Comparative Effect of Different Preoperative Antibiotics on Dental Implant Failure: A Retrospective Cohort Study.

BACKGROUND: There is a lack of standardized guidelines for the prescription of antibiotics prior to implant surgery. The purpose of this study was to compare the effect of different antibiotics preoperatively on dental implant treatment outcome. METHODS: This retrospective analysis involved a cohort of patients who received dental implant treatment at ten university dental clinics participating in the BigMouth network. All patients records who received antibiotic medication prior to implant surgery including amoxicillin, amoxicillin/clavulanic acid, clindamycin, azithromycin, ciprofloxacin, doxycycline, and metronidazole were analysed. The treatment outcome was assessed as a binary outcome, classified as either survival or failure of the implant. RESULTS: A total of 41,135 implants inserted in 17,483 individuals and followed-up for a mean time of 81 +/- 52.33 months. The implant failure rate was 3% at the patient level and 1.6% at the implant level. Hispanic and non-Hispanic ethnic groups showed higher likelihood to have an implant failure than other races, as well as White and African-American races, were more likely to experience implant loss compared to Hispanic patients. Implants placed in patients who received Ciprofloxacin preoperatively showed significantly lower cumulative survival implant time than those who had amoxicillin. CONCLUSIONS: Within the limitations of this retrospective study, premedication with Ciprofloxacin led to statistically significant lower implant survival time than with amoxicillin. Future prospective randomized clinical trials are needed to validate the present findings.