Effects of Antibiotic Prophylaxis for Lateral Window Maxillary Sinus Augmentation

Objectives: Lateral window sinus augmentation is indicated in patients with inadequate alveolar bone height for dental implant placement in the atrophic posterior maxilla. Although many authors suggest the use of perioperative antibiotic prophylaxis for sinus augmentation, the effect of antibiotic prophylaxis has not yet been supported by scientific evidence. The aim of this retrospective study was to evaluate the effect of antibiotic prophylaxis by examining the incidence of post-operative infection and implant failure in patients who received lateral window sinus augmentation.
Methods: Data was gathered from the electronic health records (EHRs) of patients who received lateral window sinus augmentations from July 1, 2006 to June 30, 2017 at Tufts University School of Dental Medicine. The following information was extracted: age, sex, smoking history, prophylactic antibiotics, post-operative infection, and implant failures. Generalized estimating equations were used to reveal statistical significance in the incidence of post-operative infection and implant failure between patients with and without the use of prophylactic antibiotics. Patient- and surgery-related variables associated with infection and implant failure were also assessed. This study protocol was approved by the Tufts Health Sciences Institutional Review Board.
Results: 764 patients were initially identified in the EHRs. After exclusion of 333 patients, a total of 431 patients were included in the study. The incidence of post-operative infection was 3.25%. There was significantly less infection in patients who received antibiotic prophylaxis (2.54%) than those who did not receive antibiotic prophylaxis (10.53%) (p= 0.015). With regard to the incidence of implant failure, a statistical significance (p=0.005) was found between patients who received prophylactic antibiotics before surgery (2.11%) and those who did not (12.50%).
Conclusions: Within the limitations of this study, patients requiring lateral window sinus augmentation for dental implants may benefit from the use of prophylactic antibiotics to prevent post-operative infections and implant failure.