Adjunctive antibiotics improved marginal bone level stability post dental implants: Study

A recent study found the efficacy of adjunctive systemic antibiotics in the treatment of peri-implantitis, a condition which poses a significant challenge in dental implantology. The major findings of this study were published in the newest edition of Journal of Clinical Periodontology. This study was conducted by the team led by Caroline Riben Grundström analyzed the clinical, radiographic and microbiological outcomes following surgical intervention, with or without the use of antibiotics.

The study recruited 84 patients overall with peri-implantitis which encompassed a total of 113 implants. The patients were randomly assigned to three groups, where one group received amoxicillin and metronidazole, another received phenoxymethylpenicillin and metronidazole and the third group received a placebo. The treatment protocol involved resective surgery and implant surface decontamination with adjunctive antibiotics or placebo.

Over the course of up to 12 months, the study meticulously evaluated various parameters including probing pocket depth (PPD) reduction, marginal bone level (MBL) stability, bleeding on probing (BOP), suppuration on probing (SOP), mucosal recession (REC), clinical attachment level (CAL), bacterial levels and adverse events.

The findings of the study unveiled notable improvements across all groups in terms of clinical and radiological parameters. But, statistically significant differences were observed between these groups regarding MBL stability and treatment success rates. Antibiotic groups demonstrated superior outcomes when compared to the placebo group with increased MBL stability and greater treatment success rates.

The bacterial levels of specific pathogens associated with peri-implantitis, namely Aggregatibacter actinomycetemcomitans and Tannerella forsythia, expressed a marked reduction in the antibiotic groups by further highlighting the efficacy of adjunctive antibiotic therapy in controlling microbial colonization. Also, the study identified antibiotic use as a potential prognostic indicator for treatment success that emphasized the pivotal role of antibiotics in achieving favorable treatment outcomes.

Amidst the promising results, the outcomes illuminated the importance of carefully weighing the benefits against the risks associated with antibiotic therapy. Gastrointestinal disorders were observed as the most reported adverse events in the antibiotic groups that emphasized the need for meticulous consideration of potential side effects and the looming threat of antibiotic resistance. This study offers valuable inputs into the role of adjunctive systemic antibiotics in improving clinical outcomes and further research regarding these findings could pave the way for enhanced therapeutic approaches to manage this prevalent dental condition.

Source:

Riben Grundström, C., Lund, B., Kämpe, J., Belibasakis, G. N., & Hultin, M. (2024). Systemic antibiotics in the surgical treatment of peri‐implantitis: A randomized placebo‐controlled trial. In Journal of Clinical Periodontology. Wiley. https://doi.org/10.1111/jcpe.13994