Early Wound Healing Following One-Stage Dental Implant Placement With and Without Antibiotic Prophylaxis: A Pilot Study

Background: One-stage implant placement has clinically acceptable treatment outcomes. Among other advantages, it may allow investigation of early wound healing. The purpose of this pilot study was to determine whether peri-implant crevicular fluid (PICF) can be used to detect early changes around implants placed with one-stage surgical protocol following I week of healing. Methods: Twenty subjects (I I males and nine females; aged 22 to 72 years; two smokers) were included. Exclusion criteria were allergies to amoxicillin and systemic conditions that may affect healing. Subjects had a healthy periodontium and needed a single implant; eight received antibiotic prophylaxis, and 12 served as controls. Clinical healing was evaluated with plaque and gingival indices (PI and GI, respectively). Gingival crevicular fluid (GCF) from the surgical site was obtained prior to the surgery, whereas PICF was collected at the I-week visit. Enzyme-linked immunosorbent assay was used to determine GCF/PICF interleukin (IL)-1 beta and -8 concentrations. Peripheral blood and GCF antibiotic levels were measured by high-performance liquid chromatography. Results: Postoperative PI and GI were slightly increased. Total GCF and PICF volumes did not show a significant difference between appointments. There was an increase in PICF IL-1 beta and -8 levels at 1 week postoperatively. Mean amoxicillin serum concentration was 5.1 +/- 2 mu g/ml at I to 4 hours following the initial dose, whereas GCF amoxicillin levels were below the limit of detection. Antibiotic prophylaxis had a modest effect on clinical indices (PI and GI) and no appreciable effect on biomarkers. Conclusions: PICF content can be studied as early as 1 week following one-stage implant placement. The results raise doubts regarding the clinical usefulness of amoxicillin prophylaxis. J Periodontol 2008;79:1904-1912.