Are dental practitioners overprescribing antibiotics in implant dentistry? A cross-sectional questionnaire study

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Main Author: Akshyata Panda
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Published: Zenodo 2026
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contents <p class="MsoNormal"><strong><span>Background:</span></strong><span> Peri-implantitis is a biofilm-associated infection of dental implants that often requires intervention. Management approaches vary widely, including mechanical debridement and adjunctive antibiotics. Antibiotic prophylaxis in implant surgery is controversial and the routine use may not be justified given the low baseline infection risk. Recent surveys report high prophylactic prescribing rates (up to ~80% of clinicians) despite awareness of resistance. Thus, there is concern that dentists may be overprescribing antibiotics after the placement of implants. </span></p> <p class="MsoNormal"><strong><span>Aim:</span></strong><span> To assess antibiotic prescribing patterns among implant dentistry practitioners and identify factors associated with potential overprescription.</span></p> <p class="MsoNormal"><strong><span>Methods:</span></strong><span> A cross-sectional questionnaire survey was conducted among 180 dental practitioners, including periodontists, implantologists, postgraduate students and general dentists.<span>  </span>The questionnaire (pilot-tested for content validity) included sections on demographics, knowledge of antibiotic use, and clinical scenarios (e.g., uncomplicated implant placement, bone grafting, peri-implantitis treatment). Data were analysed with chi-square tests, independent t-tests/ANOVA for group comparisons, and multivariate logistic regression to identify predictors of routine antibiotic use. Significance was set at p < 0.05.</span></p> <p class="MsoNormal"><strong><span>Results:</span></strong><span> The majority of respondents (approximately 75–90%) reported routinely prescribing antibiotics for implant placement, with higher rates in complex cases. For example, 90% used prophylaxis in grafted implant cases, compared to 75% in straight cases. Antibiotics were also frequently used for peri-implantitis (60–80% of cases, especially for surgical therapy). Experienced clinicians (>10 yr) were significantly more likely to prescribe perioperative antibiotics than those with <10 yr experience (prophylaxis in straightforward cases: 85% vs. 70%, χ², p=0.02). Periodontists were somewhat less likely to prescribe antibiotics for routine cases than general dentists (65% vs. 80%, p=0.04). Logistic regression identified >10 yr experience as an independent predictor of routine prophylaxis (OR=1.8, 95% CI 1.1–2.9, p=0.02), while specialty (periodontist vs. general dentist) was associated with lower odds (OR=0.6, 0.4–0.9, p=0.01). No differences were found by gender or practice setting. Knowledge score (mean 7.5/10) was modest and only marginally higher among specialists (ANOVA, p=0.03).</span></p> <p class="MsoNormal"><strong><span>Conclusion:</span></strong><span> In this survey, most dentists reported liberal antibiotic use in implant therapy, aligning with prior reports of high prescription rates. The findings suggest potential overprescription, driven by clinician factors such as experience and specialty. Standardized guidelines and educational efforts are needed to optimize antibiotic stewardship in implant dentistry</span><span>.</span></p>
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publishDate 2026
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spellingShingle Are dental practitioners overprescribing antibiotics in implant dentistry? A cross-sectional questionnaire study
Akshyata Panda
<p class="MsoNormal"><strong><span>Background:</span></strong><span> Peri-implantitis is a biofilm-associated infection of dental implants that often requires intervention. Management approaches vary widely, including mechanical debridement and adjunctive antibiotics. Antibiotic prophylaxis in implant surgery is controversial and the routine use may not be justified given the low baseline infection risk. Recent surveys report high prophylactic prescribing rates (up to ~80% of clinicians) despite awareness of resistance. Thus, there is concern that dentists may be overprescribing antibiotics after the placement of implants. </span></p> <p class="MsoNormal"><strong><span>Aim:</span></strong><span> To assess antibiotic prescribing patterns among implant dentistry practitioners and identify factors associated with potential overprescription.</span></p> <p class="MsoNormal"><strong><span>Methods:</span></strong><span> A cross-sectional questionnaire survey was conducted among 180 dental practitioners, including periodontists, implantologists, postgraduate students and general dentists.<span>  </span>The questionnaire (pilot-tested for content validity) included sections on demographics, knowledge of antibiotic use, and clinical scenarios (e.g., uncomplicated implant placement, bone grafting, peri-implantitis treatment). Data were analysed with chi-square tests, independent t-tests/ANOVA for group comparisons, and multivariate logistic regression to identify predictors of routine antibiotic use. Significance was set at p < 0.05.</span></p> <p class="MsoNormal"><strong><span>Results:</span></strong><span> The majority of respondents (approximately 75–90%) reported routinely prescribing antibiotics for implant placement, with higher rates in complex cases. For example, 90% used prophylaxis in grafted implant cases, compared to 75% in straight cases. Antibiotics were also frequently used for peri-implantitis (60–80% of cases, especially for surgical therapy). Experienced clinicians (>10 yr) were significantly more likely to prescribe perioperative antibiotics than those with <10 yr experience (prophylaxis in straightforward cases: 85% vs. 70%, χ², p=0.02). Periodontists were somewhat less likely to prescribe antibiotics for routine cases than general dentists (65% vs. 80%, p=0.04). Logistic regression identified >10 yr experience as an independent predictor of routine prophylaxis (OR=1.8, 95% CI 1.1–2.9, p=0.02), while specialty (periodontist vs. general dentist) was associated with lower odds (OR=0.6, 0.4–0.9, p=0.01). No differences were found by gender or practice setting. Knowledge score (mean 7.5/10) was modest and only marginally higher among specialists (ANOVA, p=0.03).</span></p> <p class="MsoNormal"><strong><span>Conclusion:</span></strong><span> In this survey, most dentists reported liberal antibiotic use in implant therapy, aligning with prior reports of high prescription rates. The findings suggest potential overprescription, driven by clinician factors such as experience and specialty. Standardized guidelines and educational efforts are needed to optimize antibiotic stewardship in implant dentistry</span><span>.</span></p>
title Are dental practitioners overprescribing antibiotics in implant dentistry? A cross-sectional questionnaire study
url https://doi.org/10.5281/zenodo.19641296