Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
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Index Copernicus  – 161.11; MEiN – 140 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
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Advances in Clinical and Experimental Medicine

2020, vol. 29, nr 3, March, p. 355–363

doi: 10.17219/acem/115087

Publication type: experimental paper

Language: English

License: Creative Commons Attribution 3.0 Unported (CC BY 3.0)

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A prospective observational study on perioperative use of antibacterial agents in implant surgery

Marzena Dominiak1,A,C,D,E,F, Stanislava Shuleva2,A,B,C,D,E,F, Spiridon Silvestros3,A,C,D,E,F, Gil Alcoforado4,A,C,D,E,F

1 Department of Oral Surgery, Wroclaw Medical University, Poland

2 Private practice, Sofia, Bulgaria

3 Department of Prosthodontics, Dental School National and Kapodistrian University of Athens, Greece

4 Private practice, Lisbon, Portugal


Background. Dental implant surgery has become routine practice for replacing missing teeth. Little is known about the use of local antisepsis to control the development of bacterial plaque and to facilitate healing, as current practice guidelines do not address this issue.
Objectives. The objectives of this study were to describe antiseptic practices for implant surgery and to assess plaque control at the operative site as well as the investigator’s satisfaction.
Material and Methods. This prospective, observational study conducted in 4 European countries enrolled 911 adult patients receiving a single or multiple implant on the day of inclusion. Any medication prescribed during the preor postoperative periods was documented, particularly antibiotics, antiseptic mouthwashes and topical antiseptic gels. At a follow-up visit, the presence of plaque was documented on teeth adjacent to the implant and its extent determined using the Silness–Löe index.
Results. Oral antibiotics were prescribed prior to surgery in 53.8% of the patients. Antiseptic mouthwashes were prescribed to patients (49.6–65.7%) according to country. Following dental implant placement, 84.1–94.7% of patients were prescribed oral antibiotics, 45.6–86.5% of patients were prescribed antiseptic mouthwash and 72.8–100% of patients were prescribed an antiseptic gel. At the follow-up visit, plaque was observed in 45.4% of the patients. The mean Silness–Löe plaque index was 0.7 or 0.8, indicating a low level of plaque accumulation. The Löe and Silness gingival index was 0.6 or 0.7, which is consistent with a low level of gingival inflammation.
Conclusion. Use of antibiotics preand post-surgery is frequent in implant surgery, despite it being discouraged in practice guidelines. Use of antiseptic mouthwashes and topical antiseptic gels is widespread, although treatment paradigms vary widely. Practice guidelines covering antisepsis provision would be useful, since those products could be used as an alternative to antibiotics to facilitate wound healing.

Key words

dental implants, chlorhexidine, antibacterial agents, antiseptic gel, mouthwash

References (26)

  1. Ramanauskaite A, Baseviciene N, Wang HL, Tozum TF. Effect of history of periodontitis on implant success: Meta-analysis and systematic review. Implant Dent. 2014;23(6):687–696.
  2. Quirynen M, Herrera D, Teughels W, Sanz M. Implant therapy: 40 years of experience. Periodontol 2000. 2014;66(1):7–12.
  3. Dunlap J. Implants: Implications for general dentists. Dent Econ. 1988;78(10):101–102,104,106 passim.
  4. American Academy of Implant Dentistry. Facts and figures on dental implants
  5. Jung RE, Pjetursson BE, Glauser R, Zembic A, Zwahlen M, Lang NP. A systematic review of the 5-year survival and complication rates of implant-supported single crowns. Clin Oral Implants Res. 2008;19(2):119–130.
  6. Pjetursson BE, Tan K, Lang NP, Bragger U, Egger M, Zwahlen M. A systematic review of the survival and complication rates of fixed partial dentures (FPDs) after an observation period of at least 5 years. Clin Oral Implants Res. 2004;15(6):625–642.
  7. Association of Dental Implantology. A Dentist’s Guide to Implantology. London, UK: ADI; 2012.
  8. Zitzmann NU, Berglundh T. Definition and prevalence of peri-implant diseases. J Clin Periodontol. 2008;35(8 Suppl):286–291.
  9. Figuero E, Graziani F, Sanz I, Herrera D, Sanz M. Management of peri-implant mucositis and peri-implantitis. Periodontol 2000. 2014;66(1):255–273.
  10. Bornstein MM, Al-Nawas B, Kuchler U, Tahmaseb A. Consensus statements and recommended clinical procedures regarding contemporary surgical and radiographic techniques in implant dentistry. Int J Oral Maxillofac Implants. 2014;29(Suppl):78–82.
  11. Heitz-Mayfield LJ, Needleman I, Salvi GE, Pjetursson BE. Consensus statements and clinical recommendations for prevention and management of biologic and technical implant complications. Int J Oral Maxillofac Implants. 2014;29(Suppl):346–350.
  12. Ad Hoc Committee for the Development of Dental Implant Guidelines. Guidelines for the provision of dental implants. Int J Oral ­Maxillofac Implants. 2008;23(3):471–473.
  13. Sanz M, Donos N, Alcoforado G, et al. Therapeutic concepts and methods for improving dental implant outcomes. Summary and consensus statements. The 4th EAO Consensus Conference 2015. Clin Oral Implants Res. 2015;26(Suppl 11):202–206.
  14. Academy of Osseointegration. 2010 Guidelines of the Academy of Osseointegration for the provision of dental implants and associated patient care. Int J Oral Maxillofac Implants. 2010;25(3):620–627.
  15. van Waas MA, Denissen HW, de Koomen HA, et al. Dutch consensus on guidelines for superstructures on endosseous implants in the edentulous mandible. J Oral Implantol. 1991;17(4):390–392.
  16. Santé HA. Conditions de réalisation des actes d’implantologie orale: Environnement technique. Rev Stomatol Chir Maxillo-faciale. 2008;109(5):334–340.
  17. Hammad HM, Hammad MM, Abdelhadi IN, Khalifeh MS. Effects of topically applied agents on intra-oral wound healing in a rat model: A clinical and histomorphometric study. Int J Dent Hyg. 2011;9(1):9–16.
  18. Löe H, Silness J. Periodontal disease in pregnancy. I. Prevalence and severity. Acta Odontol Scand. 1963;21(6):533–551.
  19. Rebelo MAB, De Queiroz AC. Gingival indices: State of art. In: Panagakos F, Davies R, eds. Gingival Diseases: Their Aetiology, Prevention and Treatment. London, UK: InTech; 2011:41–54.
  20. Park J, Tennant M, Walsh LJ, Kruger E. Is there a consensus on antibiotic usage for dental implant placement in healthy patients? Aust Dent J. 2018;63(1):25–33.
  21. 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.
  22. Esposito M, Grusovin MG, Coulthard P, Oliver R, Worthington HV. The efficacy of antibiotic prophylaxis at placement of dental implants: A Cochrane systematic review of randomised controlled clinical trials. Eur J Oral Implantol. 2008;9(Suppl 1(2)):95–103.
  23. Ahmad N, Saad N. Effects of antibiotics on dental implants: A review. J Clin Med Res. 2012;4(1):1–6.
  24. Lawler B, Sambrook PJ, Goss AN. Antibiotic prophylaxis for dentoalveolar surgery: Is it indicated? Aust Dent J. 2005;50(4 Suppl 2):S54–59.
  25. Agence française de sécurité sanitaire des produits de santé. Prescription des antibiotiques en pratique buccodentaire. Med Mal Infect. 2012;42(5):193–202.
  26. Esposito M, Grusovin MG, Polyzos IP, Felice P, Worthington HV. Timing of implant placement after tooth extraction: Immediate, immediate-delayed or delayed implants? A Cochrane systematic review. Eur J Oral Implantol. 2010;3(3):189–205.