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Self-reported penicillin allergy and dental implant therapy outcome, a clinical retrospective study Noroozi, Mehdi

Abstract

Objectives: The histologic, clinical, and radiographic findings together indicated infection as a major etiology of implant failure. Antibiotics have been prescribed following implant surgery to control infection. Inability to take penicillin seems to be a determining factor in implants failure in particular, with certain types of implant-related procedures. The aim of this study was to investigate retrospectively whether self-reported allergy to penicillin contributes to higher rate of implant failure. Methods: The survival of 5576 implants (985 Nobel Biocare and 4591 Straumann) placed surgically by an experienced periodontist was assessed in patients with the age range of 20-89 (mean: 60 years old) and with the follow-up period of up to 10 years. 4132 implants followed for at least one year. The survival was defined as the implant remaining in the jaw. Pearson χ2 test and Logistic regression were applied to examine the relation between pairs of variables. All tests were 2-tailed with a significance level of 0.05. Results: Out of 5106 implants placed for patients taking penicillin, 0.8% failed, while out of 470 implants placed for patients with self-reported allergy to penicillin, 2.1% failed with statistically significant difference (P= 0.002). Odds of failure for implants placed in patients allergic to penicillin were 3.2 times higher than those for non-allergic patients while controlling for the other variables. Kaplan Meier test revealed statistically significant difference between survivals of implants placed in penicillin-allergic group compared with non-allergic group. 54% of implant failures in non-allergic group have occurred during the first 6 months of implant insertion, while in penicillin allergic group this amount was 80% with statistically significant difference. Immediate implant placement in fresh extraction socket had 10-times higher rate of failure in patients with self-reported allergy to penicillin. Significant association between smoking and implant failure was found (p=0.005). Implants in the area of second molars have the highest failure rate with more frequency in maxilla relative to mandible. Conclusion: Inability to take penicillin may contribute to higher rate of implant failure and thus, penicillin allergy test could be implemented in clinical settings to increase the likelihood of prescribing penicillin relative to its alternates.

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Attribution-NonCommercial-NoDerivs 2.5 Canada

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