Key Considerations in Implant Treatment from an Oral Surgeon’s Perspective

Abstract

Implant placement is an invasive surgical procedure, and in cases involving extensive bone grafting, the degree of invasiveness increases, potentially leading to various complications related to the surgical technique. This review discusses appropriate antibiotic administration for infection prevention, as well as management strategies for implant-related complications that oral surgeons should address. These include measures for managing implant migration into the maxillary sinus and, although rare, gingival cancer occurring around the implant. The latest manual, Manual of Antimicrobial Stewardship The 4th Edition, does not recommend administering antibiotics to prevent surgical site infections during implant treatment. However, in practice, antibiotics are often overprescribed for infection prevention in various dental procedures, including tooth extractions, and appropriate use is not always observed.

Another complication associated with implant placement is migration of the implant into the maxillary sinus. Foreign bodies, once implanted, should not be expected to be naturally expelled；early removal is essential to prevent further complications.

In recent years, there has been a growing number of reported cases of gingival cancer occurring around implants. When evaluating the suitability of implants, it is crucial to carefully consider the risk of implant-associated gingival cancer, particularly in patients with a history of oral cancer, tobacco or alcohol use, or pre-existing mucosal conditions such as leukoplakia or lichen planus.

This article explains these issues in detail, drawing upon the author’s clinical experience and relevant case presentations.