One of the issues that makes us Maxillofacial Surgeons think the most is whether the use of antibiotics is necessary in implant surgeries.
Unnecessarily used antibiotics today unfortunately lead to the formation of bacterial species that are more resistant to antibiotics
Because of antibiotics, we have enabled the development of bacterial species that do not give up easily and threaten our lives much more, and millions of lira are spent every year to develop new types of antibiotics that can defeat these new types of bacteria.
Of course, we surgeons are the most important ones. The greatest responsibility is the health of our valued patients.
We can say that the most important questions we need to decide on are these.
Should Antibiotics Be Given Routinely to All Patients During Implant Operations?
If antibiotics are to be given, should they be given before or after the surgery?
How many days should antibiotics be used after the surgery?
Which one? Should group antibiotics be preferred?
There are hundreds of studies on this subject. As someone who has read and reviewed a significant number of articles on this subject, the articles I take into consideration the most are the consensus reports on this subject.
What is a consensus report? On any controversial issue, the final reports of the impartial board of scientists who examine all articles written in important scientific journals are the most important sources of information.
Let's see what the consensus report published on this subject last year says?
Impartial scientists examining whether the use of antibiotics during the implant surgery period is necessary or not have evaluated 846 articles of high scientific value and presented a consensus report on this issue last year.
2015 CONSENSUS REPORT SUMMARY
The use of antibiotics in implant placement surgeries reduces implant losses by only 2 percent.
In other words, this report shows that the use of antibiotic prophylaxis during implant placement provides a small but statistically significant decrease in implant loss.
Analysis shows that one in every 50 implants is lost due to not using antibiotics.
However, when we look at the details, we see that the most important issue is related to the degree of complexity of the surgery.
In fact, in healthy individuals, in the presence of sufficient bone and gingival tissue, single tooth implant applications can be performed. There is no benefit from the use of antibiotics.
So we can say that the use of antibiotics is of no benefit and unnecessary in simple, uncomplicated implant applications in healthy people.
However, we call advanced applications such as bone grafting procedures, bone transplant surgeries, implants. Antibiotics are definitely recommended in advanced surgical applications such as bone graft application at the same time with implant, soft tissue graft application with implant, implant application at the same time with tooth extraction, cases where many implants will be placed, sinus lifting surgery, serial tooth extraction and implant application at the same time.
How Do I Work in My Clinic?
After examining my patients clinically, I make radiological panoramic and / or tomographic 3D examination to evaluate the bone structure.
p>
After these radiological and clinical evaluations, I decide on the degree of complexity of the procedure.
The majority of the patients I encounter in my clinic are patients who have lost their teeth long ago.
These patients undergo tooth extraction. Due to naturally occurring bone resorption and thinning, I often need to apply bone graft (bone cement) in addition to implant surgery. and antibiotic prophylaxis is definitely recommended in such advanced applications.
This is the rule rather than an exception.
As a person who has been performing jaw surgery for 16 years, bone grafting is a must for the long-term success of my implants. and/or I use free gingival & connective tissue graft.
I perform such advanced surgical interventions in an average of 70-80% of my surgeries.
For this reason, I will perform procedures in addition to implant placement before all my surgeries. I try to minimize the risks of post-operative infection by starting antibiotics for my patients.
The surgeries that I perform very frequently in my clinic and for which I recommend antibiotic prophylaxis are as follows.
1- In my relatively large surgeries where I place a large number of implants
2- In cases where I applied implants and grafts at the same time as tooth extraction
3- Immediate loading by inserting the teeth the next day after 4-6 implant applications in completely edentulous mouths
4- Regaining the alveolar contour in the thinned bone on the front of the implant
5- In open major sinus lifting surgeries I performed due to large sinus sagging in the posterior region of the upper jaw
6- In cases where implants could not be placed due to extreme bone deficiency, in patients in whom I performed bone transplantation from the lower jaw or hip bone
br /> 7- Due to soft tissue deficiency, in the soft tissue plastic surgery surgeries I perform to create keratinized gingiva or to support the gingiva with connective tissue graft and to cover the implant or root surface. 8- I frequently perform all tooth removal on patients who are at the point of losing all their remaining teeth. In my major implant surgeries, where we apply 6 or 8 implants at the same time with extraction, bone grafting and screwing the new fixed teeth to the implants the next day
Absolutely
Read: 0
