Sat - By Appointment
July 22, 2016
This review, carried out by authors of the Cochrane Oral Health Group, has been produced to assess the possible benefits of antibiotics taken orally at the time of the placement of a dental implant in order to prevent infection. If antibiotics are shown to be of benefit in preventing infection, this review also seeks to establish which type, dosage and duration of treatment is the most effective. The use of antibiotics to prevent infection in implant dentistry is controversial, and there is a need to answer these questions in order to improve the success rates of dental implants whilst minimising complications, harms or adverse effects.
Missing teeth can sometimes be replaced with dental implants to which a crown, bridge or denture can be attached. Bacteria introduced during the placement of implants can lead to infection, and sometimes implant failure. Infections around biomaterials (such as dental implants) are difficult to treat and almost all infected implants have to be removed, which is why it is so important to prevent infection if possible.
It has been suggested that taking antibiotics orally either before or after placement (or both) can minimise the chances of infection.
Generally the use of antibiotics in surgery in order to prevent infection is only recommended for people at risk, when surgery is extensive, or performed in infected sites, and when large foreign materials are implanted in the body. Recently, a short term course of antibiotics has been recommended when antibiotics have to be used, because sometimes antibiotics can cause side effects that range from diarrhoea to life-threatening allergic reactions. Another major concern associated with the widespread use of antibiotics is the increase in the appearance of antibiotic-resistant bacteria.
The evidence on which this review is based was up to date as of 17 June 2013. Six trials were included with a total of 1162 participants.
All six of these trials compared the use of antibiotics to prevent infection (failures and complications) with no treatment or treatment with a placebo (a fake medicine with no active ingredient). The antibiotic used in all the trials was amoxicillin; doses and timing of doses varied, although most used a single dose taken just before the implant was placed. One of the trials, with 100 participants, also looked at different doses of amoxicillin taken at different times.
There were no trials that looked at alternative antibiotics.
Participants were people over 18 years of age who were able to give consent to taking part in a medical trial. Potential participants were excluded for a variety of reasons that included: if they were at risk of heart disease, had artificial joints, had problems with their immune system, were affected by diabetes, had received radiotherapy in the head and neck area, had need of additional procedures at the time of implant placement, were allergic to penicillin, had chronic/acute infections near the planned implant site, were already receiving antibiotic treatment for any other reasons (or had taken them up to six months previously), had been treated with or were receiving intravenous amino-bisphosphonates, were pregnant or breast feeding, were receiving long-term nonsteroidal anti-inflammatory drug therapy, or had blood clotting problems. The follow-up period in all the trials was at least three months.
It appears that the oral administration of two grams of amoxicillin one hour before placement of dental implants is effective in reducing implant failures. More specifically, giving antibiotics to 25 people will avoid one person experiencing early implant losses. It is still unclear whether postoperative antibiotics are beneficial, or which antibiotics work best.
Quality of the evidence
The evidence from the six trials (1162 participants) that compared the use of antibiotics with placebo or no treatment was considered to be of moderate quality. However, the one trial (100 participants) that investigated antibiotics given for different lengths of time was found to be at high risk of bias.
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The dentist is very friendly and gentle during procedures.
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The atmosphere in this office is beyond believe, I instantly felt comfortable with Dr Dimitiri and his assistant Yuri. They work great together. I had 6 veneers put in and...
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Vlad Shishko (Sunny Isles, FL)
Very good cleaning
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A Center for Dental Excellence is fantastic. They’re understanding and extremely competent. Not only is the dental care itself excellent, but their quality of caring about their patients is unparalleled....
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I have lived and worked all over North America. One of the greatest challenges of relocating is finding the best dental practice. "Center For Dental Excellence" was recommended to me...
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I always have a great experience when I come here, the staff is wonderful and I would not change my dental office for anything in the world.. Jessica is amazing...
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The receptionist goes above and be on for the customers. Excellent service the doctor treats you with all his attention feels like I’m right at home and explain everything detailed....
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I’ve been coming here for almost 10 years now and can surely say that the customer service provided is one of the best in town. Make sure to be nice...
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Fast service and the best staff! I highly recommend this Dentist. I've been going to this Dentist for 2 years and I travel far now just to come here. They...
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I recommend this place to anyone that needs any type of dental work done , I always feel welcome from the moment i sign in untill my visit is over...
Lyn F (Wellington, FL)
Thank you doctor for my beautiful smile!
V V (Hollywood, FL)
I take my 90yr great grandmother to this office and they are so kind and she feels so loved here. Every visit she receives excellent service and quality work. Thank...
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Love the staff and great service!!
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I finally found a great dentist who does its all, root canals, caps, and implants. I needed major work on my mouth all at once, although it was expensive because...
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This is the Best Dental Office I ever was. Great personality, gentle touch and perfectionism in all aspects of cosmetic dentistry. Thank you Dr. Gorbatov for creating Smile I always...
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Very impressed with Dr. Gorbatov's ethics. He truly cared about my situation, the fact that I was from another city and had limited time off of work to address my...
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Been going here forever and they do an excellent job with all your dental needs and even with cosmetic dentistry as well!