Necessity of Antibiotics After Implants Questioned

Richard Gawel
Image courtesy of Mister GC at


Image courtesy of Mister GC at

Antibiotics are prescribed after implant procedures to prevent implant failure and postoperative complications. Yet there is growing concern that overprescription of antibiotics is producing bacterial resistance, leading to life-threatening illnesses and public health crises. Researchers at the University of North Carolina, Chapel Hill, then, conducted a study to see how necessary antibiotics are after implant surgery.

The double-blind, randomized control trial examined the effects of antibiotics on the clinical outcomes of immediate implant placement upon replacing a tooth with an apical pathology. In each subject, a tooth with a chronic apical lesion was extracted, thoroughly curetted, irrigated, and replaced with a single implant with a screw-retained custom provisional abutment/crown.

The researchers measured postoperative pain and discomfort at one- and 4-week postsurgical follow-up visits using visual analog scales. Also, they measured facial alveolar bone and soft-tissue changes via pre-operative and postoperative CBCT and impressions. They found survival rates of 100% with the antibiotics and 78% with the control.

There was no statistical difference in means for any clinical outcome (t tests with Bonferroni adjustment for multiple testing) except for midfacial soft-tissue changes, though: 0.43 mm (standard deviation [SD], 0.76) in the antibiotics group and 1.70 mm (SD, 1.06) in the placebo group (t15 = -2.89, P = 0.011). The average change of the midfacial alveolar plate was 0.62 mm (SD, 0.46) for the antibiotic group and 1.34 mm (SD, 0.91) for the placebo group.

No significant correlation (Spearman correlation) existed between the changes in facial alveolar bone and the facial gingival margin. The researchers concluded that antibiotics appear to have little effect on immediate implant treatment outcomes. Their study was published by the Journal of Oral Implantology.

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