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Antibiotics Prescription by Spanish General Practitioners in Primary Dental Care. Antibiotics (Basel) 2021; 10:antibiotics10060703. [PMID: 34208145 PMCID: PMC8230768 DOI: 10.3390/antibiotics10060703] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 06/01/2021] [Accepted: 06/08/2021] [Indexed: 11/16/2022] Open
Abstract
The aim of this study was to analyze the antibiotics prescription habits, both prophylactically and therapeutically, of Spanish general dental practitioners in the management of endodontic infections in primary care. Two hundred Spanish general dental practitioners were asked to respond to a survey on indications for antibiotics prescription in the treatment of endodontic infections, being 190 general dentists (95%) included in the study. Data were analyzed using descriptive statistics and the chi-square test. The average duration of antibiotics therapy was 6.5 ± 1.0 days. In patients without medical allergies, most of them (97%) selected amoxicillin as the antibiotic of the first choice, alone (51.1%) or associated with clavulanic acid (45.8%); in patients with penicillin allergies, the drug of choice was clindamycin 300 mg (70%). For cases of symptomatic irreversible pulpitis, 44% of the respondents prescribed antibiotics, in the scenario of prophylactic antibiotic prescription, up to 27% of the general dentists prescribe according to non-current guidelines (1 g 1 h before or 1 g 1 h before and 1 g 1 h after) in non-indicated cases (16% in patients taking oral bisphosphonates). It is necessary to improve the antibiotic prescription habits of Spanish general dentists in endodontics.
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Shamszadeh S, Asgary S, Shirvani A, Eghbal MJ. Effects of antibiotic administration on post-operative endodontic symptoms in patients with pulpal necrosis: A systematic review and meta-analysis. J Oral Rehabil 2020; 48:332-342. [PMID: 32681652 DOI: 10.1111/joor.13057] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 06/28/2020] [Accepted: 06/30/2020] [Indexed: 12/30/2022]
Abstract
OBJECTIVES The current systematic review and meta-analysis aimed to assess the efficacy of prophylactic oral antibiotics in the management of post-operative endodontic symptoms in adults with necrotic pulp. MATERIALS AND METHODS A systematic search up to April 2020 was performed to find all randomised controlled trials (RTCs) comparing oral antibiotics with placebo to manage post-endodontic symptoms. The outcome measures were post-operative pain, swelling and/or the combined pain and swelling at different follow-ups. Standardised mean differences (SMDs) and 95% confidence intervals (CIs) were estimated using random-effect inverse-variance method. Additional analysis was performed if heterogeneity existed (P < .05). RESULTS For post-endodontic pain, 8 RCTs (n = 690) were included. Antibiotic prescription had no significant effect on endodontic pain at 6 (SMD = -0.008, 95% CI -0.279 - 0.264, P = .95), 12 (SMD = -0.080, 95% CI -1.39 - 1.23, P = .90), 24 (SMD = -0.044, 95% CI -0.29 - 0.20, P = .72), 48 (SMD = 0.18, 95% CI -0.26 - 0.62, P = .42) and 72 h (SMD= -0.050, 95% CI -0.33 - 0.23, P = .723) post-operatively. For post-endodontic swelling, 4 RCTs (n = 149) were included. Antibiotic prescription had no significant effect on endodontic swelling at 24 (SMD = 0.29, 95% CI -0.72 - 1.32, P = .56), 48 (SMD = -0.23, 95% CI -0.98 - 0.51, P = .54) and 72 hours (SMD= -0.03, 95% CI -1.25 - 1.33, P = .96), post-operatively. For combined pain and swelling, no meta-analysis was performed. CONCLUSION The administration of prophylactic antibiotics to prevent post-operative endodontic symptoms is not supported by the current evidence.
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Affiliation(s)
- Sayna Shamszadeh
- Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Saeed Asgary
- Iranian Center for Endodontic Research, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Armin Shirvani
- Iranian Center for Endodontic Research, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Mohammad Jafar Eghbal
- Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Science, Tehran, Iran
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Shamszadeh S, Shirvani A, Asgary S. Does occlusal reduction reduce post-endodontic pain? A systematic review and meta-analysis. J Oral Rehabil 2020; 47:528-535. [PMID: 31880822 DOI: 10.1111/joor.12929] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 11/30/2019] [Accepted: 12/20/2019] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Pain management during endodontic therapy is an important issue in clinical practice. The objective of this systematic review and meta-analysis was to evaluate the efficacy of occlusal reduction to control the post-operative endodontic pain in adults undergoing root canal therapy. MATERIALS AND METHODS Electronic database and manual searches of English papers were conducted up to August 2019 to identify randomised placebo-controlled trials. The MeSH terms used were (endodontics OR root canal therapy) AND (postoperative pain) AND (occlusal reduction). The primary outcome measure was the post-operative pain intensity up to 72 hours. Pooled standardised mean differences (SMDs) and 95% confidence intervals (CIs) were calculated using random-effects inverse variance method. The statistical heterogeneity was assessed using the Cochrane Q test. The significance level was set at P < .05. RESULTS In total, six randomised controlled trials including 344 participants were included. Our meta-analyses showed that relief of occlusal surface did not significantly reduce the pain intensity scores at 12- (SMD = -0.46; 95% CI = -1.24, 0.30; P = .239), 24- (SMD = -0.17; 95% CI = -0.73, 0.38; P = .533) and 48- (SMD = -0.67; 95% CI = -1.38, 0.03; P = .063) when compared to placebo. However, at 72 hours, patients received intervention showed significant more pain reduction than placebo groups (SMD = -1.07; 95% CI = -1.81, -0.32; P = .005). CONCLUSION Based on this meta-analysis, the efficacy of occlusal reduction in post-endodontic pain control for up to 2 days is not supported. However, on day three, it had a positive influence on the control of post-endodontic pain.
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Affiliation(s)
- Sayna Shamszadeh
- Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Armin Shirvani
- Iranian Center for Endodontic Research, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Saeed Asgary
- Iranian Center for Endodontic Research, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Science, Tehran, Iran
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Isik BK, Gürses G, Menziletoglu D. Acutely infected teeth: to extract or not to extract? Braz Oral Res 2018; 32:e124. [PMID: 30540102 DOI: 10.1590/1807-3107bor-2018.vol32.0124] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 11/05/2018] [Indexed: 11/22/2022] Open
Abstract
Not only laymen but also dentists generally believe that extraction of acutely infected teeth should be avoided until the infection subdues by using systemic antibiotics. The aim of this study was to compare perioperative complications in routine extractions of acutely infected teeth with extractions of asymptomatic teeth. This prospective study was performed with 82 patients. Severe pain on percussion of the relevant tooth was considered as basic criteria for acute infection. The acutely infected teeth were labeled as the study group (n = 35) and the asymptomatic teeth as the control group (n = 47). The extractions were done using standard procedures. The amount of anesthetic solution used and duration of extractions were recorded. Postoperative severe pain and exposed bone with no granulation tissue in the extraction socket were indications of alveolar osteitis (AO). The level of statistical significance was accepted as 0.05. Symptoms that could indicate systemic response, including fever, fatigue, and shivering were not found. There was no statistically significant difference between groups in terms of AO, amount of anesthetic solution used, and duration of extraction. The presence of an acute infection characterized by severe percussion pain is not a contraindication for tooth extraction. Infected teeth should be extracted as soon as possible and the procedure should not be postponed by giving antibiotics.
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Affiliation(s)
- Bozkurt Kubilay Isik
- Necmettin Erbakan University, Faculty of Dentistry, Oral and Maxillofacial Surgery Department, Konya, Turkey
| | - Gökhan Gürses
- Necmettin Erbakan University, Faculty of Dentistry, Oral and Maxillofacial Surgery Department, Konya, Turkey
| | - Dilek Menziletoglu
- Necmettin Erbakan University, Faculty of Dentistry, Oral and Maxillofacial Surgery Department, Konya, Turkey
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Emara RS, Abou El Nasr HM, El Boghdadi RM. Evaluation of postoperative pain intensity following occlusal reduction in teeth associated with symptomatic irreversible pulpitis and symptomatic apical periodontitis: a randomized clinical study. Int Endod J 2018; 52:288-296. [DOI: 10.1111/iej.13012] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Accepted: 08/28/2018] [Indexed: 01/17/2023]
Affiliation(s)
- R. S. Emara
- Department of Endodontics Faculty of Oral and Dental Medicine Cairo University Cairo Egypt
| | - H. M. Abou El Nasr
- Department of Endodontics Faculty of Oral and Dental Medicine Cairo University Cairo Egypt
| | - R. M. El Boghdadi
- Department of Endodontics Faculty of Oral and Dental Medicine Cairo University Cairo Egypt
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Germack M, Sedgley CM, Sabbah W, Whitten B. Antibiotic Use in 2016 by Members of the American Association of Endodontists: Report of a National Survey. J Endod 2017; 43:1615-1622. [DOI: 10.1016/j.joen.2017.05.009] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 05/17/2017] [Indexed: 10/19/2022]
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Alattas HA, Alyami SH. Prescription of antibiotics for pulpal and periapical pathology among dentists in southern Saudi Arabia. J Glob Antimicrob Resist 2017; 9:82-84. [PMID: 28455077 DOI: 10.1016/j.jgar.2017.01.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 01/23/2017] [Accepted: 01/31/2017] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES Few dental conditions require treatment with antibiotics, yet dentists account for 7% of antimicrobial prescribing. In light of the emerging global problem of antibiotic resistance, this fact is problematic. Little is known about the antibiotic prescribing practices of dentists in Saudi Arabia. This study therefore aimed to investigate the attitudes of dentists in Saudi Arabia towards the prescription of antibiotics for pulpal and periapical pathology. METHODS This was a cross-sectional study involving an online questionnaire on antibiotic prescribing practices. A total of 195 dentists in three areas of southern Saudi Arabia (Najran, Gizan and Asser) completed the survey. RESULTS No significant differences in prescribing habits were found among respondents according to age, sex, level of education or time in endodontic practice. The percentage of respondents who reported that they would prescribe antibiotics for five endodontic conditions not requiring antibiotic treatment ranged from 8.1% to 28.1%. Most respondents (81.9%) would correctly prescribe antibiotics for a necrotic pulp with acute apical periodontitis and swelling; this result was consistent with previous studies. Reported antibiotic usage among the surveyed dentists was quite high. CONCLUSIONS Relatively high antibiotic use suggests a need to educate both dentists and patients about restricting the use of antibiotics to cases of severe infection and when indicated. More educational initiatives to rationalise the use of antibiotics in dental practice are needed to avoid further contributing to antibiotic resistance.
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Affiliation(s)
- Hussien A Alattas
- Department of Restorative Dental Sciences, College of Dentistry, Najran University, P.O. Box 1988, Najran, Saudi Arabia.
| | - Saif H Alyami
- Department of Restorative Dental Sciences, College of Dentistry, Najran University, P.O. Box 1988, Najran, Saudi Arabia
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Segura-Egea JJ, Martín-González J, Jiménez-Sánchez MDC, Crespo-Gallardo I, Saúco-Márquez JJ, Velasco-Ortega E. Worldwide pattern of antibiotic prescription in endodontic infections. Int Dent J 2017; 67:197-205. [PMID: 28417452 DOI: 10.1111/idj.12287] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Odontogenic infections, and especially endodontic infections, are polymicrobial, involving a combination of Gram-positive and Gram-negative facultative anaerobes and strictly anaerobic bacteria. Therefore, antibiotics can be used as an adjunct to endodontic treatment. However, most chronic and even acute endodontic infections can be successfully managed by disinfection of the root-canal system, which eliminates the source of infection, followed by abscess drainage or tooth extraction, without the need for antibiotics. The literature provides evidence of inadequate prescribing practices by dentists. The aim of this concise review was to analyse the worldwide pattern of antibiotic prescription in endodontic infections. METHODS Comprehensive searches were conducted in MEDLINE/PubMed, Wiley Online Database, Web of Science and Scopus. The databases were searched up to 13 March 2016 for studies in which dentists used systemic antibiotics to treat endodontic lesions and which reported data on the type of antibiotic prescribed and on the diagnosis of the endodontic disease treated. RESULTS The electronic and hand searches identified 69 titles, of which 25 were included in the final analysis. Amoxicillin was reported as the drug of choice for endodontic infections in most countries, and clindamycin and erythromycin were the choice for patients allergic to penicillin. Dentists worldwide prescribe antibiotics for non-indicated conditions, such as pulpitis. CONCLUSION Antibiotics are overprescribed for the management of endodontic infections. It is necessary to improve antibiotic-prescribing habits in the treatment of endodontic infections, as well as to introduce educational initiatives to encourage the coherent and proper use of antibiotics in such conditions.
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Affiliation(s)
- Juan José Segura-Egea
- Department of Stomatology (Endodontics), School of Dentistry, University of Sevilla, Sevilla, Spain
| | - Jenifer Martín-González
- Department of Stomatology (Endodontics), School of Dentistry, University of Sevilla, Sevilla, Spain
| | | | - Isabel Crespo-Gallardo
- Department of Stomatology (Endodontics), School of Dentistry, University of Sevilla, Sevilla, Spain
| | - Juan José Saúco-Márquez
- Department of Stomatology (Endodontics), School of Dentistry, University of Sevilla, Sevilla, Spain
| | - Eugenio Velasco-Ortega
- Department of Stomatology (Comprehensive Dentistry), School of Dentistry, University of Sevilla, Sevilla, Spain
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Alsomadi L, Al Habahbeh R. Role of Prophylactic Antibiotics in the Management of Postoperative Endodontic Pain. J Contemp Dent Pract 2015; 16:939-943. [PMID: 27018027 DOI: 10.5005/jp-journals-10024-1785] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
AIM To investigate the efficacy of using antibiotics in post endodontic treatment as a method to alleviate post-treatment pain. MATERIALS AND METHODS After completion of endodontic treatment 129 patients were randomly divided into two groups: Group A (65 patients) received Ibuprofen 400 mg one tablet before procedure and one tablet every 8 hours for the first day, then one tablet once indicated by pain. Group B (64 patients) received the same regimen as group A in addition to amoxicillin, clavulanic acid tablets (one tablet before the procedure, and then one tablet twice daily for a total of 3 days). Intensity of pain at 8 hours interval using visual analog scale (VAS) and total number of Ibuprofen tablets used was recorded by patients. RESULTS Peak postoperative pain occurred at 16 hours post-treatment in both groups, there was a significant difference in the pain scale between the two groups in favor for group B over group A (3.8 vs 2.1 respectively). Pain scale was significantly lower in group B at 24, 32, 40, and 48 hours post-treatment with a p-value of < 0.05. The pain scale at 56, 64 and 72 hours were also less in group B, although could not show up as statistical difference. Patients in group A used statistically significant more Ibuprofen than patients in group B (486 vs 402). CONCLUSION Antibiotic prescription to manage post endodontic treatment pain results in less pain with less consumption of Ibuprofens. CLINICAL SIGNIFICANCE Pain management in endodontics is a real challenge, nonsteroidal anti-inflammatory drugs (NSAIDS) are used effectively in many patients to alleviate post endodontic pain. Nonsteroidal anti-inflammatory drugs may have adverse reactions or may be contraindicated. Short-term use of antibiotics to alleviate pain can be of clinical benefits in these patients.
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Affiliation(s)
- Leena Alsomadi
- Associate Professor Department of Conservative Dentistry, University of Jordan PO Box 830453, Amman, Jordan, Phone: 009626797728100 e-mail:
| | - Riyad Al Habahbeh
- Department Conservative Dentistry, Royal Medical Services Amman, Jordan
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Bidar M, Gharechahi M, Soleimani T, Eslami N. A Survey over the Dentists' and Endodntists' Approaches towards the Management of Endodontic Emergencies in Mashhad, Iran. IRANIAN ENDODONTIC JOURNAL 2015; 10:256-62. [PMID: 26523142 PMCID: PMC4609665 DOI: 10.7508/iej.2015.04.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Introduction: Pain or swelling caused by various stages of inflammation/infection of the pulp/periradicular area is among endodontic emergencies. Determining the most effective method of emergency treatment is a challenging issue in endodontics. The goal of this study was to determine and compare the level of knowledge in general dentists and endodontists about endodontic emergency treatment plan in Mashhad, Iran in 2012-2013. Methods and Materials: In this cross-sectional descriptive study, 152 questionnaires were distributed among 120 general dentists and 32 endodontists of Mashhad. The questionnaire contained two separate parts. The first part included demographic information and in the second part different treatment protocols were suggested for 12 various conditions of pulp/periapical emergencies, and the participants were asked to choose the correct option(s). To determine the relationship between qualitative variables, the chi-square analysis was used. The level of significance was set at 0.05. Results: There were significant differences between treatment plans presented by general dentists and endodontists about endodontic emergencies, especially in cases of necrotic pulp and subsequent swelling. Conclusion: Level of knowledge of dentists about the indications of incision and drainage, intra-canal medicament, root filing beyond the apical foramen and antibiotic prescription was not enough. These findings highlight the importance of refreshing courses for general dentists to improve their competency in the management of endodontic emergencies.
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Affiliation(s)
- Maryam Bidar
- Dental Research Center, Dental School, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Gharechahi
- Dental Research Center, Dental School, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Neda Eslami
- Dental Research Center, Dental School, Mashhad University of Medical Sciences, Mashhad, Iran
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Iqbal A, Akbar I, Qureshi B, Sghaireen MG, AL-Omiri MK. A Survey of Standard Protocols for Endodontic Treatment in North of KSA. ISRN DENTISTRY 2014; 2014:865780. [PMID: 24944823 PMCID: PMC4040192 DOI: 10.1155/2014/865780] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/12/2014] [Accepted: 03/10/2014] [Indexed: 11/18/2022]
Abstract
The objective of this study was to collect information regarding methods, materials, and attitudes employed during the endodontic treatment by dentists in north of Saudi Arabia. A questionnaire was designed and distributed among 300 dentists in north of Saudi Arabia to collect the data about the standard protocols of endodontic treatment. The collected data was analyzed by using the SPSS 10 computer software. Out of a total of 300 surveyed dentists, the 66% response rate showed that this study was true representation of the endodontic treatment performed by the dentists in north of Saudi Arabia. 152 (76%) were general dentists and 48 (24%) were endodontists. 18 (9%) were using rubber dam as the method of isolation during endodontic treatment. 173 (86.5%) were using only measurement radiographs for working length determination and 27 (13.5%) were using both electronic apex locator and measurement radiographs. 95 (47.5%) of the respondents were using standardized technique and 25 (12.5%) were using step-down as a root canal preparation technique. 127 (63.5%) of the respondents were using lateral condensation technique, with gutta percha points for root canal obturation.
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Affiliation(s)
- Azhar Iqbal
- Department of Conservative Dentistry, Faculty of Dentistry, AlJouf University, P.O. Box 2014, Sakaka, AlJouf, Saudi Arabia
| | - Iftikhar Akbar
- Department of Conservative Dentistry, Faculty of Dentistry, AlJouf University, P.O. Box 2014, Sakaka, AlJouf, Saudi Arabia
| | - Beenish Qureshi
- Department of Operative Dentistry, Islamabad Medical and Dental College, Bahria University, Islamabad, Pakistan
| | - Mohd G. Sghaireen
- Department of Prosthodontics, Faculty of Dentistry, AlJouf University, Sakaka, Saudi Arabia
| | - Mahmoud K. AL-Omiri
- Faculty of Dentistry, University of Jordan, Amman, Jordan
- AlJouf University, Sakaka, Saudi Arabia
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Antibiotic prescribing habits of dental surgeons in hyderabad city, India, for pulpal and periapical pathologies: a survey. Adv Pharmacol Sci 2013; 2013:537385. [PMID: 24187549 PMCID: PMC3804281 DOI: 10.1155/2013/537385] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Accepted: 09/03/2013] [Indexed: 11/17/2022] Open
Abstract
Aim. To determine the antibiotic prescribing habits for pulpal and periapical pathology among dentists in Hyderabad city, India. Methodology. A total of 246 questionnaires were distributed to all the dentists registered with the local dental branch. Demographic details and questions regarding type and dosage of antibiotics prescribed for allergic and nonallergic patients were recorded. Inferential statistics were performed, and P < 0.05 was considered statistically significant. Results. The response rate for the study was 87.8%. Around 148 (68.5%) of respondents regularly prescribed antibiotics for endodontic management. The first antibiotic of choice for patients with no history of medical allergies was a combination of amoxicillin and metronidazole, followed by amoxicillin alone (29.1%). The first antibiotic of choice in case of allergy to penicillin was erythromycin. Necrotic pulp with acute apical periodontitis with swelling and moderate/severe preoperative symptom was the condition most commonly identified for antibiotic therapy (92.1%). Conclusion. The present study reveals that the overall antibiotic prescribing practices among this group of dentists were quite high, and there is a need for more educational initiatives to rationalize the use of antibiotics in dentistry.
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Gaikwad A, Jain D, Rane P, Bhondwe S, Taur S, Doshi S. Attitude of general dental practitioners toward root canal treatment procedures in India. J Contemp Dent Pract 2013; 14:528-31. [PMID: 24172001 DOI: 10.5005/jp-journals-10024-1356] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The percentage of general dental practitioners is very common in India, so the purpose of this study was to assess attitude of general dental practitioners toward root canal treatment (RCT) procedures. MATERIALS AND METHODS In a cross-sectional study, 178 dentists (96 males and 82 females) were surveyed using a selfadministered, structured questionnaire pretested through a pilot survey. The questionnaire collected information regarding RCT procedures among participants. Data were analyzed using SPSS version 15. Frequency and percentage distributions were calculated. RESULTS In the present study most of the participants, i.e. 86.4% reported that they perform (RCT) procedures in posterior teeth. Isolation is mainly done with cotton rolls only (74.6%) and very few are using rubber dam in their practice (3.2%). Radiographs were not taken after every step in most of the cases. Rotary instruments were used in less number of cases and K-files were the most popular instruments (66.2%). Also single sitting RCT was not commonly seen. CLINICAL SIGNIFICANCE This study indicates that most of the general dental practitioners' do not comply with quality standards guidelines such as use of rubber dam as isolation. So dentist should update their knowledge and practices with current techniques and materials through CDE programs.
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Affiliation(s)
- Ashwini Gaikwad
- Professor and Head, Department of Conservative Dentistry and Endodontics, School of Dental Sciences, Krishna Dental College and Hospital, Karad, Maharashtra, India, e-mail:
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Udoye CI, Sede MA, Jafarzadeh H, Abbott PV. A survey of endodontic practices among dentists in Nigeria. J Contemp Dent Pract 2013; 14:293-8. [PMID: 23811662 DOI: 10.5005/jp-journals-10024-1316] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIM To investigate the pattern of routine endodontic practices among Nigerian dentists. MATERIALS AND METHODS This study was a questionnaire-based survey of samples of dentists in the Nigerian cities of Enugu and Benin. The self-administered questionnaire contained 25 close-ended questions with multiple choice options. The data collected included demographic details of respondents, root canal preparation techniques, irrigants and intracanal medicaments used, the number of appointments, method of working length determination, root filling techniques, cements used, and the scope of treatment performed. RESULTS Most respondents used sodium hypochlorite as the irrigant, the step back technique for canal preparation, and lateral condensation with a zinc oxide-eugenol-based sealer for obturation. Most respondents did root canal treatment on all types of teeth and used radiographs to determine the working length 70% of the time. Most respondents followed up their patients for less than 12 months and most treated teeth with periapical areas larger than 10 mm by root canal therapy combined with apical surgery. CONCLUSION Most Nigerian dentists use step back technique for canal preparation and lateral condensation for obturation. CLINICAL SIGNIFICANCE Endodontic practice by Nigerian dentists differs from some established practice quality guidelines in many other countries, particularly in nonperfusion of modern techniques into practice, popularity of antibiotic use for endodontic emergencies and a high rate of perforations.
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Affiliation(s)
- Christopher I Udoye
- Department of Restorative Dentistry/Endodontics Faculty of Dentistry, College of Medicine, University of Nigeria Enugu Campus, Nigeria
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Parirokh M, Rekabi AR, Ashouri R, Nakhaee N, Abbott PV, Gorjestani H. Effect of occlusal reduction on postoperative pain in teeth with irreversible pulpitis and mild tenderness to percussion. J Endod 2012; 39:1-5. [PMID: 23228248 DOI: 10.1016/j.joen.2012.08.008] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2012] [Revised: 08/19/2012] [Accepted: 08/21/2012] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Pain management after root canal treatment is a very important issue in clinical practice. The purpose of this study was to evaluate the effect of occlusal reduction on postoperative pain in teeth with irreversible pulpitis and tenderness to percussion. METHODS Fifty-four posterior vital teeth with sensitivity to percussion requiring endodontic treatment were included in this study. After administration of local anesthesia, the root canals were instrumented, and an intracanal calcium hydroxide dressing was placed. The patients were randomly divided into 2 groups of 27 each. In 1 group the occlusal surface was reduced (OR group), whereas in the other group the occlusal surface was not modified (no occlusal reduction, NOR group). Each patient was asked to record their postoperative pain on a visual analogue scale with 4 categories at 6 hours, 12 hours, 18 hours, 1 day, and then daily for 6 days after this treatment. Data were analyzed by t test, Cochran Q, χ(2), and Mann-Whitney tests. RESULTS Forty-six patients returned the visual analogue scale forms. There was no significant difference in postoperative pain between the 2 groups (P > .05) after root canal preparation and calcium hydroxide dressing. CONCLUSIONS Occlusal surface reduction did not provide any further reduction in postoperative pain for teeth with irreversible pulpitis and mild tenderness to percussion compared with no occlusal reduction.
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Affiliation(s)
- Masoud Parirokh
- Oral and Dental Diseases Research Center, School of Dentistry, Kerman University of Medical Sciences, Kerman, Iran.
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Al-Fouzan KS. A survey of root canal treatment of molar teeth by general dental practitioners in private practice in Saudi Arabia. Saudi Dent J 2010; 22:113-7. [PMID: 23960485 PMCID: PMC3723261 DOI: 10.1016/j.sdentj.2010.04.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2009] [Revised: 06/30/2009] [Accepted: 12/23/2009] [Indexed: 11/15/2022] Open
Abstract
The purpose of this study was to evaluate the practice and depth of knowledge of root canal treatment by general dental practitioners working in private dental centers in different cities within the Kingdom of Saudi Arabia. A questionnaire was distributed to 400 general dental practitioners. Completed questionnaires were analyzed in term of simple summary statistics. A total of 252 (63%) practitioners responded. The majority of the respondents were Syrians (59%) and Egyptians (32%). Ninety-one per cent of the respondents indicated that they performed root canal treatment. Amongst those who carried out root canal treatment, only seven practitioners (3%) used rubber dam for isolation. More than half of the respondents (55%) used saline to irrigate canals during treatment. Forty-six per cent of practitioners used formocresol as an inter appointment medicament. The standardized and step-back preparation techniques were the method of choice for the majority of the respondents (91%). Ninety-seven per cent of the practitioners used stainless steel hand instruments to prepare root canals and the majority (92%) used gutta-percha for obturation. Seventy-four per cent of the respondent used cold lateral condensation. The average number of radiographs routinely taken for root canal treatment was four. Ninety-three per cent indicated that they usually completed a root canal treatment of molar teeth in three or more visits. Eighty-eight per cent of the practitioners preferred waiting for 1 or 2 weeks to restore the teeth permanently. Results of this study confirm that many general dental practitioners are not following quality guidelines for endodontic treatment.
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Affiliation(s)
- Khalid S. Al-Fouzan
- Dental Services Department, Head Section of Endodontic Department #1243, King Abdulaziz Medical City, P.O. Box 22490, Riyadh 11426, Saudi Arabia
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Segura-Egea JJ, Velasco-Ortega E, Torres-Lagares D, Velasco-Ponferrada MC, Monsalve-Guil L, Llamas-Carreras JM. Pattern of antibiotic prescription in the management of endodontic infections amongst Spanish oral surgeons. Int Endod J 2010; 43:342-50. [DOI: 10.1111/j.1365-2591.2010.01691.x] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Rodriguez-Núñez A, Cisneros-Cabello R, Velasco-Ortega E, Llamas-Carreras JM, Tórres-Lagares D, Segura-Egea JJ. Antibiotic Use by Members of the Spanish Endodontic Society. J Endod 2009; 35:1198-203. [DOI: 10.1016/j.joen.2009.05.031] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2009] [Revised: 05/25/2009] [Accepted: 05/28/2009] [Indexed: 10/20/2022]
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Current Trends in Endodontic Practice: Emergency Treatments and Technological Armamentarium. J Endod 2009; 35:35-9. [DOI: 10.1016/j.joen.2008.10.007] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2008] [Revised: 10/02/2008] [Accepted: 10/05/2008] [Indexed: 11/17/2022]
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Silva Garcez A, Núñez SC, Lage-Marques JL, Jorge AOC, Ribeiro MS. Efficiency of NaOCl and laser-assisted photosensitization on the reduction of Enterococcus faecalis in vitro. ACTA ACUST UNITED AC 2006; 102:e93-8. [PMID: 16997103 DOI: 10.1016/j.tripleo.2006.02.015] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2005] [Revised: 02/02/2006] [Accepted: 02/08/2006] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To investigate the action of a red laser associated with a photosensitizer on the reduction of Enterococcus faecalis in dental root canal in vitro. STUDY DESIGN Thirty prepared teeth with single canals were contaminated. The chemical group was irrigated with 0.5% NaOCl and left flooded for 30 minutes. In the laser group, a paste-based photosensitizer was maintained in the root canals for 5 minutes, and then irradiated with a laser at 685 nm using an optical fiber for an E of 1.8 J during 3 minutes. After treatment, the canal content was collected, serially diluted, and cultured to determine the number of colony-forming units. RESULTS Photosensitizer alone or laser alone did not have any bactericidal effect. Chemical solution reduced viable bacteria in 93.25%. Laser photosensitization resulted in a reduction of 99.2%, a significantly higher bacterial reduction than NaOCl. CONCLUSION Laser photosensitization was effective for reducing E. faecalis in root canals and could be an adjunct to endodontic treatment.
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Al-Omari WM. Survey of attitudes, materials and methods employed in endodontic treatment by general dental practitioners in North Jordan. BMC Oral Health 2004; 4:1. [PMID: 15361258 PMCID: PMC518977 DOI: 10.1186/1472-6831-4-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2004] [Accepted: 09/10/2004] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND: General dental practitioners provide the majority of endodontic treatment in Jordan. The aim of this study was to gather information on the methods, materials and attitudes employed in root canal treatment by dentists in North Jordan, in order to evaluate and improve the quality of current practice. METHODS: A questionnaire was posted to all registered general dental practitioners working in private practice in Irbid Governate in North Jordan (n = 181). The questionnaire included information on methods, materials and techniques used in endodontic treatment. RESULTS: Reply rate was 72% (n = 131). The results demonstrated that only five dentists used rubber dam occasionally and not routinely. The majority used cotton rolls for isolation solely or in combination with a high volume saliva ejector (n = 116). The most widely used irrigants were sodium hypochlorite and hydrogen peroxide, which were used by 32.9% (n = 43) and 33.6% (n = 44) of the respondents, respectively. Forty eight percent of the respondents (n = 61) used the cold lateral condensation technique for canal obturation, 31.3% (n = 41) used single cone, 9.9% (n = 13) used vertical condensation and 12.2% (n = 16) used paste or cement only for the obturation. The majority used zinc oxide eugenol as a sealer (72.5%). All, but one, respondents used hand instruments for canal preparation and the technique of choice was step back (52.7%). More than 50% (n = 70) of the dentists took one radiograph for determining the working length, whilst 22.9% (n = 30) did not take any radiograph at all. Most practitioners performed treatment in three visits for teeth with two or more root canals, and in two visits for teeth with a single root canal. CONCLUSIONS: This study indicates that dentists practicing in North Jordan do not comply with international quality standards and do not use recently introduced techniques. Many clinicians never take a radiograph for determining the working length and never used rubber dam or intra-canal medicaments.
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Affiliation(s)
- Wael M Al-Omari
- Department of Restorative Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan.
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Kawakami J, Muto T, Shigeo K, Takeda S, Kanazawa M. Tooth exfoliation and necrosis of the crestal bone caused by the use of formocresol. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 2003; 95:736-8. [PMID: 12789157 DOI: 10.1067/moe.2003.100] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
A 68-year-old woman received a formocresol pulpectomy of the right lower lateral incisor. The temporary restoration was lost within hours. The next day, the patient suffered continuous pain, the gingiva sloughed, and the alveolar bone was exposed. Four days after treatment, the patient complained of moderate pain. Six days after the pulpectomy, the tooth spontaneously exfoliated. At this time she was referred to our hospital. The clinical diagnosis was chronic alveolitis. Treatment consisted of irrigation of the area. Three weeks after the pulpectomy, the dull pain had subsided, but the alveolar bone of the area showed increased mobility. Five weeks after the pulpectomy, the mobility of the alveolar bone was more significant and a sequestrectomy was performed with the patient under local anesthesia. The sequestrum of necrotic bone was approximately 10 x 5 x 5 mm in size. The patient has been symptom-free for 2 years since the sequestrectomy.
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Affiliation(s)
- Johji Kawakami
- Health Sciences University of Hokkaido, Hokkaido, Japan.
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Abstract
AIM The purpose of this study was to gather information on routine endodontic treatment performed by Flemish (Dutch-speaking Belgian) dentists. METHODOLOGY A postal questionnaire was sent to all the 4545 Dutch-speaking dentists registered in Belgium. The questionnaire was made up of 38 questions with multiple-choice answers. Results from 32 questions are presented, covering subjects, such as demographic and professional activity, root-canal preparation and instrumentation, emergency procedures and postoperative complications, choice of irrigants and disinfectants, and choice of obturation techniques. RESULTS A total of 1143 questionnaires (25.1%) were returned. Approximately 94% of the respondents were general practitioners. The results indicate that there are discrepancies between daily practice and academic teaching, especially regarding the use of rubber dam (only 3.4% report using it as a standard procedure) and the detection and preparation of a second mesiobuccal canal in maxillary first molars (70% never or seldom). Most GDPs reported that they completed treatment in two visits. The majority of practitioners used manual instruments manipulated with a filing technique; 38.9% of the respondents prepared root canals 1 mm short of the radiographic apex. The most popular emergency procedure for acute pain was pulpectomy (40.2%); 48% performed pulpectomy, prescribed analgesics and antibiotics for acute apical periodontitis. Approximately 35% reported complications after cases with chronic apical periodontitis were treated. The first-choice root-canal irrigant was sodium hypochlorite and approximately 65% used intracanal medication. The most popular obturation technique was cold lateral condensation (60%) with 29% using AH26 as a sealer. A high proportion of GDPs (80%) performed re-treatments. CONCLUSIONS The results of this study confirm that many Flemish general practitioners are not following quality guidelines for endodontic treatment.
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Affiliation(s)
- G Slaus
- Department of Endodontics, Free University of Brussels, Laarbeeklaan 103, B-1090 Brussels, Belgium
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Yingling NM, Byrne BE, Hartwell GR. Antibiotic use by members of the American Association of Endodontists in the year 2000: report of a national survey. J Endod 2002; 28:396-404. [PMID: 12026927 DOI: 10.1097/00004770-200205000-00012] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The purpose of this study was to determine the prescribing habits of active members of the American Association of Endodontists (AAE) with regard to antibiotics. A one-page, double-sided questionnaire was sent to the active members of the AAE living in the United States. The 1999 mailing list of 3203 members was obtained from the AAE, and the return rate was 50.1% (1606 surveys). With a sample size over 1000, the study was able to distinguish differences to within 0.5% with power = 80% (at alpha = 5%). The data were analyzed using descriptive statistics and chi-square tests of independence. Penicillin VK, 500 mg, 4 times a day, was the first choice antibiotic prescribed by 61.48% of respondents. Clindamycin (Cleocin), 150 mg, 4 times a day, was selected by 29.59%. For those patients with a penicillin allergy, 57.03% prescribed clindamycin and various erythromycin preparations were prescribed by 26.65%. A loading dose was used by 85.14%. The average duration of antibiotic therapy was 7.58 days. Those respondents involved in academics, either part-time or full-time, were significantly more likely to prescribe penicillin VK, 500 mg, 4 times a day at a rate of 85% versus those in part-time or full-time private practice at a rate of 67%. For cases of irreversible pulpitis, 16.76% of responding endodontists prescribed antibiotics. For the scenario of a necrotic pulp, acute apical periodontitis, and no swelling, 53.93% prescribed antibiotics. Almost 12% prescribed antibiotics for necrotic pulps with chronic apical periodontitis and a sinus tract. For the most part, the majority of the members of the AAE were selecting the appropriate antibiotic for use in orofacial infections, but there are still many who are prescribing antibiotics inappropriately. Although there were trends of improvement in some areas with regards to prescribing antibiotics, there were other areas where there had been no improvement in 25 years. Unless these trends change, our generation and those to come may not have effective antibiotics for use in the management of true orofacial infections.
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Inamoto K, Kojima K, Nagamatsu K, Hamaguchi A, Nakata K, Nakamura H. A survey of the incidence of single-visit endodontics. J Endod 2002; 28:371-4. [PMID: 12026922 DOI: 10.1097/00004770-200205000-00006] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This survey was conducted to obtain answers to some basic questions regarding the timing of root canal obturation. A questionnaire was sent via e-mail to 738 randomly chosen United States endodontists listed in the 1998 to 1999 membership roster of the American Association of Endodontists. One hundred fifty-six replies were received. In pulpectomy cases, root canal obturation at the first visit was carried out by 55.8% of the responding endodontists; in infected root canal cases, the percentage was 34.4%. Of the responding endodontists, 34.2% indicated that their patients had experienced some trouble after root canal obturation at the first visit.
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Affiliation(s)
- Kyoko Inamoto
- Department of Endodontics, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
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Nist E, Reader A, Beck M. Effect of apical trephination on postoperative pain and swelling in symptomatic necrotic teeth. J Endod 2001; 27:415-20. [PMID: 11487138 DOI: 10.1097/00004770-200106000-00013] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The purpose of this prospective, randomized, blinded study was to determine the effect of apical trephination on postoperative pain and swelling in symptomatic necrotic teeth. Fifty emergency patients participated, and each had a clinical diagnosis of a symptomatic necrotic tooth with associated periapical radiolucency. After endodontic treatment, patients randomly received either an apical trephination or mock trephination procedure. The trephination procedure used a Stabident perforator to provide an initial opening in the cortical bone that was enlarged with files (#25 through #120) and an endodontic spoon. Postoperatively, each patient received: ibuprofen; acetaminophen with codeine (30 mg); and a 7-day diary to record pain, percussion pain, swelling, and number and type of pain medication taken. Results demonstrated the use of an apical trephination procedure did not significantly (p > 0.05) reduce pain, percussion pain, swelling, or number of ibuprofen tablets taken in symptomatic necrotic teeth with periapical radiolucencies. The trephination procedure did significantly (p < 0.05) reduce the use of acetaminophen with codeine overall for the 7 days. In conclusion, because there was not a significant reduction in pain, percussion pain, or swelling we cannot recommend the routine use of an apical trephination procedure, as used in this study, in symptomatic necrotic teeth with radiolucencies.
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Affiliation(s)
- E Nist
- Department of Health Services Research, College of Dentistry, The Ohio State University, Columbus 43210, USA
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Henry M, Reader A, Beck M. Effect of penicillin on postoperative endodontic pain and swelling in symptomatic necrotic teeth. J Endod 2001; 27:117-23. [PMID: 11491635 DOI: 10.1097/00004770-200102000-00016] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The purpose of this prospective, randomized, double-blind, placebo-controlled study was to determine the effect of penicillin on postoperative pain and swelling in symptomatic necrotic teeth. Forty-one emergency patients participated and each had a clinical diagnosis of a symptomatic necrotic tooth with associated periapical radiolucency. After endodontic treatment patients randomly received a 7-day oral dose (twenty-eight 500 mg capsules to be taken every 6 h) of either penicillin or a placebo control in a double-blind manner. Patients also received ibuprofen; acetaminophen with codeine (30 mg); and a 7-day diary to record pain, percussion pain, swelling, and number and type of pain medication taken. The majority of patients with symptomatic necrotic teeth had significant postoperative pain and require analgesic medication to manage this pain. The administration of penicillin postoperatively did not significantly (p > 0.05) reduce pain, percussion pain, swelling, or the number of analgesic medications taken for symptomatic necrotic teeth with periapical radiolucencies.
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Affiliation(s)
- M Henry
- Department of Health Services Research, College of Dentistry, The Ohio State University, Columbus 43210, USA
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Houck V, Reader A, Beck M, Nist R, Weaver J. Effect of trephination on postoperative pain and swelling in symptomatic necrotic teeth. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 2000; 90:507-13. [PMID: 11027389 DOI: 10.1067/moe.2000.108960] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The purpose of this prospective, randomized, blinded study was to determine the effect of trephination on postoperative pain and swelling in symptomatic necrotic teeth. STUDY DESIGN Fifty emergency patients participated, and each had a clinical diagnosis of a symptomatic necrotic tooth with associated periapical radiolucency. After endodontic treatment, patients randomly received either a trephination or mock trephination procedure. The trephination procedure used an intraosseous perforator to provide an initial opening in the cortical bone that was enlarged with files (No. 25 through No. 70) and an endodontic spoon. After surgery, each patient received ibuprofen; acetaminophen with codeine (30 mg); and a 7-day diary to record pain, percussion pain, swelling, and number and type of pain medication taken. RESULTS The majority of patients with symptomatic necrotic teeth had significant postoperative pain and required analgesics to manage this pain. The use of a trephination procedure with an intraosseous perforator, files, and a spoon excavator did not significantly reduce pain, percussion pain, swelling, or the number of analgesic medications taken in symptomatic necrotic teeth with periapical radiolucencies (P >.05). CONCLUSION We cannot recommend the routine use of a trephination procedure, as used in this study, for relief of pain in symptomatic necrotic teeth with radiolucencies.
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Affiliation(s)
- V Houck
- The Ohio State University, Columbus, OH, USA
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Abstract
Hundreds of new articles are added to the body of knowledge in endodontics each year. However, a comparatively small number of articles have had a disproportionately large influence on the progress and development of the specialty of endodontics. A survey of postgraduate program directors was conducted to attempt to identify a highly selective short list of articles that program directors felt should be included on every postgraduate reading list. The survey results were then compared with the more objective benchmark of citation indexing. The results of this survey suggest that the collective opinion of the postgraduate program directors correlates well with the results obtained from citation analysis.
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Affiliation(s)
- B R Johnson
- Department of Endodontics (M/C 642), University of Illinois at Chicago, 801 South Paulina Street, Chicago, IL 60612-7212, USA
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Kandemir S, Ergül N. Grievances in cases using antibiotics due to orodental problems and assessment of the need for antibiotics. Int Dent J 2000; 50:73-7. [PMID: 10945185 DOI: 10.1002/j.1875-595x.2000.tb00802.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVE To assess the complaints of patients who were prescribed antibiotics following orodental problems and the need for antibiotics prescribed for this purpose. SETTING Examinations were carried out in the Department of Oral Diagnosis and Radiology, Ege University, Turkey. PARTICIPANTS A total of 203 patients (129 females and 74 males) between 8-70 years of age (mean age 37.7 +/- 13.9). INTERVENTION Examination and report. MAIN OUTCOME MEASURES Frequency of unnecessary antibiotic use. RESULTS Antibiotic therapy was not necessary for 151 (74.4 per cent) cases. Antibiotics were unnecessarily prescribed in 45 cases of acute irreversible pulpitis, 10 chronic apical abscess, 6 acute apical paradontitis, 7 gingivitis, 10 periodontitis, 4 epulis, 2 TMJ (temporomandibular junction) dysfunction, 2 sharp ridge of alveolar bone, 1 burning mouth syndrome and 1 recurrent aphthous stomatitis. In 108 (53.2 per cent) of the cases, the prescribed antibiotics were found to be penicillins, 102 of which were broad-spectrum. It was also determined that only 6 (7.7 per cent) of the 78 cases diagnosed as acute apical abscess were given drainage as local therapy. CONCLUSIONS Principles for treating dental infections suggest that an antibiotic should only be used to supplement and not substitute for conventional surgical methods. Therefore, in cases with acute apical abscess, mechanical treatment (drainage) should be the first step. Inappropriate antibiotic use is quite widespread in dentistry. Dentists should avoid inappropriate use of antibiotics. To prevent inappropriate administration, necessary precautions need to be taken against dispensing antibiotics without prescription.
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Affiliation(s)
- S Kandemir
- Ege University, Faculty of Dentistry, Department of Oral Diagnosis and Radiology, Izmir, Turkey
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Saunders WP, Chestnutt IG, Saunders EM. Factors influencing the diagnosis and management of teeth with pulpal and periradicular disease by general dental practitioners. Part 2. Br Dent J 1999; 187:548-54. [PMID: 10630043 DOI: 10.1038/sj.bdj.4800328] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To identify techniques commonly used in the management of periradicular disease by general dental practitioners and to ascertain views on continuing professional education in endodontics. DESIGN Data was collected via a postal questionnaire distributed to 617 general dental practitioners in Scotland (33% of practitioners registered with the Dental Practice Board). RESULTS 417 (69%) questionnaires were completed and returned. Only 24.9% of respondents used rubber dam routinely. The majority of respondents used hand instruments for preparation with either sodium hypochlorite or local anaesthetic being used most frequently for irrigation. The mean time for treatment of a single rooted tooth was 71 minutes. The demand for continuing education courses was high with 340 and 197 respondents requesting endodontic and rubber dam courses, respectively. CONCLUSIONS Traditional methods for preparing the root canal using hand instruments were favoured by most dentists. The major disincentive to the use of rotary instruments and new techniques for obturating with thermally softened gutta-percha was expense. The importance of rubber dam isolation requires reiteration and more continuing education courses are required to update clinical skills.
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Rosenberg PA, Babick PJ, Schertzer L, Leung A. The effect of occlusal reduction on pain after endodontic instrumentation. J Endod 1998; 24:492-6. [PMID: 9693578 DOI: 10.1016/s0099-2399(98)80054-x] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
One hundred seventeen patients with posterior teeth requiring endodontic treatment were studied. Specific clinical findings were recorded, including pulp, vitality, preoperative pain, sensitivity to percussion, and the presence of a periradicular radiolucency. Excluded from the study were teeth with restorations to be maintained, greater than class I mobility, pocket depths > 5 mm, endodontic retreatments, and patients taking pain altering medications. Teeth were randomly assigned to 1 of 3 groups: (i) total occlusal reduction, (ii) simulated occlusal reduction (nonfunctional cusp reduction), or (iii) control (occlusion untouched). After canal instrumentation, a questionnaire was used by patients to record pain responses over a 48-h post-operative period. Responses were tabulated using a chi(2) test (p = < 0.05), and a statistically valid profile of patients most likely to benefit from occlusal reduction was developed. Occlusal reduction should prevent postoperative pain in those patients whose teeth initially exhibit pulp vitality, percussion sensitivity, preoperative pain, and/or the absence of a periradicular radiolucency.
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Affiliation(s)
- P A Rosenberg
- Division of Surgical Sciences, New York University College of Dentistry, NY, USA
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Whitten BH, Gardiner DL, Jeansonne BG, Lemon RR. Current trends in endodontic treatment: report of a national survey. J Am Dent Assoc 1996; 127:1333-41. [PMID: 8854609 DOI: 10.14219/jada.archive.1996.0444] [Citation(s) in RCA: 72] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The authors surveyed 360 general dentists and 291 endodontists to obtain information on routine, nonemergency endodontic treatments adapted to clinical practice. Frequent practices and recent advances in treatment modalities-including instrumentation, obturation, intracanal preparations, medications and restorations-are highlighted.
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Affiliation(s)
- B H Whitten
- Instructional Services, School of Dentistry, Louisiana State University Medical Center, New Orleans, USA
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Fouad AF, Rivera EM, Walton RE. Penicillin as a supplement in resolving the localized acute apical abscess. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 1996; 81:590-5. [PMID: 8734709 DOI: 10.1016/s1079-2104(96)80054-0] [Citation(s) in RCA: 78] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
PROBLEM Antibiotics are often prescribed indiscriminately to treat endodontic emergencies. OBJECTIVES This study examined (1) the effect of penicillin supplementation on reduction of symptoms and (2) the course of recovery of localized acute apical abscess after emergency treatment. STUDY DESIGN Patients with pulp necrosis and periapical pain and/or localized swelling were considered. Those eligible did not have any signs of spreading infections. Patients received appropriate local treatment, and a double-blind protocol was used to randomly assign them to one of three groups: penicillin VK group, placebo group, or neither medication group. All received ibuprofen 600 mg four times daily for 24 hours. Patients entered their pre- and postoperative pain and swelling experience on a visual analog scale for up to 72 hours. RESULTS Resolution was fairly rapid in most patients. Statistical analysis of the scores of 32 respondents revealed no significant differences (at p < 0.05) between the three groups in course of recovery or symptoms at any time period. CONCLUSIONS Patients with localized periapical pain or swelling generally recovered quickly with local treatment. The data did not show a demonstrable benefit from penicillin supplementation.
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Affiliation(s)
- A F Fouad
- Department of Restorative Dentistry and Endodontology, University of Connecticut Health Center, Farmington, USA
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Abstract
Ten extracted human maxillary first molars were selected with a variety of root curvatures. The distofacial roots were resected and the mesiofacial canals were instrumented to a size #25 K file. Three techniques were used to introduce Ca(OH)2 paste into the instrumented canals. These techniques were evaluated for their ability to carry the Ca(OH)2 to working length and also to produce a dense fill. The Lentulo spiral was most effective in carrying the paste to working length. The Lentulo spiral also produced the highest quality fill. The Calasept injection system followed by a #25 finger plugger was the second most effective technique. Counterclockwise rotation of a #25 K file was the least effective of the techniques tested.
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Affiliation(s)
- A Sigurdsson
- School of Dentistry, University of North Carolina at Chapel Hill
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