Preventive Antibiotic Therapy in the Placement of Immediate Implants: A Systematic Review

Abstract

Immediate implants present a high risk of early failure. To avoid this, preventive antibiotics (PAs) are prescribed; however, their inappropriate administration leads to antimicrobial resistance. The present study aims to clarify whether the prescription of PAs reduces the rate of early failure of immediate implants and to establish guidelines to avoid the overprescription of these drugs. An electronic search of the MEDLINE database (via PubMed), Web of Science, Scopus, LILACS and OpenGrey was carried out. The criteria described in the PRISMA® statement were used. The search was temporarily restricted from 2010 to 2021. The risk of bias was analysed using the SIGN Methodological Assessment Checklist for Systematic Reviews and Meta-Analyses and the JBI Prevalence Critical Appraisal Tool. After searching, eight studies were included that met the established criteria. With the limitations of this study, it can be stated that antibiotic prescription in immediate implants reduces the early failure rate. Preoperative administration of 2–3 g amoxicillin one hour before surgery followed by 500 mg/8 h for five to seven days is recommended. It is considered prudent to avoid the use of clindamycin in favour of azithromycin, clarithromycin or metronidazole in penicillin allergy patients until further studies are conducted.

The Effectiveness of a Bioactive Healing Abutment as a Local Drug Delivery System to Impact Peri-Implant Mucositis: A Prospective Case Series Study

“…An animal’s tooth size is significantly different to that of a human, and the diet and chewing function seems to be the next obstacle to providing a reliable animal model to study the action of the bioactive healing abutment. In order to obtain the most reliable data, the study was conducted on humans after obtaining approval from the bioethics committee, as a follow-up of the in vitro study [ 26 ].…”

“…Although published cases have shown promising additional benefits when using systemic antibiotics as an adjunct to non-surgical treatments for peri-implantitis, no randomized clinical trials have been conducted to evaluate the effects of systemic antibiotics, including metronidazole, in addition to conservative treatment of peri-implantitis. Moreover, the justification for the use of systemic antibiotics in the periprocedural period during implantation is being questioned due to the possibility of general complications in the patient, the development of drug-resistant strains and the questionable effectiveness in reducing the number of complications [ 20 , 25 , 26 ]. The current state of medical knowledge prompts the search for modern treatments for peri-implantitis and peri-implant mucositis based on the local application of bacteriostatic and bactericidal drugs [ 24 ].…”

Aspirin/amoxicillin loaded chitosan microparticles and polydopamine modified titanium implants to combat infections and promote osteogenesis

“…Like in any surgery, the wound site is prone to bacterial infection. Although systemic application of antibiotics is enough to reduce the risk of early implantation failure in healthy patients 27 , there may be corresponding side effects such as drug resistance caused by excessive use 28 , damage to systemic organs and allergic reactions. Unlike in the systemic delivery of antibiotics, the application of antibiotics directly or locally to the wound site from implant coatings 7 , 29 , 30 has been reported to accurately and appropriately achieve antibacterial effects as well as reduce implant failure 31 .…”

Analysis of risk factors related to early implant failure: a retrospective study

“…Postoperative antibiotics are frequently used in the oral clinic; in contrast, some surgeons do not use preoperative antibiotic protocols. Nevertheless, preoperative antibiotics could signi cantly promote the survival rate during the healing period [8][9][10][11] .…”