Post‐surgical infections: Prevalence associated with various periodontal surgical procedures

BACKGROUND: This retrospective study aimed to assess the prevalence of postoperative infections after periodontal and implant surgical therapy and examined the treatment variables that may affect infection prevalence. METHODS: A retrospective review on patients who were surgically treated in the graduate periodontics clinic at the University of Texas at San Antonio School of Dentistry was performed. Surgeries included osseous surgery, extractions, alveolar ridge preservation, guided tissue regeneration, implant placement, treatment of peri-implantitis, guided bone regeneration, crestal and lateral sinus augmentation, and mucogingival surgery. Postoperative infections that occurred within the first 2 weeks of healing were recorded. Postoperative infection prevalence was compared between procedures with and without specific treatment variables (e.g., bone grafts, biologics, membranes, antibiotics, chlorhexidine rinse, surgical dressing). RESULTS: Of the 18,505 procedures included in this study, 217 had postoperative infections resulting in an overall infection prevalence of 1.17% at the procedure-level. The prevalence varied from 0-5% based on procedure type, with guided bone regeneration demonstrating the highest prevalence. On a patient-level 176 patients experienced at least one postoperative infection, resulting in a patient-level infection prevalence of 4.06% (95%CI, 3.51%-4.69%). The Random Forest Model showed the use of biologics and antibiotics correlated with increased infection prevalence; however, these agents were generally utilized for more complex surgeries with an inherently greater risk of infection. Bone grafts, membranes, and chlorhexidine prescription did not show a major influence on infection prevalence. CONCLUSIONS: The post-surgical infection prevalence of periodontal surgery is low. These findings do not support the routine use of perioperative antibiotics as a preventive measure for infections. Rather than implementing routine administration, clinicians must evaluate the necessity of post-surgical antibiotic therapy on an individual basis. This assessment should comprehensively account for the patient's medical history, the specific surgical procedure, the complexity of the treatment, and the incorporation of biomaterials. Prospective studies are needed to elucidate the role antibiotics and biomaterials have on post-surgical infections.