Early healing after regenerative periodontal surgery with or without antibiotics

Abstract

Background: The effectiveness of guided tissue regeneration (GTR) has been thoroughly documented. Since most post-GTR complications are related to the exposure of the membrane and its subsequent bacterial contamination, clinicians treat the incorporation of systemic antibiotics as an integral component of the standard surgical procedure. However, this approach remains controversial.

Objectives: The aim of the study was to assess the effect of postsurgical administration of antibiotics on early healing and patient morbidity after treatment of periodontal intrabony defects with deproteinized bovine bone mineral (DBBM) and a collagen membrane (GTR).

Material and methods: The study encompassed 41 patients with 41 intrabony defects. The subjects were randomly assigned to either the test group (DBBM/GTR+AB (postsurgical antibiotic)) or the control group (DBBM/GTR). In the test group, 1 g of amoxicillin was administered twice daily for 7 days. The early healing index (EHI) was assessed 1 and 2 weeks after the procedure. Patient morbidity was recorded. The clinical attachment level (CAL), probing depth (PD) and gingival recession (GR) were measured at baseline and 6 months after surgery.

Results: Early healing was uneventful in both groups. No adverse events were recorded in either group. In the second week, EHI-defined primary flap closure was evident in 95% of the test group sites and 80% of the control group sites. The CAL changed significantly in both groups: from 8.7 ±1.4 mm to 4.6 ±1.7 mm in the DBBM/GTR+AB group (p < 0.0001); and from 8.6 ±1.9 mm to 5.7 ±1.2 mm in the DBBM/GTR group (p < 0.0001). The significant outcome was in favor of the test group (p = 0.010). Probing depth significantly decreased in both groups, without any observed intergroup differences.

Conclusions: The administration of systemic amoxicillin after regenerative periodontal surgery did not have any effect on early wound healing; however, it yielded a statistically significant CAL gain after 6 months compared to the group treated without antibiotics.

Keywords: antibiotics; guided tissue regeneration; intrabony defects; regenerative dentistry.