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Antibiotic prophylaxis during dental implant placement in the UK

British Dental Journal volume 229, pages 787–792 (2020)Cite this article

Abstract

Background Antimicrobial resistance is a growing concern globally. It has previously been demonstrated that antibiotic prescribing for dental implants within the UK is varied with an apparent lack of guidance. This study aimed to establish current use of antibiotic prophylaxis during dental implant placements in the UK.

Method An anonymous validated online questionnaire was distributed to members of the BAOS, BSSPD, BSP, ADI and ITI. Data were then collated and analysed.

Results Two hundred and twenty-nine responses were received during April-July 2018. Fifty-five percent of dentists routinely prescribed antibiotics during implant placements. One-third did sometimes, but not routinely. Thirteen percent never prescribed. Reported protocols contained 61 different drug/dose combinations given over 124 different regimens. Those who prescribed routinely had significantly higher levels of training/qualification (P = 0.008), placed more implants (P = 0.014) and undertook more complex placements (P = 0.002) than non-prescribers. Seventy-three percent believed antibiotics decrease post-operative infection. One in ten felt they gave no benefit. Half believed they decrease implant failure. Over 90% would like national guidelines.

Conclusion Significant variance in practice is clear. Almost half of practitioners did not routinely prescribe. Those who did were significantly more experienced, highly trained and did more complex placements. There was a difference between practitioners' perceived benefits of antibiotic prophylaxis and the evidence in the literature. There was a great desire for clearer guidance.

Key points

  • Protocols for antibiotic prophylaxis during dental implant placement vary enormously across the UK and the rest of the world.

  • Routine antibiotic prescribing appears to have decreased in the UK since 2012 but is still used by the majority of practitioners.

  • There is an overwhelming desire for clear guidance within the profession.

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References

  1. Diffenthal R. The sky's the limit with implant dentistry. 2020. Available at: https://www.dentistry.co.uk/2018/02/20/skys-limit-implant-dentistry/ (accessed April 2020).

  2. Adell R, Lekholm U, Rockler B, Brånemark P I. A 15-year study of osseointegrated implants in the treatment of the edentulous jaw. Int J Oral Surg 1981; 10: 387-416.

  3. Chrcanovic B R, Albrektsson T, Wennerberg A. Prophylactic antibiotic regimen and dental implant failure: a meta-analysis. J Oral Rehab 2014; 41: 941-956.

  4. Ata-Ali J, Ata-Ali F. Do antibiotics decrease implant failure and postoperative infections? A systematic review and meta-analysis. Int J Oral Maxillofac Surg 2014; 43: 68-74.

  5. Lund B, Hultin M, Tranæus S, Naimi-Akbar A, Klinge B. Complex systematic review - Perioperative antibiotics in conjunction with dental implant placement. Clin Oral Implants Res 2015; 26(S11): 1-14.

  6. Park J, Tennant M, Walsh L, Kruger E. Is there a consensus on antibiotic usage for dental implant placement in healthy patients? Aust Dent J 2018 Mar; 63: 25-33.

  7. Keenan J R, Veitz-Keenan A. Antibiotic prophylaxis for dental implant placement? Evid Based Dent 2015; 16: 52-53.

  8. Singh Gill A, Morrissey H, Rahman A. A Systematic Review and Meta-Analysis Evaluating Antibiotic Prophylaxis in Dental Implants and Extraction Procedures. Medicina (Kaunas) 2018; 54: 95.

  9. Esposito M, Grusovin M G, Worthington H V. Interventions for replacing missing teeth: antibiotics at dental implant placement to prevent complications. Cochrane Database Syst Rev 2013; 7: CD004152. DOI: 10.3390/medicina54060095.

  10. Klinge B, Flemming T, Cosyn J et al. The patient undergoing implant therapy. Summary and consensus statements. The 4th EAO Consensus Conference 2015. Clin Oral Implants Res 2015; 26(S11): 64-67.

  11. World Health Organisation. Antibiotic resistance: multi-country public awareness survey. 2015. Available at https://www.who.int/drugresistance/documents/baselinesurveynov2015/en/ (accessed October 2020).

  12. O'Neill J. Tackling Drug-resistant Infections Globally: Final Report and Recommendations. 2016. Available at https://amr-review.org/sites/default/files/160518_Final%20paper_with%20cover.pdf (accessed October 2020).

  13. Jisc. Online Surveys (formerly BOS). 2018. Available at https://www.onlinesurveys.ac.uk/ (accessed July 2019).

  14. Ireland R S, Palmer N O, Lindenmeyer A, Mills N. An investigation of antibiotic prophylaxis in implant practice in the UK. Br Dent J 2012; 213: E14. DOI: 10.1038/sj.bdj.2012.960.

  15. Faculty of General Dental Practice. Antimicrobial Prescribing for General Dental Practitioners. 2014. Available at https://www.fgdp.org.uk/antimicrobial-prescribing-standards/contents (accessed April 2020).

  16. Arteagoitia I, Rodríguez-Andrés C, Rodríguez-Sánchez F. Antibiotic prophylaxis habits in dental implant surgery among dentists in Spain. A cross-sectional survey. Med Oral Patol Oral Cir Bucal 2018;23: e608-e618. DOI: 10.4317/medoral.22626.

  17. Rodríguez Sánchez F, Arteagoitia I, Rodríguez Andrés C, Caiazzo A. Antibiotic prophylaxis habits in oral implant surgery among dentists in Italy: a cross-sectional survey. BMC Oral Health 2019;19: 265.

  18. Roíguez Sánchez F, Arteagoitia I, Roíguez Anés C, Bruers J. Antibiotic prophylaxis prescribing habits in oral implant surgery in the Netherlands: a cross-sectional survey. BMC Oral Health 2019;19: 281.

  19. Deeb G R, Soung G Y, Best A M, Laskin D M. Antibiotic prescribing habits of oral and maxillofacial surgeons in conjunction with routine dental implant placement. J Oral Maxillofac Surg 2015; 73: 1926-1931.

  20. Khalil D, Hultin M, Andersson Fred L, Parkbring Olsson N, Lund B. Antibiotic prescription patterns among Swedish dentists working with dental implant surgery: adherence to recommendations. Clin Oral Implants Res 2015; 26: 1064-1069.

  21. Tan W C, Ong M, Han J et al. Effect of systemic antibiotics on clinical and patient-reported outcomes of implant therapy - a multicentre randomized controlled clinical trial. Clin Oral Implants Res 2014; 25: 185-193.

  22. Ahmad N, Saad N. Effects of antibiotics on dental implants: a review. J Clin Med Res 2012; 4: 1.

  23. Department of Health and Social Care. UK Five Year Antimicrobial Resistance Strategy 2013 to 2018. 2013. Available at: https://www.gov.uk/government/publications/uk-5-year-antimicrobial-resistance-strategy-2013-to-2018 (accessed April 2020).

  24. Public Health England. Antibiotic Guardian. 2014. Available at https://www.antibioticguardian.com/ (accessed April 2020).

  25. Joint Formulary Committee. British National Formulary (online). Available at https://bnf.nice.org.uk/treatment-summary/antibacterials-use-for-prophylaxis.html (accessed April 2020).

  26. Abu-Ta'a M, Quirynen M, Teughels W, van Steenberghe D. Asepsis during periodontal surgery involving oral implants and the usefulness of peri-operative antibiotics: a prospective, randomized, controlled clinical trial. J Clin Periodontol 2008; 35: 58-63.

  27. General Dental Council. Standards for the Dental Team. 2013. Available at https://www.gdc-uk.org/information-standards-guidance/standards-and-guidance/standards-for-the-dental-team (accessed April 2020).

  28. National Institute for Health and Care Excellence (NICE). Prophylaxis against infective endocarditis: antimicrobial prophylaxis against infective endocarditis in adults and children undergoing interventional procedures. 2008. Available at https://www.nice.org.uk/guidance/CG64 (accessed October 2020).

  29. Thornhill M H, Dayer M J, Forde J M et al. Impact of the NICE guideline recommending cessation of antibiotic prophylaxis for prevention of infective endocarditis: before and after study. BMJ 2011; 342: DOI: 10.1136/bmj.d2392.

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Acknowledgements

I would like to give thanks to Professor Ireland for generously sharing the questionnaire and results from his 2012 study. Thank you also to all of the colleagues who took the time to contribute to this study.

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  1. Wirral University Teaching Hospitals, Oral and Maxillofacial Surgery, Arrowe Park Hospital, Upton, Wirral, WRL CH49 5PE, UK

    Robert G. M. Williams

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Correspondence to Robert G. M. Williams.

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Williams, R. Antibiotic prophylaxis during dental implant placement in the UK. Br Dent J 229, 787–792 (2020). https://doi.org/10.1038/s41415-020-2352-6

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