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Kiramira D, Uphaus T, Othman A, Heermann R, Deschner J, Müller-Heupt LK. Stroke Caused by Vasculitis Induced by Periodontitis-Associated Oral Bacteria after Wisdom Teeth Extraction. Brain Sci 2024; 14:550. [PMID: 38928550 DOI: 10.3390/brainsci14060550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Revised: 05/26/2024] [Accepted: 05/27/2024] [Indexed: 06/28/2024] Open
Abstract
Invasive dental procedures, such as wisdom teeth removal, have been identified as potential triggers for vascular events due to the entry of oral bacteria into the bloodstream, leading to acute vascular inflammation and endothelial dysfunction. This study presents the case of a 27-year-old healthy male who developed ischemic stroke resulting from bacteremia after undergoing wisdom teeth extraction. Initially, the patient experienced fever and malaise, which were followed by right-sided hemiplegia. Diagnostic imaging, including a CT scan, identified a subacute infarction in the posterior crus of the left internal capsule, and MRI findings indicated inflammatory changes in the masticatory muscles. Further investigations involving biopsies of the masticatory muscles, along with blood and cerebrospinal fluid samples, confirmed bacterial meningitis with associated vasculitis. Notably, oral bacteria linked to periodontitis, including Porphyromonas gingivalis, Fusobacterium nucleatum, Tannerella forsythia, and Parvimonas micra, were found in the biopsies and microbiological analyses. To the best of our knowledge, this is the first reported case showing that bacteremia following dental procedures can lead to such severe neurological outcomes. This case underscores the importance of recognizing bacteremia-induced vasculitis in patients presenting with neurological symptoms post-dental procedures, emphasizing the broader implications of oral infections in such pathologies.
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Affiliation(s)
- David Kiramira
- Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany
| | - Timo Uphaus
- Department of Neurology and Focus Program Translational Neuroscience (FTN), Rhine Main Neuroscience Network (rmn2), University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany
| | - Ahmed Othman
- Department of Neuroradiology, University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany
| | - Ralf Heermann
- Institute of Molecular Physiology, Microbiology and Biotechnology, Johannes Gutenberg University Mainz, 55131 Mainz, Germany
- Institute for Biotechnology and Drug Research gGmbH (ibwf), 55128 Mainz, Germany
| | - James Deschner
- Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany
| | - Lena Katharina Müller-Heupt
- Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany
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Singh AK, Mishra R, Kumar H, Priya L, Choudhary HV, Kumar K. Assessment of Oral Health-Care Needs for Patients under Palliative Care. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2021; 13:S180-S183. [PMID: 34447070 PMCID: PMC8375847 DOI: 10.4103/jpbs.jpbs_636_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 10/03/2020] [Accepted: 10/04/2020] [Indexed: 11/30/2022] Open
Abstract
Background: Patients under palliative care and their caregivers often ignore the dental treatment and oral hygiene needs as a result of which they face many day to day problems, which include difficulty in chewing, halitosis, and dry mouth eventually deteriorating the quality of life. Objective: The aim of this study is to understand the oral needs and oral health-related concerns of the patients under palliative care. Methodology: A total of eight patients agreed to enroll in the study. A detailed interview with oral examination, including Sillness and Loe Plaque Index and Decayed Missing and Filled Teeth (dmft) Index, was recorded. Patients were also given the treatment needed if willing for the same. Results: In our study, we observed that the mean dmft scores of dentulous patients were 7.96 ± 3.35, and mean plaque score was 1.75 ± 2.12, which was significantly higher and further highlights the need for dental treatment. Conclusion: The patients under palliative care have many oral problems such as dry mouth, difficulty in eating, halitosis which needs to be addressed; hence, dental health plays an important role in improving the quality of life of these patients.
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Affiliation(s)
- Atul Kumar Singh
- Department of Dentistry, Uttar Pradesh University of Medical Sciences, Saifai, Etawah, Uttar Pradesh, India
| | - Rahul Mishra
- Department of Dentistry, Uttar Pradesh University of Medical Sciences, Saifai, Etawah, Uttar Pradesh, India
| | - Harsh Kumar
- Department of Dentistry, Patna Medical College, Patna, Bihar, India
| | - Leena Priya
- Department of Oral Medicine and Radiology, Buddha Institute of Dental Science and Hospital, Kankarbagh, Patna, Bihar, India
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4
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Wu Y, Cheng X, Jiang G, Tang H, Ming S, Tang L, Lu J, Guo C, Shan H, Huang X. Altered oral and gut microbiota and its association with SARS-CoV-2 viral load in COVID-19 patients during hospitalization. NPJ Biofilms Microbiomes 2021; 7:61. [PMID: 34294722 PMCID: PMC8298611 DOI: 10.1038/s41522-021-00232-5] [Citation(s) in RCA: 95] [Impact Index Per Article: 31.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 07/01/2021] [Indexed: 02/06/2023] Open
Abstract
The human oral and gut commensal microbes play vital roles in the development and maintenance of immune homeostasis, while its association with susceptibility and severity of SARS-CoV-2 infection is barely understood. In this study, we investigated the dynamics of the oral and intestinal flora before and after the clearance of SARS-CoV-2 in 53 COVID-19 patients, and then examined their microbiome alterations in comparison to 76 healthy individuals. A total of 140 throat swab samples and 81 fecal samples from these COVID-19 patients during hospitalization, and 44 throat swab samples and 32 fecal samples from sex and age-matched healthy individuals were collected and then subjected to 16S rRNA sequencing and viral load inspection. We found that SARS-CoV-2 infection was associated with alterations of the microbiome community in patients as indicated by both alpha and beta diversity indexes. Several bacterial taxa were identified related to SARS-CoV-2 infection, wherein elevated Granulicatella and Rothia mucilaginosa were found in both oral and gut microbiome. The SARS-CoV-2 viral load in those samples was also calculated to identify potential dynamics between COVID-19 and the microbiome. These findings provide a meaningful baseline for microbes in the digestive tract of COVID-19 patients and will shed light on new dimensions for disease pathophysiology, potential microbial biomarkers, and treatment strategies for COVID-19.
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Affiliation(s)
- Yongjian Wu
- grid.452859.7Center for Infection and Immunity, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, Guangdong China ,grid.12981.330000 0001 2360 039XSchool of Public Health, Sun Yat-sen University, Guangzhou, Guangdong China ,grid.452859.7Guangdong Provincial Engineering Research Center of Molecular Imaging, Guangdong Provincial Key Laboratory of Biomedical Imaging, and Department of Interventional Medicine, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, Guangdong China ,grid.511004.1Southern Marine Science and Engineering Guangdong Laboratory, Zhuhai, Guangdong China ,grid.410741.7National Clinical Research Center for Infectious Disease, Shenzhen Third People’ s Hospital; The Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, Guangdong China
| | - Xiaomin Cheng
- grid.12981.330000 0001 2360 039XSchool of Public Health, Sun Yat-sen University, Guangzhou, Guangdong China
| | - Guanmin Jiang
- grid.452859.7Center for Infection and Immunity, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, Guangdong China ,grid.452859.7Guangdong Provincial Engineering Research Center of Molecular Imaging, Guangdong Provincial Key Laboratory of Biomedical Imaging, and Department of Interventional Medicine, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, Guangdong China ,grid.452859.7Department of Clinical Laboratory, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, Guangdong China
| | - Huishu Tang
- grid.452859.7Center for Infection and Immunity, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, Guangdong China ,grid.452859.7Guangdong Provincial Engineering Research Center of Molecular Imaging, Guangdong Provincial Key Laboratory of Biomedical Imaging, and Department of Interventional Medicine, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, Guangdong China
| | - Siqi Ming
- grid.452859.7Center for Infection and Immunity, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, Guangdong China ,grid.452859.7Guangdong Provincial Engineering Research Center of Molecular Imaging, Guangdong Provincial Key Laboratory of Biomedical Imaging, and Department of Interventional Medicine, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, Guangdong China ,grid.410741.7National Clinical Research Center for Infectious Disease, Shenzhen Third People’ s Hospital; The Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, Guangdong China
| | - Lantian Tang
- grid.452859.7Center for Infection and Immunity, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, Guangdong China ,grid.452859.7Guangdong Provincial Engineering Research Center of Molecular Imaging, Guangdong Provincial Key Laboratory of Biomedical Imaging, and Department of Interventional Medicine, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, Guangdong China
| | - Jiahai Lu
- grid.12981.330000 0001 2360 039XSchool of Public Health, Sun Yat-sen University, Guangzhou, Guangdong China
| | - Cheng Guo
- grid.21729.3f0000000419368729Center for Infection and Immunity, Mailman School of Public Health, Columbia University, New York, NY USA
| | - Hong Shan
- grid.452859.7Guangdong Provincial Engineering Research Center of Molecular Imaging, Guangdong Provincial Key Laboratory of Biomedical Imaging, and Department of Interventional Medicine, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, Guangdong China ,grid.511004.1Southern Marine Science and Engineering Guangdong Laboratory, Zhuhai, Guangdong China
| | - Xi Huang
- grid.452859.7Center for Infection and Immunity, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, Guangdong China ,grid.452859.7Guangdong Provincial Engineering Research Center of Molecular Imaging, Guangdong Provincial Key Laboratory of Biomedical Imaging, and Department of Interventional Medicine, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, Guangdong China ,grid.511004.1Southern Marine Science and Engineering Guangdong Laboratory, Zhuhai, Guangdong China ,grid.410741.7National Clinical Research Center for Infectious Disease, Shenzhen Third People’ s Hospital; The Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, Guangdong China
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Korsch M, Walther W, Robra BP, Sahin A, Hannig M, Bartols A. How do specialist surgeons treat the atrophic tooth gap? A vignette-based study among maxillofacial and oral surgeons. BMC Oral Health 2021; 21:331. [PMID: 34217268 PMCID: PMC8254999 DOI: 10.1186/s12903-021-01688-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 06/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is little information available regarding the decision-making process of clinicians, especially in the choice of therapy for a severely atrophic tooth gap. The aim of this research was to use case vignettes to determine the influence of possible factors on the decision making of maxillofacial and oral surgeons. METHODS A total of 250 maxillofacial (MFS) and oral (OS) surgeons in southern Germany were surveyed for atrophic single- or multiple-tooth gap with the help of case vignettes. The influence of different determinants on the therapy decision was investigated. Two case vignettes were designed for this purpose: vignette 1 with determinants "patient age" and "endocarditis prophylaxis" and vignette 2 with determinants "anxiety" and "bisphosphonate therapy". Furthermore, the specialist designation was assessed for both. The options available to achieve a sufficient implant site were "bone split", "bone block", "augmentation with bone substitute material" and "bone resection". Therapy was either recommended or rejected based on principle. RESULTS A total of 117 participants returned the questionnaire: 68 (58%) were OS and 49 (42%) MFS. "Patient age" and "patient anxiety" were not significantly associated with any therapy decision. However, required "endocarditis prophylaxis" led to significantly higher refusal rates for "bone split", "bone block" and "bone replacement material" and to higher rates of general refusal of a therapy. "Bisphosphonate therapy" was significantly associated with general refusal of therapy, but with no significant correlation with different therapy options. In vignette 1, OS refused therapy significantly more often than MFS, though there was no association with the specialist designation for other therapy modalities. In vignette 2, specialty was not significantly associated with the therapy decision. CONCLUSION "Patient age" as well as "patient anxiety" appear to have no or little influence on the treatment decision for severely atrophic single- or multiple-tooth gap by specialist surgeons. Surgeons more often refuse treatment for patients with endocarditis prophylaxis and bisphosphonate therapy.
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Affiliation(s)
- Michael Korsch
- Dental Academy for Continuing Professional Development, Lorenzstrasse 7, 76135, Karlsruhe, Germany. .,Clinic of Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital, Saarland University, Building 73, 66421, Homburg, Germany. .,Center for Implantology and Oral Surgery, 69120, Heidelberg, Germany.
| | - Winfried Walther
- Dental Academy for Continuing Professional Development, Lorenzstrasse 7, 76135, Karlsruhe, Germany
| | - Bernt-Peter Robra
- Institute of Social Medicine and Health Services Research, Otto-von-Guericke-University of Magdeburg, Magdeburg, Germany
| | - Aynur Sahin
- , Blumenstrasse 5, 69115, Heidelberg, Germany
| | - Matthias Hannig
- Clinic of Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital, Saarland University, Building 73, 66421, Homburg, Germany
| | - Andreas Bartols
- Dental Academy for Continuing Professional Development, Lorenzstrasse 7, 76135, Karlsruhe, Germany.,Clinic for Conservative Dentistry and Periodontology, School for Dental Medicine, Christian-Albrechts-University Kiel, Kiel, Germany
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6
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Dijkstra GW, Glaudemans AWJM, Erba PA, Wouthuyzen-Bakker M, Sinha B, Vállez García D, van der Sluis LWM, Slart RHJA. Relationship between 18F-FDG Uptake in the Oral Cavity, Recent Dental Treatments, and Oral Inflammation or Infection: A Retrospective Study of Patients with Suspected Endocarditis. Diagnostics (Basel) 2020; 10:E625. [PMID: 32846896 PMCID: PMC7555096 DOI: 10.3390/diagnostics10090625] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 08/18/2020] [Accepted: 08/20/2020] [Indexed: 12/15/2022] Open
Abstract
[18F]-fluorodeoxyglucose positron emission tomography ([18F]FDG PET/CT) has proven to be a useful diagnostic tool in patients with suspected infective endocarditis (IE), but is conflicting in relation to dental procedures. QUESTIONS Is there a correlation between [18F]FDG PET/CT findings, recent dental treatment, and an affected oral cavity? (2) Is there a correlation between infective endocarditis (IE), oral health status, and (extra)cardiac findings on [18F]FDG PET/CT? METHODS This retrospective study included 52 patients. All [18F]FDG PET/CT scans were examined visually by pattern recognition using a three-point scale and semi-quantified within the volume of interest (VOI) using SUVmax. RESULTS 19 patients were diagnosed with IE (group 1), 14 with possible IE (group 2), and 19 without IE based on the modified Duke criteria (group 3). No correlation was found between visual PET and SUVmax and sites of oral inflammation and infection. The visual PET scores and SUVmax were not significantly different between all groups. A significant difference in the SUVmax of the valve between all groups was observed. CONCLUSIONS This study suggests that no correlation exists between the PET findings in the oral cavity and dental treatments or inflammation/infection. No correlation between IE, actual oral health status, and extra-cardiac findings was demonstrated. Additional research is needed to conclude whether [18F]FDG PET/CT imaging is a reliable diagnostic modality for oral inflammation and infection sites.
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Affiliation(s)
- Geertruida W. Dijkstra
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, PO 9700 RB Groningen, The Netherlands; (G.W.D.); (L.W.M.v.d.S.)
| | - Andor W. J. M. Glaudemans
- Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, PO 9700 RB Groningen, The Netherlands; (P.A.E.); (D.V.G.); (R.H.J.A.S.)
| | - Paola A. Erba
- Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, PO 9700 RB Groningen, The Netherlands; (P.A.E.); (D.V.G.); (R.H.J.A.S.)
- Department of Nuclear Medicine, Department of Translational Research and New Technology in Medicine, University of Pisa, 56128 Pisa, Italy
| | - Marjan Wouthuyzen-Bakker
- Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, PO 9700 RB Groningen, The Netherlands; (M.W.-B.); (B.S.)
| | - Bhanu Sinha
- Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, PO 9700 RB Groningen, The Netherlands; (M.W.-B.); (B.S.)
| | - David Vállez García
- Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, PO 9700 RB Groningen, The Netherlands; (P.A.E.); (D.V.G.); (R.H.J.A.S.)
| | - Luc W. M. van der Sluis
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, PO 9700 RB Groningen, The Netherlands; (G.W.D.); (L.W.M.v.d.S.)
| | - Riemer H. J. A. Slart
- Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, PO 9700 RB Groningen, The Netherlands; (P.A.E.); (D.V.G.); (R.H.J.A.S.)
- Department of Biomedical Photonic Imaging, University of Twente, 7522 NB Enschede, The Netherlands
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7
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Slullitel PA, Oñativia JI, Piuzzi NS, Higuera-Rueda C, Parvizi J, Buttaro MA. Is there a Role for Antibiotic Prophylaxis Prior to Dental Procedures in Patients with Total Joint Arthroplasty? A Systematic Review of the Literature. J Bone Jt Infect 2020; 5:7-15. [PMID: 32117684 PMCID: PMC7045525 DOI: 10.7150/jbji.40096] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Accepted: 11/13/2019] [Indexed: 12/29/2022] Open
Abstract
Background: The indication of prophylactic antibiotics prior to dental procedures for non-infected causes in order to reduce the risk of haematogenous periprosthetic joint infection (PJI) remains as controversial. We performed a systematic review of the literature assessing the relationship between PJI and invasive dental procedures and whether there is evidence to support the use of antibiotic prophylaxis. Methods: This review was conducted in accordance with the 2009 Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement. MEDLINE, EMBASE and the Cochrane Database of Systematic Reviews were searched for studies focusing on dental procedures after TJA, reporting on PJI as an outcome. The methodological quality was assessed with the Newcastle-Ottawa quality assessment scale for case-control and cohort studies and by the tool proposed by Murad et al. for observational studies. Results: Our systematic literature review yielded 90 individual studies, of which 9 met the inclusion criteria. The overall infection rate ranged from 0.26% to 2.12%. Of these, cases associated with a dental procedure ranged from 0% to 15.9%. Five of the studies described cases in which antibiotic prophylaxis was administered; however, no clear algorithm regarding type and dosage of antibiotic was mentioned. When assessing the methodological quality of the evidence, all studies had an overall low to moderate quality. Conclusion: The current systematic review, mostly composed of low-quality studies, suggests that there is no direct evidence to indicate prophylactic antibiotics prior to dental procedures in patients with TJA. In line with the current guidelines, no prophylaxis should be used on interventions for non-infected causes, except for occasional unusual situations, which can then be judged individually.
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Affiliation(s)
- Pablo Ariel Slullitel
- Hip Surgery Unit, Institute of Orthopaedics “Carlos E. Ottolenghi”, Italian Hospital of Buenos Aires, Buenos Aires, Argentina
- Division of Orthopaedic Surgery, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - José Ignacio Oñativia
- Hip Surgery Unit, Institute of Orthopaedics “Carlos E. Ottolenghi”, Italian Hospital of Buenos Aires, Buenos Aires, Argentina
| | - Nicolás Santiago Piuzzi
- Adult Reconstructive Surgery, Division of Orthopaedic Surgery, Cleveland Clinic, Ohio, United States
| | - Carlos Higuera-Rueda
- Adult Reconstructive Surgery, Division of Orthopaedic Surgery, Cleveland Clinic, Ohio, United States
| | - Javad Parvizi
- Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA; United States
| | - Martín Alejandro Buttaro
- Hip Surgery Unit, Institute of Orthopaedics “Carlos E. Ottolenghi”, Italian Hospital of Buenos Aires, Buenos Aires, Argentina
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8
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Zeng BS, Lin SY, Tu YK, Wu YC, Stubbs B, Liang CS, Yeh TC, Chen TY, Carvalho AF, Lin PY, Lei WT, Hsu CW, Chen YW, Tseng PT, Chen CH. Prevention of Postdental Procedure Bacteremia: A Network Meta-analysis. J Dent Res 2019; 98:1204-1210. [PMID: 31469596 DOI: 10.1177/0022034519870466] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Postdental procedure bacteremia is common and troublesome. The comparative efficacy of multiple prophylactic interventions is unclear. We compared the efficacy of interventions for the prevention of postdental procedure bacteremia. We conducted a review of ClinicalKey, Cochrane CENTRAL, Embase, ProQuest, PubMed, ScienceDirect, Web of Science, and ClinicalTrials.gov from inception to December 4, 2018. Randomized controlled trials that evaluated prophylactic interventions for the prevention of postdental procedure bacteremia were eligible. The primary outcome was the incidence of postdental procedure bacteremia. A total of 24 trials were included with 2,147 participants. Our network meta-analysis demonstrated that intravenous administration of 1,000/200 mg of amoxicillin/clavulanate provided the least incidence of postdental procedure bacteremia among all the prophylactic interventions (odds ratio = 0.03, 95% CI = 0.00 to 0.63) as compared with the placebo/controls. Oral 3 g of amoxicillin had the least incidence of postdental procedure bacteremia among all oral or topical forms of prophylactic interventions (odds ratio = 0.10, 95% CI = 0.02 to 0.44) as compared with the placebo/controls. No serious adverse events, such as anaphylactic shock, mortality, and the development of antibiotic-resistant bacteria, were reported. None of the included subjects were of high risk of infectious endocarditis. Our network meta-analysis demonstrates that intravenous amoxicillin/clavulanate and oral amoxicillin might be the best prophylactic interventions in preventing postdental procedure bacteremia among all the oral/topical forms of interventions for the overall populations.
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Affiliation(s)
- B S Zeng
- Department of Internal Medicine, E-Da Hospital, Kaohsiung, Taiwan
| | - S Y Lin
- Department of Dentistry, MacKay Memorial Hospital, Taipei, Taiwan
| | - Y K Tu
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.,Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - Y C Wu
- Department of Sports Medicine, Landseed International Hospital, Taoyuan, Taiwan
| | - B Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK.,Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, UK.,Positive Ageing Research Institute, Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, UK
| | - C S Liang
- Department of Psychiatry, Beitou Branch, Tri-Service General Hospital; School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
| | - T C Yeh
- Department of Psychiatry, Tri-Service General Hospital; School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - T Y Chen
- Department of Psychiatry, Tri-Service General Hospital; School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - A F Carvalho
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Centre for Addiction & Mental Health (CAMH), Toronto, ON, Canada
| | - P Y Lin
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.,Institute for Translational Research in Biomedical Sciences, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - W T Lei
- Division of Allergy, Immunology, Rheumatology Disease, Department of Pediatrics, Mackay Memorial Hospital, Hsinchu, Taiwan
| | - C W Hsu
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Y W Chen
- Prospect Clinic for Otorhinolaryngology and Neurology, Kaohsiung City, Taiwan
| | - P T Tseng
- Prospect Clinic for Otorhinolaryngology and Neurology, Kaohsiung City, Taiwan.,WinShine Clinics in Specialty of Psychiatry, Kaohsiung City, Taiwan
| | - C H Chen
- Program in Translational Medicine, National Chung Hsing University, Taichung City, Taiwan.,Rong Hsing Research Center for Translational Medicine, National Chung Hsing University, Taichung City, Taiwan.,Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
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9
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Assessment of the bioavailability of an antibiotic prophylactic protocol in patients undergoing third molar surgery. Int J Oral Maxillofac Surg 2019; 48:1470-1474. [PMID: 31072798 DOI: 10.1016/j.ijom.2019.04.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 02/12/2019] [Accepted: 04/09/2019] [Indexed: 11/24/2022]
Abstract
The aim of this prospective study was to determine the antibiotic bioavailability of a prophylactic protocol in patients undergoing third molar surgery. Samples from 25 patients were analysed (average age 21 ± 3.89 years, range 18-33 years; 14 female). The patients received single-dose prophylaxis of 2 g amoxicillin orally 1 hour prior to third molar surgery. Venous blood (1.5 ml) and blood from the third molar socket (1.50 ml) were obtained. The amoxicillin plasma concentration was determined in both samples by high performance liquid chromatography with a diode-array detector (HPLC/DAD). Their associations with demographic variables (age, height, weight, body mass index (BMI), sex) and antibiotic exposure time were analyzed using linear regression models. The mean amoxicillin plasma level detected in the venous blood was 1.21 ± 1.17 μg/ml (range 0.49-6.34 μg/ml) and in the third molar socket was 4.14 ± 2.24 μg/ml (range 0.86-7.46 μg/ml) (P < 0.001). No relationship was observed between the bioavailability of the drug and the patient biometric indices evaluated. The prophylactic administration of 2 g amoxicillin in third molar surgery showed greater bioavailability in the molar socket than the concentrations established as necessary to inhibit the growth of microorganisms that cause oral infections. The results show the need to review the current infection control protocols in oral surgery in light of the overestimated doses observed.
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10
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Bellows J, Berg ML, Dennis S, Harvey R, Lobprise HB, Snyder CJ, Stone AE, Van de Wetering AG. 2019 AAHA Dental Care Guidelines for Dogs and Cats*. J Am Anim Hosp Assoc 2019; 55:49-69. [DOI: 10.5326/jaaha-ms-6933] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
ABSTRACT
The 2019 AAHA Dental Care Guidelines for Dogs and Cats outline a comprehensive approach to support companion animal practices in improving the oral health and often, the quality of life of their canine and feline patients. The guidelines are an update of the 2013 AAHA Dental Care Guidelines for Dogs and Cats. A photographically illustrated, 12-step protocol describes the essential steps in an oral health assessment, dental cleaning, and periodontal therapy. Recommendations are given for general anesthesia, pain management, facilities, and equipment necessary for safe and effective delivery of care. To promote the wellbeing of dogs and cats through decreasing the adverse effects and pain of periodontal disease, these guidelines emphasize the critical role of client education and effective, preventive oral healthcare.
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Affiliation(s)
- Jan Bellows
- From All Pets Dental, Weston, Florida (J.B.); Beyond the Crown Veterinary Education, Lawrence, Kansas (M.L.B.); Stratham-Newfields Veterinary Hospital, Newfields, New Hampshire (S.D.); Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, Tennessee (R.H.); Main Street Veterinary Dental Hospital, Flower Mount, Texas (H.B.L.); Department o
| | - Mary L. Berg
- From All Pets Dental, Weston, Florida (J.B.); Beyond the Crown Veterinary Education, Lawrence, Kansas (M.L.B.); Stratham-Newfields Veterinary Hospital, Newfields, New Hampshire (S.D.); Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, Tennessee (R.H.); Main Street Veterinary Dental Hospital, Flower Mount, Texas (H.B.L.); Department o
| | - Sonnya Dennis
- From All Pets Dental, Weston, Florida (J.B.); Beyond the Crown Veterinary Education, Lawrence, Kansas (M.L.B.); Stratham-Newfields Veterinary Hospital, Newfields, New Hampshire (S.D.); Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, Tennessee (R.H.); Main Street Veterinary Dental Hospital, Flower Mount, Texas (H.B.L.); Department o
| | - Ralph Harvey
- From All Pets Dental, Weston, Florida (J.B.); Beyond the Crown Veterinary Education, Lawrence, Kansas (M.L.B.); Stratham-Newfields Veterinary Hospital, Newfields, New Hampshire (S.D.); Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, Tennessee (R.H.); Main Street Veterinary Dental Hospital, Flower Mount, Texas (H.B.L.); Department o
| | - Heidi B. Lobprise
- From All Pets Dental, Weston, Florida (J.B.); Beyond the Crown Veterinary Education, Lawrence, Kansas (M.L.B.); Stratham-Newfields Veterinary Hospital, Newfields, New Hampshire (S.D.); Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, Tennessee (R.H.); Main Street Veterinary Dental Hospital, Flower Mount, Texas (H.B.L.); Department o
| | - Christopher J. Snyder
- From All Pets Dental, Weston, Florida (J.B.); Beyond the Crown Veterinary Education, Lawrence, Kansas (M.L.B.); Stratham-Newfields Veterinary Hospital, Newfields, New Hampshire (S.D.); Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, Tennessee (R.H.); Main Street Veterinary Dental Hospital, Flower Mount, Texas (H.B.L.); Department o
| | - Amy E.S. Stone
- From All Pets Dental, Weston, Florida (J.B.); Beyond the Crown Veterinary Education, Lawrence, Kansas (M.L.B.); Stratham-Newfields Veterinary Hospital, Newfields, New Hampshire (S.D.); Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, Tennessee (R.H.); Main Street Veterinary Dental Hospital, Flower Mount, Texas (H.B.L.); Department o
| | - Andrea G. Van de Wetering
- From All Pets Dental, Weston, Florida (J.B.); Beyond the Crown Veterinary Education, Lawrence, Kansas (M.L.B.); Stratham-Newfields Veterinary Hospital, Newfields, New Hampshire (S.D.); Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, Tennessee (R.H.); Main Street Veterinary Dental Hospital, Flower Mount, Texas (H.B.L.); Department o
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Chen X, D'Souza V, Yu L. The oral health status of residents with different cognitive and dental-related functions in three North Carolina assisted living facilities. Gerodontology 2019; 36:142-148. [PMID: 30724388 DOI: 10.1111/ger.12391] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 11/03/2018] [Accepted: 12/08/2018] [Indexed: 11/27/2022]
Abstract
INTRODUCTION The aim of the study was to describe the oral health status of persons with different cognition and dental-related functions (DRFs). METHODS The present study was a secondary analysis of data collected for a cross-sectional study of residents in three assisted living facilities in North Carolina. The participants were aged 50 years or older, had normal to severely impaired cognition and spoke English. Upon obtaining informed consent, an oral assessment was completed by a trained geriatric dentist. A research team member who was blind to the oral examination outcomes then used the Minimum Data Set Cognition Scale to assess participants' cognition and the dental activities test to evaluate oral self-care and other DRFs. Descriptive statistics were used to describe the demographic, cognitive, functional and oral health status of the study participants. The impacts of cognitive and functional status on oral health measures were examined using simple linear regression models, negative binomial and zero-inflated negative binomial models. RESULTS A total of 91 long-term residents from three long-term care facilities participated in the study. Oral hygiene and gingival health were significantly associated with cognition (P = 0.056 and P = 0.017, respectively) and DRFs (P = 0.013 and P = 0.008, respectively). Residents with poor cognitive and dental-related function also presented with poor oral hygiene and gingival health. CONCLUSION The study results suggest that oral hygiene and gingival health were significantly associated with cognition and DRFs.
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Affiliation(s)
- Xi Chen
- Department of Preventive and Community Dentistry, College of Dentistry, University of Iowa, Iowa City, Iowa
| | - Violet D'Souza
- Department of Preventive and Community Dentistry, College of Dentistry, University of Iowa, Iowa City, Iowa
| | - Lixi Yu
- Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, Iowa
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Arnold WV, Bari AK, Buttaro M, Huang R, Mirez JP, Neira I, Poojary A, Purtill JJ, Quevedo MS, García Ricaurte JC, Scuderi G, Thakur H, Tozun IR. General Assembly, Prevention, Postoperative Factors: Proceedings of International Consensus on Orthopedic Infections. J Arthroplasty 2019; 34:S169-S174. [PMID: 30348574 DOI: 10.1016/j.arth.2018.09.067] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
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