Intra-Operative Cultures

Four Level I studies compared the effects of using one as opposed to more than one positive culture as a threshold for diagnosing infection, with histology of peri-implant tissue as the gold standard.^{2, 94, 104, 105} Two of these studies obtained at least three cultures per patient and two of these studies obtained at least two cultures per patient. Compared to histology, more than one positive culture result had a higher positive likelihood ratio for diagnosing infection than a single positive culture result. 

Assessing infection using multiple cultures increases the chances of identifying infection. Cultures are easily performed during the procedure and provide reliable results as indicated by the postive likelihood ratio. Obtaining more than one culture decreases the likelihood of false negative result and may assist the clinician in clarifying a result that may be deemed a false positive based on the results of other tests.