Abstract
Aims: A single blinded randomized controlled trial was conducted to test the efficiency of two antibiotic regimens on post operative outcome and implant stability in single tooth dental implant to overcome the increasing drug resistance due to over prescription of medicines and side effects of the same.
 Methodology: 20 participants needing single tooth dental implant were enrolled based on inclusion and exclusion criteria. The participants were randomly assigned into groups. 10 participants in group 1 received only a single preoperative dosage of amoxicillin 1gm which was followed by paracetamol. In group 2, 500mg amoxicillin was given postoperatively followed by a three times a day for 3 days regimen. The postoperative outcome was evaluated based on swelling, post-operative bruising, suppuration and wound dehiscence noticed on 2nd and 7th day postoperatively. ISQ (implant stability quotient) was checked 3 months post implant placement as osseointergration is the main goal of implant placement.
 Results: Post-operative bruising, suppuration and wound dehiscence were not noticed in the entire study due to sterile environment during implant placement. When swelling was compared between group 1 and 2 it was statistically insignificant on day 2 (Mann Whitney u=40.00, p=0.383) and day 7 (Mann Whitney u=50.00, p=01.00). ISQ (IMPLANT STABILITY QUOTIENT) score in group 1&2 also showed statistically insignificant results (t=0.00, p=1.00) Which states that there was no significant difference in the stability of implants when single preoperative antibiotic dose of amoxicillin(1gm) and postoperative antibiotic dose of amoxicillin drug(500mg) regimen 3 times a day for 3 days was given.
 Conclusion: this study shows that in healthy individual, when single implant is placed in proper sterile environment with routine dental hygiene such as brushing and chlorhexidine mouthwash use by patient, single preoperative dose of amoxicillin 1gm is sufficient for the success of implant. However, considering the limitations of the study, further work is necessary to validate reliability.
 No adverse effects were observed in the study
 Funding: NIL
 Reg no:DYPDCH/EC/648/12/2021
Highlights
Adhesion of bacteria to implant surface result in infections associated with implants [1]
Comparison of mean rank score between group 1 and 2 showed statistically insignificant results on day 2 (Mann whitney u=40.00, p=0.383) and day 7 (Mann whitney u=50.00, p=01.00). This states that there was no remarkable difference in the postoperative swelling seen on 2nd and 7th day after implant placement when single preoperative antibiotic dose of amoxicillin(1g) and postoperative antibiotic dose of amoxicillin drug(500mg) regimen 3 times a day for 3 days was given
There was no remarkable difference in the postoperative swelling seen on 2nd and 7th day after implant placement when single preoperative antibiotic dose of amoxicillin(1g) and postoperative antibiotic dose of amoxicillin drug(500mg) regimen was given
Summary
Adhesion of bacteria to implant surface result in infections associated with implants [1]. As the implant surgery is not possible to be executed in an absolute sterile environment and the titanium implant surface being bio inert and micro rough, bacteria readily adheres to the surface of the implant and colonizes to form biofilm. For biofilm formation, the first bacterial attachment within an hour is significant. The bacteria in biofilm which are an easy target to antibiotics such bacteria are resistant to immune responses. Making it strenuous to eradicate them truly once biofilm is formed. The precaution of adhesion and growth of the bacteria is more significant than the removal of the biofilms to avoid implant related infections. Biofilm formation and antibiotic resistance being time sensitive; different antibiotic protocols
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