**Antibiotics in Implant Dentistry**

Dalia Khalil, Bodil Lund and Margareta Hultin

Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/62681

#### **Abstract**

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18 Dental Implantology and Biomaterial

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evolving-practice/clinical-complications-of-dental-implants

Antibiotics have been recommended either as an extended treatment for several days or as a single antibiotic prophylaxis dose since the development of dental implant osseointegration technique in the 1970s. It is also performed as part of surgical protocol during the peri-operative phase in the treatment of peri-implantitis. To date, there is a lack of scientific evidence regarding the additive effect of antibiotics in the treatment of dental implant. This has thus left the clinician with inconclusive recommendations, leading to increase antibiotic prescription. With this increase, the development of antibiotic resistance is becoming a threat to modern healthcare that requires revisiting of current indications and implementation of rational treatment strategies. Therefore, more studies are needed to assess the benefit of antibiotic prescription and whether it is safe to refrain from its use.

**Keywords:** Dental implant failure, dental implant surgery, antibiotic prophylaxis, treatment of peri-implantitis, selection of antibiotic resistance

### **1. Introduction**

Since the introduction of dental implants as treatment for missing teeth, systemically admin‐ istered antibiotics have been used to prevent and treat implant failure. In conjunction with implant placement, antibiotics have been recommended either as extended treatment or shortterm prophylaxis during the peri-operative period. In the treatment of peri-implantitis, the majority of surgical flap protocols described in the literature also include administration of systemic antibiotics in the peri-operative phase.

Today, antibiotic resistance is the largest threat to modern healthcare where many treatment options, including advanced surgical interventions, require access to effective antibiotics [1].

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Therefore, original or consensus-based recommendations, such as the use of antibiotics in implant dentistry, are being reevaluated. Previous policies of prescribing antibiotics, until it is proven safe to refrain from their use, are today considered an outdated option in otherwise healthy patients. Currently, the potential risk of using antibiotics must be weighed against possible benefits for individual patients when undergoing dental implant treatment.

A dental implant is a titanium device anchored and integrated into the jawbone. Osseointe‐ grated dental implants have been an established treatment modality for replacing missing teeth since the beginning of the 1970s [2]. A substantial number of studies using long-term follow-ups have shown successful results for patients with partially and completely edentu‐ lous jaws [3–8]. Survival rates of 90–100% of inserted implants have been reported in several longitudinal studies during follow-ups of up to 20 years later [4, 9–14]. Despite the high success rate of dental implants, failures do occur.

Biological implant failures may be categorized into early failures, that is, failure to achieve osseointegration due to surgical trauma, infection, lack of primary stability [15], or late failures, that is, failure to maintain the achieved osseointegration, due to occlusal overload, periimplantitis, or both [15]. Implant failure is an outcome that may require implant removal [15].
