Selective Antibiotics Can Save Dental Implants, Study Finds

BUFFALO, N.Y. -- Penicillin G and amoxicillin appear more effective than either tetracycline or erythromycin in preventing and treating bacterial infections that can undermine dental implants, a team of Italian and University at Buffalo researchers has found.

More than a dozen antibiotics are used routinely as adjunct treatment for bacterial infections that destroy bone and lead to tooth loss. These same microorganisms are related to infection of bone surrounding dental implants. Often the only treatment is to remove the implant.

But according to the findings of the UB study presented recently at the International Association for Dental Research meeting in Seattle, selective antibiotic therapy, tailored to the specific organisms cultured from tissue surrounding the implants, can help preserve them.

In the study, two subgingival samples from each of 19 failed implants from 13 patients were cultured in the laboratory. Three bacteria were found to have contributed to the implant failures: Porphyromonas gingivalis, Prevotella intermedia and Fusobacterium nucleatum, all of which are associated with periodontal disease.

Penicillin G and amoxicillin, as well as amoxicillin-clavulanate and amoxicillin-metronidazole, were found to be significantly more effective against the three bacteria than tetracycline, erythromycin, metronidazole or clindamycin.

But because penicillin G and amoxicillin also are commonly used for non-oral infections, they should not be used continually or indiscriminately since they could interfere with treatment of systemic infections, warned Sebastiano Andreana, D.D.S., clinical investigator in the UB Department of Oral Biology who presented the study results.

"Implant recipients cannot be given the medications as a long-term preventive measure," Andreana emphasized. "But with regular follow-up and proper oral hygiene, dentists can begin the therapy on a short-term basis to increase the longevity of the implants."

Ludovico Sbordone, M.D., D.D.S., professor and director of the Dental School of Reggio Calabria in Italy, headed the study.