Generally speaking, the use of antibiotics in dental implantology has been controversial. Amongst the reasons for early (preloading) implant failure are bacterial contamination, systemic disease, chemotherapy, overheating of bone, poor recipient site bone quality, and poor bone to implant contact upon surgery. After the prosthetic phase of the implant restoration, loading forces exceeding the bone to implant interface is an additional cause of early failure. Prophylactic antibiotics are shown to reduce dental implant failure but do not have much influence on post-operative infections [7]. The organisms most responsible for infections associated with the failing implant in a “healthy” patient are predominantly Gram-negative anaerobic rods [8].

Anecdotally, many practitioners have decided to administer prophylactic antibiotics to all of their patients receiving endosteal implants while others have taken a more conservative approach. A survey of 102 periodontists revealed that >50 % prescribe antibiotics in 10 specific periodontal or implant-related clinical circumstances [9]. A metaanalysis of patients HIV positive and with AIDS revealed no evidence of increased risk of complications associated with dental procedures [4].

HIV causes systemic infection with diverse multi-organ system manifestation, musculoskeletal symptoms often being the first clinical indication of the presence of disease. Habermann et al. in a study of 41 patients noted an increased infection rate of 12.7 % in HIV-positive hemophiliacs and non-hemophiliacs undergoing total joint arthroplasty. They also reported that there was no difference in functional outcomes in non-hemophilic HIV-positive and HIV-negative population after the surgery [10]. Supporting the above findings, a retrospective analysis of patients from 2003 to 2010 showed that none with CD4 indicative of AIDS at the time of total joint replacement developed implant infection [11].

In HIV-infected patients, CD4 count and albumin levels negatively correlate with incidence of post-operative sepsis, whereas surgical infections and previous major surgical procedures positively correlated with the incidence of post-operative sepsis [12]. Thirty-five HIV-infected patients undergoing abdominal operations with pre-operative CD4 <200 or CD4/CD8 ratio <0.15 had overall higher post-operative sepsis morbidity [13].