Influence of a single preoperative dose of antibiotics on the early implant failure rate. A randomized clinical trial
Influence of a single preoperative dose of antibiotics on the early implant failure rate. A randomized clinical trial
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DOI：
10.1111/cid.12724
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发表时间：
2019-04-01
影响因子：
3.6
通讯作者：
Friberg, Bertil
中科院分区：
文献类型：
--
作者：
Kashani, Hossein;Hilon, Jack;Friberg, Bertil
背景：术前常规使用单剂量抗生素与种植体手术相结合是有争议的，因为目前尚不清楚抗生素对早期种植失败率和耐药菌株发展风险的影响。本随机临床试验比较了两组不同患者的早期种植失败率：一组在术前接受单剂量抗生素（AB组），一组在种植手术前不接受抗生素（noAB组）。材料和方法患者被转介到瑞典西部Vastra Gotaland县议会的四个专科诊所接受治疗，并随机分为两组之一。共有447名患者接受了963个种植体纳入研究。其中，223例患者（535个种植体）属于ab组，224例患者（428个种植体）属于noab组。使用了四个商业种植体品牌，尽管一个系统只代表四个种植体。4个月后使用一期或两期手术评估结果。手术过程由经验丰富的种植外科医生进行，种植体放置的手术方案遵循标准。失败被定义为由于任何原因取出植入物。对研究结果进行统计学分析，评价两组间的差异。结果AB组11例12颗种植体失败，noAB组29例32颗种植体失败。术前抗生素AB组种植体失败率（P < 0.0011）显著低于noAB组（P < 0.0011），前者为2.2%，后者为7.5%，经患者内部依赖调整后的种植体水平，OR = 0.30, 95%可信区间为0.14-0.62。结论与不使用抗生素相比，单剂量抗生素联合种植体置入术可显著降低早期种植失败率。
Background The use of a preoperative single dose of antibiotics as routine in conjunction with implant surgery is controversial, in light of the unclear effect on early implant failure rate and risk for development of resistant bacterial strains.Purpose This randomized clinical trial compared the early implant failure rates in two different patient cohorts: One group receiving a single dose of preoperative antibiotics (AB group) and one group receiving no antibiotics, prior to implant surgery (noAB group).Materials and Methods Patients were referred for treatment at four specialist clinics in the county council of West Sweden, Vastra Gotaland and randomly assigned into one of the two groups. A total of 447 patients received 963 implants were included in the study. Of these, 223 patients (535 implants) belonged to the AB-group and 224 patients (428 implants) to the noAB-group. Four commercial implant brands were utilized, albeit one system was only represented with four implants.The outcome was evaluated after 4 months using either a one-stage or two-stage procedure. The surgical procedures were performed by experienced implant surgeons and the surgical protocol for implant placement follows standard. Failure was defined as removal of an implant for any reason. The study outcomes were statistically analyzed to evaluate the differences between the two groups.Results Twelve implants failed in 11 patients for the AB group, and 32 implants failed in 29 patients for the noAB group. Preoperative antibiotics, AB group, had significantly (P < 0.0011) lower implant failure 2.2% compared to 7.5% in the noAB group analyzed on implant level adjusted for dependence within patients, OR = 0.30, 95% confidence interval (0.14-0.62).Conclusion Administration of a single dose of antibiotics in conjunction with implant placement surgery resulted in a statistically significant lower early implant failure rate compared to when no antibiotics were used.