Effect of Postoperative Amoxicillin on Early Bacterial Colonization of Peri-Implant Sulcus: A Randomized Controlled Clinical Trial
Objectives: With side effects of antibiotics taken into consideration, the necessity of antibiotic therapy after simple implant placement procedures is still a subject of debate and the existing literature on this topic is widely controversial. The aim of this study was to assess the effect of postoperative amoxicillin therapy on early colonization of peri-implant sulcus after implant placement.
Materials and Methods: In this randomized controlled clinical trial, 20 patients requiring simple implant placement were randomly allocated to test or control groups and received postoperative amoxicillin or placebo, respectively. Microbiological samples were collected on day 0 and day 7. Mann Whitney and Wilcoxon signed rank tests were utilized to evaluate changes in colony count of identified bacterial species between the test and control groups, and between day 0 and day 7.
Results: The decrease in the number of sensitive facultative species and the increase in the number of resistant anaerobes in amoxicillin group were statistically significant as compared to the placebo group (P=0.025 and P=0.005, respectively). The increase in the number of sensitive anaerobes in the placebo group as compared to amoxicillin group, and the decrease in the number of facultative Gram-positive cocci as compared to the placebo group were statistically significant (P=0.011 and P=0.035, respectively).
Conclusions: Postoperative administration of amoxicillin resulted in an increase in the number of resistant anaerobes and a decrease in the number of sensitive facultative bacteria and facultative Gram-positive cocci, as compared to the placebo, but with no sign/symptom of infection in any group.
- Mombelli A, Marxer M, Gaberthuel T, Grunder U, Lang NP. The microbiota of osseointegrated implants in patients with a history of periodontal disease. J Clin Periodontol. 1995 Feb;22(2):124-30.
- Quirynen M, Papaioannou W, van Steenberghe D. Intraoral transmission and the colonization of oral hard surfaces. J Periodontol. 1996 Oct;67(10):986-93.
- Covani U, Marconcini S, Crespi R, Barone A. Bacterial plaque colonization around dental implant surfaces. Implant Dent. 2006 Sep;15(3):298-304.
- Costerton JW, Montanaro L, Arciola CR. Biofilm in implant infections: its production and regulation. Int J Artif Organs. 2005 Nov;28(11):1062-8.
- Zitzmann NU, Berglundh T, Marinello CP, Lindhe J. Experimental peri-implant mucositis in man. J Clin Periodontol. 2001 Jun;28(6):517-23.
- Bolukbasi N, Ozdemir T, Oksuz L, Gurler N. Bacteremia following dental implant surgery: preliminary results. Med Oral Patol Oral Cir Bucal. 2012 Jan 1;17(1):e69-75.
- Esposito M, Grusovin MG, Loli V, Coulthard P, Worthington HV. Does antibiotic prophylaxis at implant placement decrease early implant failures? A Cochrane systematic review. Eur J Oral Implantol. 2010;3(2):101-10.
- Krasny M, Krasny K, Zadurska M, Fiedor P. Evaluation of treatment outcomes and clinical indications for antibiotic prophylaxis in patients undergoing implantation procedures. Adv Med Sci. 2016 Mar;61(1):113-6.
- 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 Nov;86(11):1190-200.
- Tan WC, Ong M, Han J, Mattheos N, Pjetursson BE, Tsai AY, et al. Effect of systemic antibiotics on clinical and patient-reported outcomes of implant therapy - a multicenter randomized controlled clinical trial. Clin Oral Implants Res. 2014;25(2):185-93.
- Dent CD, Olson JW, Farish SE, Bellome J, Casino AJ, Morris HF, et al. The influence of preoperative antibiotics on success of endosseous implants up to and including stage II surgery: a study of 2,641 implants. J Oral Maxillofac Surg. 1997 Dec;55(12 Suppl 5):19-24.
- Gynther GW, Köndell 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.
- Morris HF, Ochi S, Plezia R, Gilbert H, Dent CD, Pikulski J, et al. AICRG, Part III: The influence of antibiotic use on the survival of a new implant design. J Oral Implantol. 2004;30(3):144-51.
- Hossein K, Dahlin C, Bengt A. Influence of different prophylactic antibiotic regimens on implant survival rate: a retrospective clinical study. Clin Implant Dent Relat Res. 2005 Jan;7(1):32-5.
- de Moraes Rego MR, Torres MF, Santiago LC, Lira-Junior R, Lourenço EJ, de Moraes Telles D, et al. Osseointegrated implants placed at supracrestal level may harbour higher counts of A. gerencseriae and S. constellatus - a randomized, controlled pilot study. J Oral Microbiol. 2015 Oct 23;7:27685.
- Mazzocchi A, Passi L, Moretti R. Retrospective analysis of 736 implants inserted without antibiotic therapy. J Oral Maxillofac Surg. 2007 Nov;65(11): 2321-3.
- Abu-Ta'a M, Quirynen M, Teughels W, van Steenberghe D. Asepsis during periodontal surgery involving oral implants and the usefulness of peri-operative antibiotics: a prospective, randomized, controlled clinical trial. J Clin Periodontol. 2008 Jan;35(1):58-63.
- Esposito M, Cannizzaro G, Bozzoli P, Consolo U, Felice P, Ferri V, et al. Efficacy of prophylactic antibiotics for dental implants: a multicentre placebo-controlled randomised clinical trial. Eur J Oral Implantol. 2008 Spring;1(1):23-31.
- Furst MM, Salvi GE, Lang NP, Persson GR. Bacterial colonization immediately after installation on oral titanium implants. Clin Oral Implants Res. 2007 Aug;18(4):501-8.
- Sreenivasan PK, Gittins E. Effects of low dose chlorhexidine mouthrinses on oral bacteria and salivary microflora including those producing hydrogen sulfide. Oral Microbiol Immunol. 2004 oct;19(5):309-13.
- Kaur SP, Rao R, Nanda S. Amoxicillin: a broad spectrum antibiotic. Int J Pharm Pharm Sci. 2011;3(3):30-7.
- Kuula H, Könönen E, Lounatmaa K, Konttinen YT, Könönen M. Attachment of oral gram-negative anaerobic rods to a smooth titanium surface: an electron microscopy study. Int J Oral Maxillofac Implants. 2004 Nov-Dec;19(6):803-9.
- Kulkarni S, Dodwad V, Chava V. Healing of periodontal flaps when closed with silk sutures and N-butyl cyanoacrylate: a clinical and histological study. Indian J Dent Res. 2007 Apr-Jun;18(2):72-7.
- Aruni AW, Dou Y, Mishra A, Fletcher HM. The biofilm community-rebels with a cause. Curr Oral Health Rep. 2015 Mar;2(1):48-56.
- Pitout JD, Sanders CC, Sanders WE Jr. Antimicrobial resistance with focus on beta-lactam resistance in gram-negative bacilli. Am J Med. 1997 Jul;103(1):51-9.
- Mombelli A. Microbiology of the dental implant. Adv Dent Res. 1993 Aug;7(2):202-6.
- Sbordone L, Barone A, Ramaglia L, Ciaglia RN, Iacono VJ. Antimicrobial susceptibility ofperiodontopathic bacteria associated with failing implants. J Periodontol. 1995 Jan;66(1):69-74.
- Esposito M, Coulthard P, Oliver R, Thomsen P, Worthington HV. Antibiotics to prevent complications following dental implant treatment. Cochrane Database Syst Rev. 2003; (3):CD004152