Is it possible to decrease the occurrence of dental implant failures through the use of preventative antibiotics?

Evid Based Dent. 2023 Sep;24(3):110-111. doi: 10.1038/s41432-023-00907-2. Epub 2023 Jul 4.

Abstract

Design: The research was a randomized placebo-controlled clinical trial evaluating the use of clindamycin as a preoperative medication to prevent the dental implant.

Aim: The purpose of the study was to assess if giving a single dose of 600 mg oral clindamycin 1 h before a conventional dental implant procedure could reduce the risk of early implant failure and post-surgical complications in healthy adults.

Methods: A clinical trial was conducted with ethical standards, utilizing a randomized, double-blind, placebo-controlled approach. Healthy adults who required a single oral implant and had no previous surgical site infection or need for bone grafting were enrolled. Before surgery, participants were given either oral clindamycin or placebo at random. A single surgeon performed all operations, and patients were observed by a trained professional on multiple postoperative days. The study considered early dental implant failure as the loss or removal of an implant. Clinical, radiological, and surgical data were analyzed statistically to identify group differences. The number of subjects needed to treat, or harm, was calculated.

Results: The research involved two groups of 31 patients each: the control group and the clindamycin group. Two patients in the clindamycin group experienced implant failures (NNH = 15, p = 0.246). Three patients in the study had postoperative infections; two of them were from the placebo group, while one from the clindamycin group had an unsuccessful treatment outcome. The relative risk was 0.5, with a CI of 0.05-5.23 and an absolute risk reduction of 0.03. The confidence interval was -0.07-0.13, and the NNT was 31, with a CI of 7.2-∞ and p = 0.5. In addition, only one patient treated with clindamycin reported gastrointestinal disturbances and diarrhea.

Conclusions: There is no conclusive evidence to suggest that administering clindamycin prior to oral implant surgery in healthy adults reduces the risk of implant failure or post-surgical complications.

Publication types

  • Randomized Controlled Trial
  • Comment

MeSH terms

  • Adult
  • Anti-Bacterial Agents* / therapeutic use
  • Antibiotic Prophylaxis
  • Clindamycin / therapeutic use
  • Dental Implants*
  • Humans
  • Surgical Wound Infection / drug therapy
  • Surgical Wound Infection / prevention & control

Substances

  • Anti-Bacterial Agents
  • Dental Implants
  • Clindamycin