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Does penicillin allergic patients present higher implant failure rate?
EAO Online Library. BEATRIZ A. Oct 9, 2018; 232588; P-BR-41
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One of the most common factors for early dental implant failure is infection, thereby, prophylactic and postoperative antibiotic regimens have been proposed. The American Dental Association (ADA) have recommended oral amoxicillin in high-risk patients, however, many surgeons prescribe them routinely. Consequently, the level of penicillin allergies has risen. Clindamycin has been proposed for allergic patients+ although few studies assess implant failure rate in these conditions.To determinate if patients allergic to penicillin have a higher incidence of dental implant failure compared with non-allergic patients.This cross-sectional clinical study consisted in the analysis of patients treated with dental implants from 2011 to 2015, at the Clínica Universitaria de Odontología (CUO), School of Dentistry of the UIC, by postgraduate students. 2 g of amoxicillin were taken orally 1 h before the surgery, and 600 mg of clindamycin for penicillin-allergic patients. Prescribed antibiotics were amoxicillin 750 mg three times per day and 300 mg clindamycin every 6 hours in penicillin-allergic patients+ both for one week. Implant failure was defined as the removal of the implant for any reason, and were classified as early or late failures.A total of 1,210 patient´s files were analyzed. From the 1133 non-penicillin allergic patients, 91 (8.03%) presented at least one implant failure+ for the 77 penicillin-allergic patients, 19 patients presented at least on implant failure (24.68%). **After the analysis of the relationship between the variables, 1 out 12 (8%) of not penicillin allergic patients, and 1 out 4 (25%) of penicillin allergic patients present a dental implant failure, respectively. The implant failure rate between the two groups was significantly higher for penicillin-allergic patients group. **The penicillin-allergic patients demonstrated a greater risk for implant failure with an RR of 3.84 (95% CI) when compared with patients without penicillin allergy.Within the limitations of the present retrospective study, penicillin-allergic patients treated with clindamycin have almost four times more risk to have a dental implant failure, compared with non-penicillin allergic patients. However, other variables such implant brand, location, surgeon skills must be taken into consideration. **Further studies should focus on clarify antibiotic guidelines to improve implant success.
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