Consensus Report by the Italian Academy of Osseointegration on the Use of Antibiotics and Antiseptic Agents in Implant Surgery

Purpose: Beneficial aspects of short and ultrashort antibiotic administration protocols could be clinically correlated to the reduced side effects on the gastrointestinal microflora. The aim of this Consensus Conference was to establish the necessity of an antibiotic prophylaxis and its dosage to reduce the risk of early implant failure in healthy (ASA 1 or 2), periodontally healthy patients, undergoing basic dental implant surgery (straightforward cases). Additionally, the need for an antiseptic protocol, used before and after the implant surgery, was evaluated. Materials and Methods: Active members of the Italian Academy of Osseointegration (IAO), together with several worldwide-recognized key opinion experts in the field of microbiology, implant dentistry, and infectious diseases, were participants at this Consensus Conference. Two systematic reviews were carried out, before the Consensus Conference, and their results discussed in order to give guidelines on the administration of an antibiotic/antiseptic prophylaxis in implant surgery. The systematic reviews covered the following topics: (1) the use of antibiotics to reduce both implant failure rate and peri-implant infections in healthy patients and (2) the use of chlorhexidine compositions capable of reducing complications in patients undergoing surgical interventions. Results: The main statements reached by the assembly were as follows: (1) Rinsing with chlorhexidine is highly recommended before and after implant surgery to minimize the bacterial load. (2) A single dose of antibiotics in straightforward cases is recommended. (3) In complex cases (long surgical time, regeneration procedures), it is advisable to continue the antibiotic administration. Conclusion: This Consensus Conference advocates the administration of a unique dose of antibiotics in straightforward implant cases combined with the use of chlorhexidine.