoba N, Vojvodic D, Petkovic-Curcin A, Sanz M. Bone loss biomarkers associated with peri-implantitis. A cross-sectional study. Clin Oral Implants Res. 2013 Oct;24(10):1110-6. doi: 10.1111/j.1600-0501.2012.02518.x. Epub 2012 Jun 18.
- Background Nolan R, Kemmoona M, Polyzois I, Claffey N. The influence of prophylactic antibiotic administration on post-operative morbidity in dental implant surgery. A prospective double blind randomized controlled clinical trial. Clin Oral Implants Res. 2014 Feb;25(2):252-9. doi: 10.1111/clr.12124. Epub 2013 Feb 13.
- Background Mombelli A, van Oosten MA, Schurch E Jr, Land NP. The microbiota associated with successful or failing osseointegrated titanium implants. Oral Microbiol Immunol. 1987 Dec;2(4):145-51. doi: 10.1111/j.1399-302x.1987.tb00298.x. No abstract available.
- Background Smith DE, Zarb GA. Criteria for success of osseointegrated endosseous implants. J Prosthet Dent. 1989 Nov;62(5):567-72. doi: 10.1016/0022-3913(89)90081-4.
- Background Albrektsson T, Zarb G, Worthington P, Eriksson AR. The long-term efficacy of currently used dental implants: a review and proposed criteria of success. Int J Oral Maxillofac Implants. 1986 Summer;1(1):11-25. No abstract available.
- Background De Bruyn H, Vandeweghe S, Ruyffelaert C, Cosyn J, Sennerby L. Radiographic evaluation of modern oral implants with emphasis on crestal bone level and relevance to peri-implant health. Periodontol 2000. 2013 Jun;62(1):256-70. doi: 10.1111/prd.12004.
Drugs
| Evaluation | Drug | Modality | Dose | Route |
|---|---|---|---|---|
| Comparator | Amoxicillin | Other / unclassified | 500 mg | Oral |
| Comparator | Amoxicillin | Other / unclassified | 2 g | Oral |
Indications
No indication recorded.