بسم الله الرحمن الرحیم هست کلید در گنج حکیم

ANTIMICROBIAL AGENTS FOR AVOIDING SURGICAL SITE INFECTION IN IMPLANT SURGERY Dr Alireza Talebian ResearchGate Score: Dr Roghayeh Iranpoor

REFERENCE: 1- GUIDELINES FOR INFECTION CONTROL IN DENTAL HEALTH- CARE SETTINGS — AVAILABLE AT: 2- GUIDELINE FOR PREVENTION OF SURGICAL SITE INFECTION, 1999 AVAILABLE AT: 3-USE OF ANTIBIOTICS IN DENTAL IMPLANT SURGERY: A DECISION BASED ON EVIDENCE FROM SYSTEMATIC REVIEW INTERNATIONAL JOURNAL OF ODONTOSTOMATOLOGY 9(1): , 2015 AVAILABLE FREELY AT:

 Presence of bacterial biofilms, overheating, and surgical trauma are considered the main reasons of early implant failure. Oral microbes Surgical Site Infection Implant Failure

In medicine: According to a CDC document, any graft, prostheses, or implant can be infected with Staphylococcus strains and antimicrobial prophylaxis is indicated Reference No 2 Page 255. It is applicable for dental implants.

In 2015, In a systematic review (by Claudia Asenjo-Lobos; Jorge Jofre; Marcela Cortes & Manterola Carlos), from 164 articles reviewed, 11 fulfilled the selection criteria representing 9472 placed implants. Antibiotics regimens used are as follows: Pre-operative only: 2 grs Amoxicillin PO 1 hour before surgery 1 gr Penicillin V PO 1 hour before surgery or 600 mg Clindamycin PO 1 hour before surgery Pre-operative + postoperative: Slowly unit (Pen G) IV or 600mg (Clynda) IV mg (Pen V) P.O. 4 times/day for 7 days or 150 mg (Clynda) P.O. 3 times/day for 7 days 2 g Pen V P.O. 2 times/day for 1 week postoperatively, the first dose being given1 hour preoperatively. 2 g Amox P.O. 1 hour preoperatively + postoperative doses of 500 mg 3 times/day for 5 days 2 g Amox P.O 1 hour preoperatively + 1 g 2 times/day for 7 days postoperatively 500 mg (Azithro/Clari) P.O. 1h preoperatively+500mg P.O.6h after+500mg P.O. 18h after Postoperative only: Amoxicillin/Clavulanic acid 625 mg P.O. 3 times/day for 5 days postoperatively. Amoxicillin 1 g P.O. 2 times/day postoperatively continued for 1 week.

Additionally, it should be considered that most dental implants are located in previously compromised sites with a certain degree of infection which could be a main risk for infection and risk of implant failure. (Nelson & Thomas, 2010)

Follow-up Periods varied from 7 to 180 days as indicated in the table bellow

Implant failures are as follows:

Antibiotic Adverse effects. Overall, antibiotics were well tolerated by patients. No participant presented hypersensitivity reactions. People using prophylaxis antibiotics had very low frequency of gastrointestinal effects.

Conclusion: Despite the study limitations, antibiotic prophylaxis seems to yield a favorable effect, particularly when used in regimens considering postoperative antibiotics.

Preprocedural Mouth Rinses 1)Antimicrobial mouth rinses used by patients before a dental procedure are intended to reduce the number of microorganisms the patient might release in the form of aerosols or spatter that subsequently can contaminate DHCP and equipment operatory surfaces. 2)In addition, preprocedural rinsing can decrease the number of microorganisms introduced in the patient’s bloodstream during invasive dental procedures Reference No 1 page 32 Therefore preprocedural mouth rinses (e.g. chlorhexidine) has synergistic effect on antibiotic therapy.