Clindamycin Versus Amoxicillin With Clavulanic Acid in Prevention of Early Dental Implants Failure

NCT ID: NCT04980170

Last Updated: 2021-07-28

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

EARLY_PHASE1

Total Enrollment

100 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-11-01

Study Completion Date

2022-06-01

Brief Summary

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Among patients receiving dental implants, does the choice of antibiotics reduce the frequency of early implant failure ?

Detailed Description

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The patients were selected in the implant assessment clinic from a population on the implant waiting list at the department of Maxillofacial surgery department , of Jordan University Hospital. Those consecutively assessed patients that complied with both the inclusion and the exclusion criteria and who had signed consent for participation in the study formed the study sample.

The following inclusion criteria were applied: • Presence of a partial edentulous or edentulous alveolar ridge. • Presence of a tooth or several teeth regarded as non-restorable with the intention of immediate implant placement. • Periodontally healthy remaining dentition. • Presence of a non-infected surgical site. • Presence of enough bone and soft tissue for the implant to be placed without additional augmentation procedures.

The following exclusion criteria were applied: • Patients with medical conditions that required antibiotic premedication such as prosthetic heart valve replacement, skeletal joint replacement, previous history of infective endocarditis and a history of rheumatic fever. • Patients with metabolic diseases such as type I or II diabetes mellitus. • Patients with past and present neoplastic disease. • Previous radiotherapy in the head and neck area. • Immunosuppressed patients. • Patients with blood coagulation impairment. • Patients with a history of systemic steroid medication or recent systemic antibiotic therapy. • Pregnant and lactating women • Patients with allergy to the antibiotic chosen Every patient that agreed to participate was randomly assigned to one of the following two groups: • First group - 625mg of AMOCLAN immediately postoperatively, three times a day for 5 days. • Secondl group - 600mg of CLINDAMYCIN immediately postoperatively, three times a day for 5 days. Consecutively treated patients received consecutive numbers correlating with the number of an envelope. This envelope contained either the 625mg Amoclan, or 600mg Clindamycin An independent person administered the antibiotic Neither the surgeon nor the patient knew which has been taken to ensure a double-blind approach One Professor in MaxFAx surgery was the operator One implant typr used: Blue Sky Bio, USA Implants were placed according to the manufacturers guidelines using standard surgical procedures. The local anaesthetic used was Articaine 4% with adrenaline 1 : 100,000.

Following adequate local anaesthesia, a mucoperiosteal flap was raised with or without one or two relieving incisions as determined by the local anatomy, including availability of bone, presence of neighbouring tooth roots and aesthetics. Osteotomies were then carried out under copious saline irrigation. Implants were then placed with a view to obtaining good primary stability. A decision was then made placing a cover screw and opting for a two stage approach . Closure of the surgical site with either resorbable or non-resorbable sutures was then performed ensuring tension free closure of the flaps.

The patient was personally instructed and handed out standardised forms on post-operative care. Patients were advised on the use of post-operative pain medication. To minimise the influence of independent variables, all patients were instructed to use paracetamol 500 mg tablets as required to a maximum of 4 g/day and Ibuprofen 400mg tablets to a maximum of 2000mg. Patients were advised to remain on a soft diet for the first post-operative week. Patients were instructed to use a chlorhexidine 0.2% mouthwash 4-5 times daily for the first postoperative week.

Recordings of osseointegration failure or success were recorded three months post-operatively or at 2nd stage surgery. Post-operative swelling was recorded on the 7th days.

Conditions

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Antibiotics Causing Adverse Effects in Therapeutic Use

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

NONE

Study Groups

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clindamycin group

Patients who take Clindamycin after Dental implants

Group Type EXPERIMENTAL

Clindamycin 300 mg

Intervention Type DRUG

patients will be given clindamycin 300 mg twice daily for 5 days after dental implant

Amoxicillin With Clavulanic Acid group

Patients who take Amoxicillin With Clavulanic Acid after Dental implants

Group Type EXPERIMENTAL

Amoxicillin with Clavulanic Acid 635mg

Intervention Type DRUG

patients will be given Amoxicillin with Clavulanic Acid 635mg, three times daily for 5 days after dental implant

Interventions

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Clindamycin 300 mg

patients will be given clindamycin 300 mg twice daily for 5 days after dental implant

Intervention Type DRUG

Amoxicillin with Clavulanic Acid 635mg

patients will be given Amoxicillin with Clavulanic Acid 635mg, three times daily for 5 days after dental implant

Intervention Type DRUG

Other Intervention Names

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Clinacin Augmentin

Eligibility Criteria

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Inclusion Criteria

* Presence of a partial edentulous or edentulous alveolar ridge.
* Presence of a tooth or several teeth regarded as non-restorable with the intention of immediate implant placement.
* Periodontally healthy remaining dentition.
* Presence of a non-infected surgical site.
* Presence of enough bone and soft tissue for the implant to be placed without additional augmentation procedures.

* Must be able to swallow tablets

Exclusion Criteria

* Patients with medical conditions that required antibiotic premedication such as prosthetic heart valve replacement, skeletal joint replacement, previous history of infective endocarditis and a history of rheumatic fever.
* Patients with metabolic diseases such as type I or II diabetes mellitus.
* Patients with past and present neoplastic disease.
* Previous radiotherapy in the head and neck area.
* Immunosuppressed patients.
* Patients with blood coagulation impairment.
* Patients with a history of systemic steroid medication or recent systemic antibiotic therapy.
* Pregnant and lactating women
* Patients with allergy to the antibiotic chosen.
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Jordan University Hospital

OTHER

Sponsor Role lead

Responsible Party

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Ahmad Hamdan

Oral and Maxillofacial surgery resident

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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ASHRAF ABUKARAKI, PROFESSOR

Role: STUDY_DIRECTOR

Jordan University Hospital

Locations

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The University of Jordan Hospital

Amman, , Jordan

Site Status

Countries

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Jordan

Central Contacts

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Ahmad Hamdan

Role: CONTACT

00962796767991

ASHRAF ABUKARAKI, PROFESSOR

Role: CONTACT

00962795638010

Facility Contacts

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Ahmad Hamdan, DDS

Role: primary

00962796767991

ASHRAF ABUKARAKI, PROFESSOR

Role: backup

00962795638010

References

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Malm MO, Jemt T, Stenport VF. Patient factors related to early implant failures in the edentulous jaw: A large retrospective case-control study. Clin Implant Dent Relat Res. 2021 Jun;23(3):466-476. doi: 10.1111/cid.13009. Epub 2021 May 17.

Reference Type RESULT
PMID: 33999522 (View on PubMed)

Malm MO, Jemt T, Stenport V. Early Implant Failures in Edentulous Patients: A Multivariable Regression Analysis of 4615 Consecutively Treated Jaws. A Retrospective Study. J Prosthodont. 2018 Dec;27(9):803-812. doi: 10.1111/jopr.12985. Epub 2018 Oct 29.

Reference Type RESULT
PMID: 30307086 (View on PubMed)

De Bruyn H, Raes S, Ostman PO, Cosyn J. Immediate loading in partially and completely edentulous jaws: a review of the literature with clinical guidelines. Periodontol 2000. 2014 Oct;66(1):153-87. doi: 10.1111/prd.12040.

Reference Type RESULT
PMID: 25123767 (View on PubMed)

Baqain ZH, Moqbel WY, Sawair FA. Early dental implant failure: risk factors. Br J Oral Maxillofac Surg. 2012 Apr;50(3):239-43. doi: 10.1016/j.bjoms.2011.04.074. Epub 2011 May 25.

Reference Type RESULT
PMID: 21612850 (View on PubMed)

Other Identifiers

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JordanUH

Identifier Type: -

Identifier Source: org_study_id

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