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Influence of a single preoperative dose of antibiotics on the early implant failure rate. A randomized clinical trial

Journal article
Authors Hossein Kashani
Jack Hilon
Madi Hasan Rasoul
Bertil Friberg
Published in Clinical Implant Dentistry and Related Research
Volume 21
Issue 2
Pages 278-283
ISSN 1523-0899
Publication year 2019
Published at Institute of Odontology
Institute of Clinical Sciences, Department of Biomaterials
Pages 278-283
Language en
Keywords antibiotics, dental implant surgery, failures, microbiology, survival rate, osseointegrated oral implants, perioperative antibiotics, edentulous, jaws, prophylaxis, endocarditis, multicenter, placement, immediate, survival, therapy, Dentistry, Oral Surgery & Medicine, one hh, 1979, annals of surgery, v189, p691
Subject categories Dentistry


Background The use of a preoperative single dose of antibiotics as routine in conjunction with implant surgery is controversial, in light of the unclear effect on early implant failure rate and risk for development of resistant bacterial strains. Purpose This randomized clinical trial compared the early implant failure rates in two different patient cohorts: One group receiving a single dose of preoperative antibiotics (AB group) and one group receiving no antibiotics, prior to implant surgery (noAB group). Materials and Methods Patients were referred for treatment at four specialist clinics in the county council of West Sweden, Vastra Gotaland and randomly assigned into one of the two groups. A total of 447 patients received 963 implants were included in the study. Of these, 223 patients (535 implants) belonged to the AB-group and 224 patients (428 implants) to the noAB-group. Four commercial implant brands were utilized, albeit one system was only represented with four implants. The outcome was evaluated after 4 months using either a one-stage or two-stage procedure. The surgical procedures were performed by experienced implant surgeons and the surgical protocol for implant placement follows standard. Failure was defined as removal of an implant for any reason. The study outcomes were statistically analyzed to evaluate the differences between the two groups. Results Twelve implants failed in 11 patients for the AB group, and 32 implants failed in 29 patients for the noAB group. Preoperative antibiotics, AB group, had significantly (P < 0.0011) lower implant failure 2.2% compared to 7.5% in the noAB group analyzed on implant level adjusted for dependence within patients, OR = 0.30, 95% confidence interval (0.14-0.62). Conclusion Administration of a single dose of antibiotics in conjunction with implant placement surgery resulted in a statistically significant lower early implant failure rate compared to when no antibiotics were used.

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