Department of Oral Health, Faculty of Dental Medicine, Université de Montréal, Montreal, QC, Canada.
Department of Dental Medicine, Université de Montréal Hospital Center (CHUM), Montreal, QC, Canada.
Clin Oral Implants Res. 2021 Nov;32(11):1318-1327. doi: 10.1111/clr.13832. Epub 2021 Sep 12.
The primary objective of this study was to assess whether giving postoperative antibiotics to healthy patients after straightforward platform-switched implant placement would influence peri-implant crestal bone levels and postoperative morbidity after 1 year.
Thirty-eight healthy individuals were recruited in this pilot, randomized, double-blinded, placebo-controlled clinical trial. The intervention group (n = 18) received two grams of amoxicillin one hour before implant placement followed by a 7 days postoperative regimen (500 mg tid). The control group (n = 20) took the same preoperative dose of amoxicillin and an identical placebo postoperatively. Mesial and distal peri-implant crestal bone levels were measured at baseline, four months and one year later with standardized periapical radiographs. Postoperative pain severity was assessed through self-administered questionnaires for 7 days. Surgery-associated morbidities were evaluated after one, three, 16 weeks and 1 year. Descriptive and bivariate analyses were used.
Thirty-seven participants completed the trial. At the one-year follow-up, the mean combined peri-implant crestal bone changes for the intervention (n = 18) and control (n = 19) groups were - 0.44 ± 0.41 mm and - 0.27 ± 0.56 mm, respectively. The difference between the groups (intervention-control) for mean combined crestal bone level changes was not statistically significant. There were no significant differences in surgery-associated morbidities between the intervention and control groups. The one-year implant survival rate was 100% in both groups.
Study results suggest that a routine postoperative antibiotic regimen for healthy patients undergoing straightforward platform-switched implant placement might not be necessary to prevent postoperative peri-implant bone loss and complications.
本研究的主要目的是评估在简单平台转换种植体植入后，对健康患者给予术后抗生素是否会影响术后 1 年时种植体周围嵴骨水平和术后发病率。
本试验为一项前瞻性、随机、双盲、安慰剂对照的临床试验，共招募了 38 名健康个体。干预组（n=18）在植入前 1 小时给予 2 克阿莫西林，然后进行为期 7 天的术后治疗（500mg tid）。对照组（n=20）在植入前给予相同剂量的阿莫西林和术后相同的安慰剂。在基线、4 个月和 1 年后，使用标准化的根尖片测量近中和远中种植体周围嵴骨水平。通过自我管理问卷评估术后 7 天的疼痛严重程度。在术后 1、3、16 周和 1 年评估与手术相关的发病率。采用描述性和双变量分析。
37 名参与者完成了试验。在 1 年随访时，干预组（n=18）和对照组（n=19）的种植体周围嵴骨总变化平均值分别为-0.44±0.41mm 和-0.27±0.56mm。组间（干预组-对照组）平均嵴骨水平变化差异无统计学意义。干预组和对照组之间在手术相关发病率方面无显著差异。两组的 1 年种植体存活率均为 100%。
研究结果表明，对于接受简单平台转换种植体植入的健康患者，常规术后抗生素方案可能不是预防术后种植体周围骨丢失和并发症所必需的。
