Oseointegracion

J Clin Periodontol 2008; 35: 58–63 doi: 10.1111/j.1600-051X.2007.01162.x

Asepsis during periodontal surgery involving oral implants and the usefulness of peri-operative antibiotics: a prospective, randomized, controlled clinical trial
Abu-Ta’a M, Quirynen M, Teughels W, van Steenberghe D. Asepsis during periodontal surgery involving oral implants and the usefulness of peri-operativeantibiotics: a prospective, randomized, controlled clinical trial. J Clin Periodontol 2008; 35: 58–63. doi: 10.1111/j.1600-051X.2007.01162.x. Abstract Objectives: This randomized clinical trial compares the usefulness of pre- and postoperative antibiotics while strict asepsis was followed during periodontal surgery. Material and Methods: Two groups of 40 consecutive patients each with fully or partiallyedentulous jaws were enrolled. Antibiotics group (GrAB1): 23 men, mean age 60, 128 implants, received oral amoxicillin 1 g, 1 h pre-operatively and 2 g for 2 days post-operatively. Non-antibiotics group (GrAB À ): 20 men, mean age 57, 119 implants, received no antibiotics. Bacterial samples were taken from the peri-oral skin before and at the end of surgery. In 12 patients in each group, sampleswere also taken from the nares. A VAS questionnaire evaluated symptoms of infection/ inflammation by both the patient and the periodontologist at suture removal. Results: There were no significant differences between both groups, neither for the clinical parameters nor for the microbiota. Staphylococcus aureus was detected in the nares of one patient only. The patients’ subjective perception ofpost-operative discomfort was significantly smaller in the group receiving antibiotics. Three patients lost one or two implants. Conclusions: Antibiotics do not provide significant advantages concerning postoperative infections in case of proper asepsis. It also does not reduce peri-oral microbial contamination. It does on the other hand reduce post-operative discomfort.

Mahmoud Abu-Ta’a1, MarcQuirynen1, Wim Teughels1 and Daniel van Steenberghe1,2
Department of Periodontology, School of Dentistry, Oral Pathology and Maxillofacial Surgery, Faculty of Medicine; 2Holder of P-I ˚ Branemark Chair in Osseointegration, Catholic University of Leuven, Leuven, Belgium
1

Key words: antibiotic prophylaxis; implant surgery; nose cap; periodontology; postoperative infection; Staphylococcus aureusAccepted for publication 18 September 2007

Clinical disinfection appeared in surgery in the 19th century when Semmelweiss
Conflict of interests and source of funding statement

The authors declare that they have no conflict of interests. No external funding, apart from the support of the authors’ institution, was available for this study.

suggested that it was the medical personnel who infectedpatients by moving from the autopsy to the delivery rooms without performing proper clinical aseptic measures. Around the same time Lister, influenced by the work of Louis Pasteur, believed it was possible to reduce post-operative infections by using carbolic acid to purify the air during surgery (Salvi et al. 2006).

Periodontal surgical procedures carry with them an inherent risk of developingcomplications such as infections. It is especially important to avoid peri-operative infection of the wound during surgery, when foreign bodies are implanted (Haanaes 1990). Indeed, biofilm-shielded microbial colonization on the surface of the latter is much more resistant to antimicrobials than their planctonic form (Gristina et al. 1989).

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r 2007 The Authors. Journal compilation r 2007Blackwell Munksgaard

Asepsis during periodontal surgery
Even though periodontologists and oral surgeons often prescribe antibiotics routinely following gingivectomy (Stahl et al. 1969), osseous resective (Kidd & Wade 1974), regenerative (Cortellini & Bowers 1995), and implant-related surgery (Dent et al. 1997), the validity of such tradition remains unsubstantiated. The side-effects of...