Antibiotics in Mucogingival Surgery for Recession Treatment: A Narrative Review

This article systematically summarizes the current applications of antibiotics in mucogingival surgery, emphasizing indications for antibiotic use and the importance of rational drug administration. It provides clinicians with practical guidance for infection control during gingival recession procedures.

 

Literature Overview
The article "Antibiotics in Mucogingival Surgery for Recession Treatment: A Narrative Review", published in the journal *Antibiotics*, reviews the role of systemic antibiotics in mucogingival surgery for gingival recession. It highlights that routine antibiotic use does not demonstrate significant clinical benefits in healthy patients but is recommended only for specific high-risk populations (e.g., patients with high-risk infective endocarditis or immunocompromised individuals). The study emphasizes the importance of aseptic techniques during surgery, local tissue preparation, and postoperative chemical plaque control. It also suggests that prospective studies are needed to further validate the efficacy of antibiotics in mucogingival surgery.

Background Knowledge
Gingival recession (GR) is a common periodontal condition affecting oral health and aesthetics, with treatment primarily relying on root coverage surgery. Oral microbiota introduced during surgical procedures increases infection risk, prompting consideration of antibiotics for surgical site infection (SSI) prevention. However, widespread antibiotic use accelerates the emergence of drug-resistant strains, making rational prescribing practices a clinical priority. Mucogingival surgery is often performed in non-sterile environments, but infection risks can be effectively managed through rigorous preoperative preparation, aseptic techniques, and postoperative care. This article systematically evaluates current evidence on antibiotic applications in mucogingival surgery, integrating factors such as infection control, patient immune status, and surgical environment to support individualized clinical decisions. While existing retrospective studies show limited impact of antibiotics on postoperative complications, prospective research remains necessary to clarify their role.

 

 

Research Methods and Experiments
This study employed a narrative literature synthesis approach, systematically searching the PubMed database using MeSH keyword combinations including "gingival recession," "mucogingival surgery," "antibiotic prophylaxis," "antibiotic resistance," and "surgical site infection." Existing systematic reviews, randomized controlled trials, and clinical guidelines were referenced, while case reports were excluded. The study focused on literature from the past decade, though earlier relevant studies were also included. The analysis encompassed surgical infection risk assessment, optimal timing for antibiotic administration, indications, resistance mechanisms, and postoperative care protocols.

Key Conclusions and Perspectives

• Mucogingival surgery constitutes clean-contaminated procedures with low postoperative infection rates, thus systemic antibiotics are not recommended for routine use in healthy patients.
• Antibiotic prophylaxis is primarily indicated for high-risk populations, such as those with elevated infective endocarditis risk or immunocompromised individuals.
• Postoperative infections may delay wound healing, cause surgical failure, or necessitate secondary interventions, though retrospective studies indicate an incidence rate below 3.66%.
• Preoperative tissue health optimization, aseptic surgical techniques, and postoperative chemical plaque control represent core infection prevention strategies.
• Diabetes, smoking, and malnutrition are high-risk infection factors; patient optimization (e.g., HbA1c control) should be prioritized preoperatively.
• Postoperative local care (e.g., chlorhexidine rinses and gels) effectively controls plaque, serving as a viable alternative to systemic antibiotics.
• Current evidence lacks prospective validation of antibiotic efficacy in mucogingival surgery, necessitating clinical decisions based on evidence and individual patient profiles.

Research Significance and Prospects
The study provides evidence-based guidance for rational antibiotic use in mucogingival surgery, underscoring the importance of individualized treatment and perioperative infection control. Future prospective, randomized controlled trials are required to define antibiotic roles in distinct patient cohorts and explore localized antimicrobial strategies or alternatives to reduce systemic exposure and mitigate resistance development.

 

 

Conclusion
This review highlights the absence of clinical evidence supporting routine antibiotic use in healthy patients undergoing mucogingival surgery. Antibiotic prophylaxis is reserved for high-risk groups, including those with infective endocarditis susceptibility or immunocompromised status. Postoperative infection rates remain low and are often manageable through localized care. Preoperative inflammation control, aseptic techniques, and postoperative plaque management are critical for SSI prevention. Special attention should be given to optimizing perioperative conditions in patients with diabetes, smoking habits, or nutritional deficiencies. The article advocates for prospective clinical trials to generate high-quality evidence guiding antibiotic decisions and promoting rational use to curb resistance.

 

Magdalena Latkowska-Wiśniewska, Sylwia Jakubowska, and Bartłomiej Górski. Antibiotics in Mucogingival Surgery for Recession Treatment: A Narrative Review. Antibiotics.