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Kaushik A, Rana N, Ashawat MS, Ankalgi A, Sharma A. Alternatives to β-Lactams as Agents for the Management of Dentoalveolar Abscess. Curr Top Med Chem 2024; 24:1870-1882. [PMID: 38840393 DOI: 10.2174/0115680266289334240530104637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 04/25/2024] [Accepted: 05/04/2024] [Indexed: 06/07/2024]
Abstract
Dentoalveolar abscess are localized infections within the tooth or the surrounding alveolar bone, often resulting from untreated dental caries or dental trauma causing alveolar bone resorption or even loss. Serious consequences arising from the spread of a dental abscess can often lead to significant morbidity and mortality. The acute dentoalveolar abscess is a polymicrobial infection comprising strict anaerobes, such as anaerobic cocci i.e., Prevotella fusobacterium species, and facultative anaerobes i.e., Streptococci viridians and Streptococcus anginosus. Moreover, inappropriately managed dental infections can progress to severe submandibular space infections with associated serious complications, such as sepsis and airway obstruction. An audit of the Hull Royal Infirmary between 1999 and 2004 showed an increase in the number of patients presenting to oral and maxillofacial surgery services with dental sepsis. Thus, the scientific community is forced to focus on treatment strategies for the management of dentoalveolar abscess (DAA) and other related dental problems. The current treatment includes antibiotic therapy, including β-lactams and non-β- lactams drugs, but it leads to the development of resistant microorganisms due to improper and wide usage. Furthermore, the currently used β-lactam therapeutics is non-specific and easily hydrolyzed by the β-lactamase enzymes. Thus, the research focused on the non-β-lactams that can be the potential pharmacophore and helpful in the management of DAA, as the appropriate use and choice of antibiotics in dentistry plays an important role in antibiotic stewardship. The newer target for the choice is NLRP inflammasome, which is the major chemical mediator involved in dental problems. This review focused on pathogenesis and current therapeutics for the treatment of dentoalveolar abscesses.
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Affiliation(s)
- Aditi Kaushik
- Department of Pharmaceutical Sciences, Laureate Institute of Pharmacy, Kathog, Kangra, H.P, India
| | - Nidhika Rana
- Department of Pharmaceutical Sciences, Laureate Institute of Pharmacy, Kathog, Kangra, H.P, India
| | - Mahendra Singh Ashawat
- Department of Pharmaceutical Sciences, Laureate Institute of Pharmacy, Kathog, Kangra, H.P, India
| | - Amardeep Ankalgi
- Department of Pharmaceutical Sciences, Laureate Institute of Pharmacy, Kathog, Kangra, H.P, India
| | - Ankit Sharma
- Department of Pharmaceutical Sciences, Laureate Institute of Pharmacy, Kathog, Kangra, H.P, India
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Dentoalveolar Surgery. J Oral Maxillofac Surg 2023; 81:E51-E74. [PMID: 37833029 DOI: 10.1016/j.joms.2023.06.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2023]
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Cooper L, Stankiewicz N, Sneddon J, Seaton RA, Smith A. Indications for the use of metronidazole in the treatment of non-periodontal dental infections: a systematic review. JAC Antimicrob Resist 2022; 4:dlac072. [PMID: 35959239 PMCID: PMC9361036 DOI: 10.1093/jacamr/dlac072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 06/08/2022] [Indexed: 12/03/2022] Open
Abstract
Background Dental practitioners are the largest prescribers of metronidazole. Antibiotics should only be prescribed when systemic involvement is clear and should be limited to monotherapy with β-lactams in the first instance. Objectives To determine whether metronidazole used as monotherapy or in addition to a β-lactam antibiotic offers any additional benefit over β-lactam monotherapy in non-periodontal dental infections. Methods Searches of Ovid Medline, Ovid Embase, Cochrane library and trials registries, forward and backward citations, for studies published between database inception and 2 August 2021. All randomized clinical trials (RCTs) and non-randomized trials comparing either systemic metronidazole monotherapy or metronidazole combined with a β-lactam with β-lactam monotherapy for the treatment of non-periodontal dental infections in adults or children in outpatient settings were included. Results Four publications reporting three RCTs comparing metronidazole with a β-lactam antibiotic were recovered. Studies were conducted in the 1970s–80s and aimed to demonstrate metronidazole was as effective as penicillin for the treatment of acute pericoronitis or acute apical infections with systemic involvement. Meta-analysis of results was not possible due to differences in measurement of infection signs. All studies concluded that metronidazole and penicillin are equally effective for the treatment of non-periodontal dental infections with systemic involvement. Conclusions Metronidazole does not provide superior clinical outcomes (alone or in combination with a β-lactam) when compared with a β-lactam antibiotic alone for the treatment of non-periodontal dental infections in general dental practice. Guidelines should reinforce the importance of surgical interventions and if appropriate the use of a single agent narrow-spectrum β-lactam.
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Affiliation(s)
- Lesley Cooper
- Scottish Antimicrobial Prescribing Group, Healthcare Improvement Scotland , Delta House, 50 West Nile Street , Glasgow, G1 2NP, UK
| | - Nikolai Stankiewicz
- Damira Dental Studios, Head Office , First Floor, The High Barn Pinner Hill Farm , Pinner Hill, HA5 3YQ, UK
| | - Jacqueline Sneddon
- Scottish Antimicrobial Prescribing Group, Healthcare Improvement Scotland , Delta House, 50 West Nile Street , Glasgow, G1 2NP, UK
| | - R Andrew Seaton
- Scottish Antimicrobial Prescribing Group, Healthcare Improvement Scotland , Delta House, 50 West Nile Street , Glasgow, G1 2NP, UK
- Queen Elizabeth University Hospital, NHS Greater Glasgow and Clyde , Govan Road , Glasgow, UK
| | - Andrew Smith
- College of Medical, Veterinary & Life Sciences, Glasgow Dental Hospital & School, University of Glasgow , 378 Sauchiehall Street , Glasgow, G2 3JZ, UK
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Ahmadi H, Ebrahimi A, Ahmadi F. Antibiotic Therapy in Dentistry. Int J Dent 2021; 2021:6667624. [PMID: 33574843 PMCID: PMC7861949 DOI: 10.1155/2021/6667624] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 12/18/2020] [Accepted: 01/18/2021] [Indexed: 12/13/2022] Open
Abstract
Dental caries, pulpal necrosis, trauma, and periodontal diseases can result in dental infections which could have severe consequences that affect both soft and hard tissues of the oral cavity. Dental infections commonly present with symptoms of pain, fever, and swelling. Surgical and endodontic treatments are the early management of infected teeth, followed by antibiotic therapy. Some alternative methods also exist for treating infection such as low-level laser therapy and photodynamic therapy. Antibiotics are generally used in dental procedures to treat odontogenic infections, nonodontogenic infections, local infection, focal infection, and prophylaxis. Antibiotic prophylaxis is prescribed for patients with immunosuppressed conditions, infective endocarditis, metabolic disorders, and patients with prosthetic joints. To reduce the complications of unnecessary antibiotic prescriptions especially bacterial resistance, comprehensive guidelines should be established. It has been noted that only about 12% of dentists adequately and correctly prescribe antibiotics, which shows the importance of comprehensive guidelines. Antibiotics prescription may result in some adverse effects such as hypersensitivity reactions and dermatological and allergic disorders. Furthermore, unnecessary prescription of antibiotics could result in several serious sequelae, for example, bacterial resistance, gastric and hematological problems, and diversion of bacterial microbiota. The present review attempts to summarize the indications of antibiotic therapy in dentistry and discuss the common types of antibiotics that are routinely used in dental practice based on pharmacologic classes. Moreover, types of antibiotics that are considered safe during pregnancy and childhood are also reviewed.
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Affiliation(s)
- Hanie Ahmadi
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alireza Ebrahimi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fatemeh Ahmadi
- School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
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Thornhill MH, Dayer MJ, Durkin MJ, Lockhart PB, Baddour LM. Oral antibiotic prescribing by NHS dentists in England 2010-2017. Br Dent J 2020; 227:1044-1050. [PMID: 31873263 DOI: 10.1038/s41415-019-1002-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Introduction Dentists prescribe a significant proportion of all antibiotics, while antimicrobial stewardship aims to minimise antibiotic-prescribing to reduce the risk of developing antibiotic-resistance and adverse drug reactions.Aims To evaluate NHS antibiotic-prescribing practices of dentists in England between 2010-2017.Methods NHS Digital 2010-2017 data for England were analysed to quantify dental and general primary-care oral antibiotic prescribing.Results Dental prescribing accounted for 10.8% of all oral antibiotic prescribing, 18.4% of amoxicillin and 57.0% of metronidazole prescribing in primary care. Amoxicillin accounted for 64.8% of all oral antibiotic prescribing by dentists, followed by metronidazole (28.0%), erythromycin (4.4%), phenoxymethylpenicillin (0.9%), clindamycin (0.6%), co-amoxiclav (0.5%), cephalosporins (0.4%) and tetracyclines (0.3%). Prescriptions by dentists declined during the study period for all antibiotics except for co-amoxiclav. This increase is of concern given the need to restrict co-amoxiclav use to infections where there is no alternative. Dental prescribing of clindamycin, which accounted for 43.9% of primary care prescribing in 2010, accounted for only 14.6% in 2017. Overall oral antibiotic prescribing by dentists fell 24.4% as compared to 14.8% in all of primary care.Conclusions These data suggest dentists have reduced antibiotic prescribing, possibly more than in other areas of primary-care. Nonetheless, opportunities remain for further reduction.
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Affiliation(s)
- Martin H Thornhill
- Unit of Oral & Maxillofacial Medicine Surgery and Pathology, School of Clinical Dentistry, University of Sheffield, Sheffield, UK; Department of Oral Medicine, Carolinas Medical Centre, Charlotte, NC, USA.
| | - Mark J Dayer
- Department of Cardiology, Taunton and Somerset NHS Trust, Taunton, Somerset, UK
| | - Michael J Durkin
- Division of Infectious Diseases, Washington University in St. Louis School of Medicine, MO, USA
| | - Peter B Lockhart
- Department of Oral Medicine, Carolinas Medical Centre, Charlotte, NC, USA
| | - Larry M Baddour
- Division of Infectious Diseases, Department of Medicine and the Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA
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Management of odontogenic infection in paediatric patients: a retrospective clinical study. Eur Arch Paediatr Dent 2019; 21:145-154. [PMID: 31332632 DOI: 10.1007/s40368-019-00466-0] [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: 04/19/2018] [Accepted: 07/15/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE To investigate the outpatient and inpatient management of odontogenic infections among paediatric patients attending a university hospital. METHODS A retrospective study (2013-2015) was carried out which involved retrieving relevant data from past records (manual/electronic) of paediatric patients (under 18-years-old) who presented with odontogenic infections to the Paediatric Dentistry and Oral and Maxillofacial clinic. Data collected was organised using descriptive statistics with SPSS version 12.0.1. RESULTS A total of 153 patients were identified, of which 83.7% were managed as outpatients. Odontogenic infections were more common in females (52.9%) and preschool children (58.2%). The most cases were seen in 2014 and maximum number of cases per month was 12. Common presentations were pain (62.1%), intraoral swelling (37.9%) and spontaneous pus discharge from the tooth and/or surrounding tissues (67.3%) with higher involvement of primary right molars. Dental panoramic tomograph was the most common radiographic investigation done. Outpatients were commonly managed chairside with pulpal opening (46.1%) at the paediatric dental clinic and 7% underwent extraction under general anaesthesia in day-care setting. Inpatients were admitted for 3 days on average and most commonly definitive care was extraction under local/general anaesthesia (68%). There were 22.7% outpatients and 72.0% inpatients who were prescribed antibiotics. CONCLUSIONS Overall, treatment and medications prescribed adhered to current guidelines. There was a tendency to solely prescribe antibiotics in 8.6% of outpatients which is contrary to recommendations.
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Tent PA, Juncar RI, Onisor F, Bran S, Harangus A, Juncar M. The pathogenic microbial flora and its antibiotic susceptibility pattern in odontogenic infections. Drug Metab Rev 2019; 51:340-355. [PMID: 30999773 DOI: 10.1080/03602532.2019.1602630] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Suppurative head and neck infections of odontogenic origin are the most frequent type of head and neck infections. According to the literature, 7-10% of all antibiotics are currently prescribed for their treatment. Since penicillin was invented, the overall antibiotic sensitivity and resistance pattern of the isolated pathogenic microflora has continuously changed. The response of microorganisms to antibiotics and the development of resistance to their action is a purely evolutive process characterized by genetic mutations, acquisition of genetic material or alteration of gene expression and metabolic adaptations. All this makes challenging and difficult the correct choice of empirical antibiotic treatment for head and neck space infections even today. The aim of this paper was to evaluate the literature and to evidence the most frequent locations of odontogenic head and neck infections, the dominant pathogenic microbial flora, the genetic mutations and metabolic changes necessary for bacteria in order to aquire antibiotic resistance and as well its susceptibility and resistance to common antibiotics. We also aimed to highlight the possible changes in bacterial resistance to antibiotics over time, and to assess whether or not there is a need for fundamental changes in the empirical antibiotic treatment of these infections and show which these would be.
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Affiliation(s)
- Paul Andrei Tent
- Dental Medicine, Universitatea din Oradea Facultatea de Medicina si Farmacie , Oradea , Romania
| | - Raluca Iulia Juncar
- Dental Medicine, Universitatea din Oradea Facultatea de Medicina si Farmacie , Oradea , Romania
| | - Florin Onisor
- Department of Oral and Maxilo-Facial surgery and Radiology, Iuliu Hatieganu University of Medicine and Pharmacy , Cluj-Napoca , Romania
| | - Simion Bran
- Department of Oral and Maxilo-Facial surgery and Radiology, Iuliu Hatieganu University of Medicine and Pharmacy , Cluj-Napoca , Romania
| | - Antonia Harangus
- Spitalul Clinic de Pneumoftiziologie Leon Daniello Cluj-Napoca , Cluj-Napoca , Romania
| | - Mihai Juncar
- Dental Medicine, Universitatea din Oradea Facultatea de Medicina si Farmacie , Oradea , Romania
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Abstract
Opioid analgesics and antibiotics prescribed by dentists is a useful and cost-effective measure when prescribed appropriately. Common dental conditions are best managed by extracting the offending tooth, restoring the tooth with an appropriate filling material, performing root canal therapy, and/or fabricating a prosthesis for the edentulous space. Unnecessary prescription of opioid analgesics and antibiotics to treat dental pain and bacterial infection is a growing public health concern. This article highlights the state of the literature on opioid analgesic and antibiotic prescribing practices in dentistry, the impact of opioid analgesic overdose, and prevention strategies to reduce opioid analgesics and antibiotic overprescription.
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Lang PM, Jacinto RC, Dal Pizzol TS, Ferreira MBC, Montagner F. Resistance profiles to antimicrobial agents in bacteria isolated from acute endodontic infections: systematic review and meta-analysis. Int J Antimicrob Agents 2016; 48:467-474. [DOI: 10.1016/j.ijantimicag.2016.08.018] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 08/02/2016] [Accepted: 08/08/2016] [Indexed: 01/01/2023]
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Aminoshariae A, Kulild JC. Authors’ response. J Am Dent Assoc 2016; 147:601-2. [DOI: 10.1016/j.adaj.2016.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Aminoshariae A, Kulild JC. Evidence-based recommendations for antibiotic usage to treat endodontic infections and pain: A systematic review of randomized controlled trials. J Am Dent Assoc 2015; 147:186-91. [PMID: 26724957 DOI: 10.1016/j.adaj.2015.11.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Revised: 11/01/2015] [Accepted: 11/09/2015] [Indexed: 01/08/2023]
Abstract
BACKGROUND The purpose of this investigation was to identify evidence-based scientific methodologies to aid dental clinicians in establishing the indications for prescribing antibiotics for endodontic infection or pain. METHODS The authors prepared and registered a protocol on PROSPERO. They conducted electronic searches in MEDLINE, Scopus, Cochrane Library, and ClinicalTrials.gov. In addition, the authors hand searched the bibliographies of all relevant articles, the gray literature, and textbooks for randomized controlled clinical studies. The authors independently selected the relevant articles. RESULTS The overall quality of the studies was fair with a low risk of bias, but 2 studies had a moderate risk of bias. CONCLUSIONS The best available clinical evidence signals no indications for prescribing antibiotics preoperatively or postoperatively to prevent endodontic infection or pain unless the spread of infection is systemic, the patient is febrile, or both. Generally, an accurate diagnosis coupled with effective endodontic treatment will decrease microbial flora enough for healing to occur. PRACTICAL IMPLICATIONS To help decrease the number of drug-resistant microbes, oral health care providers should not prescribe antibiotics when they are not indicated.
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Rastenienė R, Pūrienė A, Aleksejūnienė J, Pečiulienė V, Zaleckas L. Odontogenic Maxillofacial Infections: A Ten-Year Retrospective Analysis. Surg Infect (Larchmt) 2015; 16:305-12. [DOI: 10.1089/sur.2013.264] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Affiliation(s)
- Rūta Rastenienė
- Institute of Odontology, Faculty of Medicine Vilnius University, Vilnius, Lithuania
| | - Alina Pūrienė
- Institute of Odontology, Faculty of Medicine Vilnius University, Vilnius, Lithuania
| | - Jolanta Aleksejūnienė
- Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Vytautė Pečiulienė
- Institute of Odontology, Faculty of Medicine Vilnius University, Vilnius, Lithuania
| | - Linas Zaleckas
- Institute of Odontology, Faculty of Medicine Vilnius University, Vilnius, Lithuania
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Kityamuwesi R, Muwaz L, Kasangaki A, Kajumbula H, Rwenyonyi CM. Characteristics of pyogenic odontogenic infection in patients attending Mulago Hospital, Uganda: a cross-sectional study. BMC Microbiol 2015; 15:46. [PMID: 25881243 PMCID: PMC4344792 DOI: 10.1186/s12866-015-0382-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Accepted: 02/11/2015] [Indexed: 02/06/2023] Open
Abstract
Background Predisposing factors of pyogenic odontogenic infection include dental caries, pericoronitis, periodontitis, trauma to the dentition and the supporting structures or complications of dental procedures. The infections are usually polymicrobial involving normal endogenous flora. We characterised pyogenic odontogenic infection in patients attending Mulago Hospital, Uganda. Results Of the 130 patients, 62 (47.7%) were female. The most frequently involved fascial spaces were: the buccal, 52 (25.4%); submasseteric, 46 (22.4%) and the submandibular space, 36 (17.5%). Dental caries was the most prevalent predisposing factor, particularly of the lower third molar teeth. Viridans Streptococci Group and Staphylococcus aureus were the most frequent bacterial isolates: 23.5% and 19.4%, respectively. All Viridans Streptococci isolates were resistant to penicillin G, sulfamethoxazole/trimethoprim (cotrimoxazole), ampicillin and tetracycline, but susceptible to vancomycin. All Staphylococcus aureus strains were resistant to cotrimoxazole and ampicillin while retaining susceptibility to vancomycin, cefotaxime, linezolid, moxifloxacin and amoxicillin/clavulanate. Thirty five (26.9%) patients were HIV infected and the HIV status did not significantly influence the pattern of odontogenic infection. Conclusions Dental caries was the most prevalent predisposing factor for pyogenic odontogenic infection. High prevalence of bacterial resistance to ampicillin and cotrimoxazole suggests the need for regular antibiotic susceptibility tests of isolates and rational use of antibiotics in the management of these infections. Prevention requires strengthening of oral health in the community.
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Affiliation(s)
- Richard Kityamuwesi
- Department of Oral and Maxillofacial Surgery, Mulago Hospital, Kampala, Uganda.
| | - Louis Muwaz
- Department of Dentistry, School of Health Sciences, College of Health Sciences, Makerere University, Kampala, Uganda.
| | - Arabat Kasangaki
- Department of Dentistry, School of Health Sciences, College of Health Sciences, Makerere University, Kampala, Uganda.
| | - Henry Kajumbula
- Department of Microbiology, School of Biomedical Sciences, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda.
| | - Charles Mugisha Rwenyonyi
- Department of Dentistry, School of Health Sciences, College of Health Sciences, Makerere University, Kampala, Uganda.
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Ottaviani G, Costantinides F, Perinetti G, Luzzati R, Contardo L, Visintini E, Tirelli G, Di Lenarda R, Gobbo M, Biasotto M. Epidemiology and variables involved in dental abscess: survey of dental emergency unit in Trieste. Oral Dis 2013; 20:499-504. [PMID: 23879656 DOI: 10.1111/odi.12164] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2013] [Revised: 07/01/2013] [Accepted: 07/07/2013] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The objective of this epidemiologic study was to estimate the healing time of acute dental abscesses and to evaluate the main variables involved in the healing process itself. SUBJECTS AND METHODS Among a sample of over 24 000 patients visited at the emergency dental unit, 688 subjects were diagnosed with dental abscess and enrolled in the study. Case histories of all patients were collected to investigate the clinical course and healing time of dental abscess according to anamnestic and diagnostic data and therapeutic management. A multiple logistic regression model was performed to evaluate the association of each variable with the healing time required for dental abscess. RESULTS Variables associated with increased healing time were spring seasonality at admission, pyretic state, trismus, involvement of multiple anatomic spaces, and spontaneous drainage. Moreover, administration of some, but not all, classes of antibiotics was also associated with an increased healing time. CONCLUSIONS The knowledge of variables involved in healing time for dental abscess is crucial in the optimization of managing such infections in terms of cost-benefit ratio. This would represent a valuable way to ensure a shortened and more effective healing.
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Affiliation(s)
- G Ottaviani
- Department of Dental Science, University of Trieste, Trieste, Italy
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[Dentogenic infections-part I: the significance of bacterial isolation of dentogenic infections under routineous conditions]. Wien Med Wochenschr 2012; 162:316-20. [PMID: 22669314 DOI: 10.1007/s10354-012-0103-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2012] [Accepted: 05/02/2012] [Indexed: 10/28/2022]
Abstract
The microflora of odontogenic infections is typically polymicrobial with increased resistance rates against various antibiotics. The purpose of the present study was to analyze bacterial spectra and resistance in odontogenic infections under routineous conditions.Microbiological samples were collected and transported under routineous conditions in a prospective study of 19 patients. All Bacterial spectra and resistance rates were compared with the results of a former prospective evaluation.There were 11 men, 5 woman and 3 children (age range of 2-86 years). A total of only 38 bacterial strains were analyzed. The ratio between aerobes and anaerobes was nearly 1:1. The resistance rates were nearly the same for Penicillin G, but a 2-fold increased resistance for clindamycin against aerobes and a more than 10-fold increased resistance against anaerobes was noted.Prospective studies under standardized conditions are necessary to isolate strict anaerobes and to detect changes in antibiotic efficiency.
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The role of unfinished root canal treatment in odontogenic maxillofacial infections requiring hospital care. Clin Oral Investig 2012; 17:113-21. [DOI: 10.1007/s00784-012-0710-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2011] [Accepted: 03/04/2012] [Indexed: 12/23/2022]
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Flynn TR. What are the antibiotics of choice for odontogenic infections, and how long should the treatment course last? Oral Maxillofac Surg Clin North Am 2012; 23:519-36, v-vi. [PMID: 21982604 DOI: 10.1016/j.coms.2011.07.005] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
In the everyday practice of oral and maxillofacial surgeons, empiric antibiotics are prescribed in the face of uncertainty. Is there a highly resistant organism present? Are the old-line antibiotics no longer effective? Should a broad-spectrum antibiotic be used just to cover all the bases in this case? The surprising result of this systematic review is that when combined with appropriate surgery, the usual antibiotics are all effective. Safety and cost become the differentiating factors in this clinical decision.
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Skapetis T, Gerzina T, Hu W. Can a four-hour interactive workshop on the management of dental emergencies be effective in improving self reported levels of clinician proficiency? ACTA ACUST UNITED AC 2012; 15:14-22. [DOI: 10.1016/j.aenj.2011.12.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2011] [Revised: 12/13/2011] [Accepted: 12/13/2011] [Indexed: 11/29/2022]
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Ellison SJ. An outcome audit of three day antimicrobial prescribing for the acute dentoalveolar abscess. Br Dent J 2011; 211:591-4. [DOI: 10.1038/sj.bdj.2011.1051] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2011] [Indexed: 12/11/2022]
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Osteomyelitis after bilateral sagittal split osteotomy: case report and a review of the management. ACTA ACUST UNITED AC 2010; 111:442-8. [PMID: 20952224 DOI: 10.1016/j.tripleo.2010.06.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2010] [Revised: 05/29/2010] [Accepted: 06/14/2010] [Indexed: 11/22/2022]
Abstract
OBJECTIVES The purpose of this paper is to report a case of osteomyelitis following a bilateral sagittal split osteotomy in a patient who underwent 2-jaw surgery. A review of the management of osteomyelitis is included, with a discussion of implications for the reconstruction of the mandible after treatment for osteomyelitis. STUDY DESIGN A case of a rapidly progressing osteomyelitis is presented with a detailed review of the management of osteomyelitis, using this case to illustrate key points of management. RESULTS In a very short period of time the patient lost a significant portion of the left side of her mandible. The actual management that she underwent, as well as some of the controversies that are present with the treatment of osteomyelitis, is discussed. CONCLUSION Although osteomyelitis of the mandible usually is seen after odontogenic infections and trauma, it can occur in patients undergoing elective osteotomies. When recognized, it should be aggressively treated.
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Miller C. Decisions and antibiotics use: more questions and some answers. ACTA ACUST UNITED AC 2010; 110:1-3. [PMID: 20610296 DOI: 10.1016/j.tripleo.2010.03.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2010] [Accepted: 03/18/2010] [Indexed: 10/19/2022]
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Dar-Odeh NS, Abu-Hammad OA, Al-Omiri MK, Khraisat AS, Shehabi AA. Antibiotic prescribing practices by dentists: a review. Ther Clin Risk Manag 2010; 6:301-6. [PMID: 20668712 PMCID: PMC2909496 DOI: 10.2147/tcrm.s9736] [Citation(s) in RCA: 117] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2010] [Indexed: 01/04/2023] Open
Abstract
Antibiotics are prescribed by dentists for treatment as well as prevention of infection. Indications for the use of systemic antibiotics in dentistry are limited, since most dental and periodontal diseases are best managed by operative intervention and oral hygiene measures. However, the literature provides evidence of inadequate prescribing practices by dentists, due to a number of factors ranging from inadequate knowledge to social factors. Here we review studies that investigated the pattern of antibiotic use by dentists worldwide. The main defects in the knowledge of antibiotic prescribing are outlined. The main conclusion is that, unfortunately, the prescribing practices of dentists are inadequate and this is manifested by over-prescribing. Recommendations to improve antibiotic prescribing practices are presented in an attempt to curb the increasing incidence of antibiotic resistance and other side effects of antibiotic abuse.
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