Do postoperative antibiotics influence one‐year peri‐implant crestal bone remodelling and morbidity? A double‐blinded randomized clinical trial

OBJECTIVES: The primary objective of this study was to assess whether giving postoperative antibiotics to healthy patients after straightforward platform‐switched implant placement would influence peri‐implant crestal bone levels and postoperative morbidity after 1 year. METHODS: Thirty‐eight healthy individuals were recruited in this pilot, randomized, double‐blinded, placebo‐controlled clinical trial. The intervention group (n = 18) received two grams of amoxicillin one hour before implant placement followed by a 7 days postoperative regimen (500 mg tid). The control group (n = 20) took the same preoperative dose of amoxicillin and an identical placebo postoperatively. Mesial and distal peri‐implant crestal bone levels were measured at baseline, four months and one year later with standardized periapical radiographs. Postoperative pain severity was assessed through self‐administered questionnaires for 7 days. Surgery‐associated morbidities were evaluated after one, three, 16 weeks and 1 year. Descriptive and bivariate analyses were used. RESULTS: Thirty‐seven participants completed the trial. At the one‐year follow‐up, the mean combined peri‐implant crestal bone changes for the intervention (n = 18) and control (n = 19) groups were ‐ 0.44 ± 0.41 mm and ‐ 0.27 ± 0.56 mm, respectively. The difference between the groups (intervention–control) for mean combined crestal bone level changes was not statistically significant. There were no significant differences in surgery‐associated morbidities between the intervention and control groups. The one‐year implant survival rate was 100% in both groups. CONCLUSIONS: Study results suggest that a routine postoperative antibiotic regimen for healthy patients undergoing straightforward platform‐switched implant placement might not be necessary to prevent postoperative peri‐implant bone loss and complications.