Does use of local antibiotic as an adjunct to flap surgery confer benefit?
(Content under development)
The following question was submitted by a practising dentist: What is consensus on using local antibiotic with or without flap involvement? Is raising a flap and using antibiotics significantly better than without?
JCDA Editorial Consultant Dr. Debora Matthews of Dalhousie University provided this initial response for consideration:
When we talk about using antibiotics for our patients we have to think about the risk/benefit ratio. While the risk of systemic side effects is low, other potential risks exist, including increasing bacterial resistance, and the potential for allergic reactions. It is important to ask ourselves if these risks (for the individual patient under consideration) outweigh potential benefits.
Furthermore, there is limited evidence from clinical studies that show any additional benefit over traditional non-surgical therapy alone, and no studies that show a benefit for the use of local antibiotics in addition to surgical therapy.
Any benefits that some studies show are less than one mm difference in probing depths or clinical attachment levels. The American Academy of Periodontology published a position statement on Local Delivery of Antimicrobials as Adjunct Therapy in 2006.
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