and 2 other(s)
Background Few studies demonstrate the presence of bacteria inside implants’ platform at the end of healing period. The contamination of intra-implant space during its insertion lead to the development of bacteria inside which may develop further bone loss or even dehiscence during healing. It is necessary to appreciate the effect of platform antibiotic preparation in peri-implant bone preservation. Aim/Hypothesis To evaluate the effect of intra-implants space antibiotic filling during their insertion upon peri-implant bone loss. Materials and Methods Eighty partially edentulous patients (51,76±0,9 years) had 187 two-stage dental implants inserted in posterior sides of the mandible using two-steps protocol (3,3-5,0mm diameter and 6-13mm length). One hundred and four implants were inserted and saline solution only was used to clean the intra-implant space before cover screw placement (Control) while the other 83 were filled with antibiotic gel (levomicetine and methyluracil) before cover screw placement (Study). Radiographic images were taken before, after the surgery and at the end of the healing period. Implant sides were divided into anterior and posterior ones (according to the orthopantomogram). After a mean healing period of 21,38±1,049 weeks, the second surgical step was performed. The periimplant bone loss were evaluated using Photoshop CS 3 program (by transferring pixels into mm). Statistical analysis was made by calculating mean values, standard errors and indices of Student’s paired t-test. Results During healing, one short implant from the study group and two from the control group failed. After the healing period, crestal bone loss for anterior and posterior sides of the control group had the following values: 0,66±0,066mm (85 implants) from mesial and 0,5±0,057mm (82 implants) from distal. In the other 17 implants from mesial and 20 implants from distal a bone apposition was observed. In the Study group, in 19 implants from mesial and 18 from distal a bone apposition occurred as well. The bone loss in the study group were: 0,31±0,06mm (63 implants) from mesial and 0,26±0,05mm (64) from distal aspects. The comparative analyses showed a statistically lower bone loss in the study group (p<0.001 from mesial and p<0.01 for distal sides) than in the control one. Conclusions and Clinical Implications The usage of antibiotic gel as a filler for implants platforms seems to have a positive impact upon peri-implant bone preservation. By this way it is possible to conclude that the bacteria growing inside the platforms during healing period have a significant impact upon the peri-implant bone loss.
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