Binahmed Abduaziz, Stoykewych Andrew, Peterson Larry
Oral and Maxillofacial Surgery, University of Manitoba, Winnipeg, Manitoba, Canada.
Int J Oral Maxillofac Implants. 2005 Jan-Feb;20(1):115-7.
The purpose of this prospective study was to compare the efficacy of prophylactic antibiotic regimens commonly used in dental implant surgery. Preoperative single-dose and long-term prophylactic antibiotic regimens were compared.
This was a 2-center prospective study in which 215 patients underwent ambulatory endosseous implant placement. In the first group, 445 dental implants were placed in 125 patients after the administration of a single preoperative dose of prophylactic antibiotic with no postoperative antibiotics. In the second group, 302 dental implants were placed in 90 patients who received a preoperative dose of antibiotics and were instructed to take antibiotics postoperatively for 7 days. In both groups, 0.12% chlorhexidine pre- and postoperative mouth rinses were used. Patients returned for postoperative evaluation at 1 week, 2 weeks, and just prior to surgical uncovering. The surgical sites were assessed for pain, swelling, erythema, and purulence.
In the first group, 3 patients developed wound dehiscence at 5 implant sites and 1 developed a minor inflammatory response. None of the patients in this group received further antibiotics. In the second group, 3 patients developed wound dehiscence, 2 developed an inflammatory response, and 1 was diagnosed with infection, for which another course of antibiotics was required. There was no statistical difference between the 2 groups according to the Fisher 2 x 4 exact test (P = .56).
Indiscriminate use of antibiotics is unacceptable in clinical practice today. Surgeons must adhere to basic principles to gain the most benefit from the use of prophylactic antibiotics.
Long-term prophylactic antibiotic use in implant surgery was of no advantage or benefit over a single-dose preoperative antibiotic regimen in this patient population.
本前瞻性研究旨在比较牙种植手术中常用的预防性抗生素方案的疗效。比较术前单剂量和长期预防性抗生素方案。
这是一项2中心前瞻性研究，215例患者接受了非卧床骨内种植体植入。第一组，125例患者在术前单次给予预防性抗生素且术后不使用抗生素后植入445颗牙种植体。第二组，90例患者植入302颗牙种植体，这些患者术前接受一剂抗生素，并被指示术后服用抗生素7天。两组患者术前和术后均使用0.12%洗必泰漱口水。患者在术后1周、2周以及手术暴露前返回进行术后评估。评估手术部位的疼痛、肿胀、红斑和化脓情况。
第一组，3例患者在5个种植部位出现伤口裂开，1例出现轻微炎症反应。该组患者均未接受进一步的抗生素治疗。第二组，3例患者出现伤口裂开，2例出现炎症反应，1例被诊断为感染，为此需要再进行一个疗程的抗生素治疗。根据Fisher 2×4确切概率检验，两组之间无统计学差异（P = 0.56）。
在当今的临床实践中，滥用抗生素是不可接受的。外科医生必须遵循基本原则，以从预防性抗生素的使用中获得最大益处。
在该患者群体中，种植手术中长期预防性使用抗生素相对于术前单剂量抗生素方案并无优势或益处。
