(T10) Proper Antibiotic Use in Implant Dentistry from Prophylaxis to Treatment of Infections

Purpose of the Study: Antibiotics are widely prescribed in implant dentistry for prophylaxis and infection management, yet their overuse has contributed to the global crisis of antimicrobial resistance. Despite evidence showing that a single preoperative antibiotic dose significantly reduces early implant failures, many clinicians continue to prescribe prolonged regimens lasting 7–10 days, often without strong evidence-based justification. This study aims to evaluate the effectiveness of single dose of a single-dose antibiotic prophylaxis regimen in implant dentistry and to highlight the clinical consequences of prolonged antibiotic use, including antimicrobial resistance, adverse effects, and increased healthcare costs.

Methods: A literature-based evaluation was conducted by reviewing systematic reviews, meta-analyses, and randomized controlled trials (RCTs) published in the last two decades. Search terms included "antibiotic prophylaxis," "extractions", "bone grafting," "dental implants," "implant survival," "peri-implant infection," and "antimicrobial resistance." Studies were included if they directly compared single-dose prophylaxis with extended regimens, or if they assessed perioperative complications associated with antibiotic use in healthy patients undergoing implant related procedures. Clinical recommendations on antibiotic choice, timing, and dosing regime were derived from evidence-based protocols and high-quality research.

Results: A single preoperative dose of antibiotics (e.g., 2 g amoxicillin 1 hour before surgery; 500 mg azithromycin for penicillin-allergic patients) significantly reduces early implant failures.
Prolonged antibiotic regimens (≥7 days) do not provide additional benefits in implant survival or infection prevention among healthy patients.
Overprescribing is often linked to clinician habit, patient demand, and fear of complications, rather than strong evidence.
Effective prevention of complications relies on evidence-based adjunctive measures: strict aseptic technique, atraumatic surgical procedures, and postoperative care (plaque control, antiseptic rinses, analgesics, and follow-up).
For procedures lasting >4 hours, an additional intraoperative half-dose may provide benefit.
Extended antibiotic use increases risks of antimicrobial resistance, allergic reactions, gastrointestinal upset, candidiasis, and drug interactions.

Conclusion: In conclusion, implementing evidence-based protocols, combined with patient education, is crucial in reducing unnecessary antibiotic prescriptions while ensuring successful surgical outcomes.

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