Bacteraemia following dental implants' placement

To investigate the prevalence, duration and aetiology of bacteraemias following the placement of implants as well as the prophylactic efficacy of a chlorhexidine digluconate (CHX) mouthrinse.

Fifty patients undergoing implant placement were randomly distributed into two groups:

30 patients with no prophylactic intervention before surgery. CHX group: 20 patients who performed a 0.2% CHX mouthrinse before surgery. Blood samples were collected at baseline, at 30 s after the insertion of implants and at 15 min after completion of the suturing of the mucoperiosteal flap. Samples were processed in the Bactec 9240, and the subculture and further identification of the isolates were performed using conventional microbiological techniques.

The prevalence of bacteraemias was 2% at baseline. In the control group, the prevalence of bacteraemias was 6.7% at 30 s and 3.3% at 15 min, but no statistically significant differences were achieved compared with the baseline percentage. In the CHX group, there were no positive cultures from blood samples obtained at 30 s or at 15 min.

Implant placement via a mucoperiosteal flap does not carry a significant risk of developing bacteraemias. The use of antibiotic prophylaxis for the prevention of focal infections such as bacterial endocarditis in "at-risk" patients undergoing dental implants is therefore questionable. Although its efficacy has not been confirmed statistically, we recommend a 0.2% CHX mouthrinse before treatment as proposed previously by the British Society for Antimicrobial Chemotherapy.