A prospective observational study on perioperative use of antibacterial agents in implant surgery

Dental implant surgery has become routine practice for replacing missing teeth. Little is known about the use of local antisepsis to control the development of bacterial plaque and to facilitate healing, as current practice guidelines do not address this issue.

The objectives of this study were to describe antiseptic practices for implant surgery and to assess plaque control at the operative site as well as the investigator's satisfaction.

This prospective, observational study conducted in 4 European countries enrolled 911 adult patients receiving a single or multiple implant on the day of inclusion. Any medication prescribed during the preor postoperative periods was documented, particularly antibiotics, antiseptic mouthwashes and topical antiseptic gels. At a follow-up visit, the presence of plaque was documented on teeth adjacent to the implant and its extent determined using the Silness-Löe index.

Oral antibiotics were prescribed prior to surgery in 53.8% of the patients. Antiseptic mouthwashes were prescribed to patients (49.6-65.7%) according to country. Following dental implant placement, 84.1-94.7% of patients were prescribed oral antibiotics, 45.6-86.5% of patients were prescribed antiseptic mouthwash and 72.8-100% of patients were prescribed an antiseptic gel. At the follow-up visit, plaque was observed in 45.4% of the patients. The mean Silness-Löe plaque index was 0.7 or 0.8, indicating a low level of plaque accumulation. The Löe and Silness gingival index was 0.6 or 0.7, which is consistent with a low level of gingival inflammation.

Use of antibiotics preand post-surgery is frequent in implant surgery, despite it being discouraged in practice guidelines. Use of antiseptic mouthwashes and topical antiseptic gels is widespread, although treatment paradigms vary widely. Practice guidelines covering antisepsis provision would be useful, since those products could be used as an alternative to antibiotics to facilitate wound healing.