Interventions
Postoperative pain, mandibular block, ®
All participants in the test group were administered a single dose of 600-mg clindamycin (two capsules of 300 mg) 1 h before surgery. Those in the control group received two capsules of placebo 1 h before surgery. The placebo and antibiotics had similar characteristics. The participants were provided an envelope with the medication or placebo at the dental clinic 1 h before the surgery.All surgical procedures were performed by one surgeon with an extensive experience in oral implant surgery. The surgeries commenced with the following anaesthetic technique: anaesthetic block of the area using articaine (4%) with epinephrine 1:1000.000, using a mandibular block technique for implant placement in the mandible, and an infiltrative technique in the maxilla. A full-thickness mucoperiosteal flap was made via a crestal incision in the edentulous section and an intrasulcular incision in the adjacent teeth. Releasing incisions were made only on the highly resorbed ridges or in the presence of marked bone concavities. Straumann Roxolid® (TI-Zr) SLActive® (Sand-blasted large grift acid-etched) (Basel, 4002 Switzerland) implants were placed. The surgeon inserted a 1.8 mm Straumann Tissue Level Standard Plus® (TL) polished neck implant in non-aesthetic zone. Straumann Bone Level Tapered ® (BLT) type implants were inserted in the aesthetic areas of the maxilla. The manufacturer-recommended drilling sequence was used for both types of implants. None of the participants underwent a second-stage implant surgery. The bone width and available bone height determined the diameter (3.3 or 4.1 mm) and length of the implant (8, 10, or 12 mm), and therefore the drilling sequence. Al implants were placed freehand. Following the implant placement, the implant insertion torque was measured using a Straumann® ratchet wrench with a dynamometer (Nos. 046.119 and 046.049). In all cases, primary closure of the flap was done using a 5–0 non-resorbable. Polyester monofilament suture with a single interrupted suturing technique.Postoperative pain management consisted of 600-mg ibuprofen or 1-g paracetamol prescribed every 8 h on the days the participants considered it necessary, but no more than 4 days.The clindamycin and placebo capsules were presented in blister packs, individually packed, and labelled to maintain blinding. The samples were labelled with the sample number, protocol code, the number of units, dosage form, the route of administration, and expiration date.The planned antibiotic was one tablet (875/125 mg) of amoxicillin/clavulanic acid administered every 8 h for 7 days. One of the inclusion criteria was no allergy to amoxicillin or clavulanic acid.