Present status and future directions in endodontic microbiology

Siqueira, José F.; Rôças, Isabela N.

doi:10.1111/etp.12060

Cited by 68 publications

(60 citation statements)

References 199 publications

(333 reference statements)

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“…Odontogenic infections, including endodontic infections, are polymicrobial involving a combination of gram‐positive, gram‐negative, facultative anaerobes and strict anaerobic bacteria (Siqueira & Roças ). When bacteria become resistant to antibiotics, they also gain the ability to exchange this resistance (Jungermann et al .…”

Section: Introductionmentioning

confidence: 99%

Antibiotics in Endodontics: a review

Segura-Egea

Gould

Şen³

et al. 2017

Int Endodontic J

171

223

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The overuse of antibiotics and the emergence of antibiotic‐resistant bacterial strains is a global concern. This concern is also of importance in terms of the oral microbiota and the use of antibiotics to deal with oral and dental infections. The aim of this paper was to review the current literature on the indications and use of antibiotics and to make recommendations for their prescription in endodontic patients. Odontogenic infections, including endodontic infections, are polymicrobial, and in most cases, the prescription of antibiotics is empirical. This has led to the increasing use of broad‐spectrum antibiotics even in cases where antibiotics are not indicated, such as symptomatic irreversible pulpitis, necrotic pulps and localized acute apical abscesses. In case of discrete and localized swelling, the primary aim is to achieve drainage without additional antibiotics. Adjunctive antibiotic treatment may be necessary in the prevention of the spread of infection, in acute apical abscesses with systemic involvement and in progressive and persistent infections. Medically compromised patients are more susceptible to complication arising from odontogenic infections and antimicrobials have a more specific role in their treatment. Therefore, antibiotics should be considered in patients having systemic diseases with compromised immunity or in patients with a localized congenital or acquired altered defence capacity, such as patients with infective endocarditis, prosthetic cardiac valves or recent prosthetic joint replacement. Penicillin VK, possibly combined with metronidazole to cover anaerobic strains, is still effective in most cases. However, amoxicillin (alone or together with clavulanic acid) is recommended because of better absorption and lower risk of side effects. In case of confirmed penicillin allergy, lincosamides such as clindamycin are the drug of choice.

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Section: Introductionmentioning

confidence: 99%

Antibiotics in Endodontics: a review

Segura-Egea

Gould

Şen³

et al. 2017

Int Endodontic J

171

223

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“…The infection of the root canal system in immature permanent teeth with open apices and the subsequent periapical inflammation are diseases caused by mixed bacterial communities consisting of both aerobic and anaerobic bacteria (Siqueira & Roças ). Therefore, the use of a combination of antibiotics is more likely to effectively sterilize the canal, also decreasing the likelihood of the development of antibiotic resistance.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness and clinical implications of the use of topical antibiotics in regenerative endodontic procedures: a review

et al. 2018

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Regenerative endodontic procedures (REPs) are biologically based procedures planned to replace damaged tissues, including dentinee and root structures, as well as cells of the pulp-dentine complex. Effective sterilization of the root canal is essential in REPs, and antibiotics have been widely used to disinfect root canals. The aim of this paper was to review the scientific literature on (i) Effectiveness of antibiotics used in REPs against bacteria implicated in endodontic disease; (ii) Scientific evidence supporting the use of topical antibiotics in REPs; (iii) Clinical implications of the use of antibiotics in REPs and the possible side effects; (iv) Effect of antibiotics on dental pulp stem cells; and (v) Ongoing research on the use of antibiotics in REPs. Antibiotics used in REPs are effective against bacteria implicated in endodontic infections. Triple antibiotic pastes with minocycline attain complete disinfection of immature teeth with necrotic pulps, without affecting SCAP. Experimental studies carried out in dogs support the use of antibiotics in REPs. Clinical studies report high success rates of RET using antibiotics as intracanal dressings. However, tooth discolouration is an important side effect of the use of TAP. An antibiotic paste containing only metronidazole and ciprofloxacin could be a good alternative to the use of TAP. The use of antibiotic-containing scaffolds or clindamycin-modified triple antibiotic (metronidazole, ciprofloxacin and clindamycin) polymer could be a biologically safe antimicrobial drug delivery system in REPs.

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“…As endodontic infections are usually polymicrobial, involving a combination of gram-positive and gram-negative facultative and/or strict anaerobic bacteria [2,7,8], broad-spectrum antibiotics are typically prescribed. Amoxicillin is the most frequently prescribed antibiotic during endodontic treatment [1].…”

Section: Introductionmentioning

confidence: 99%

Antibiotic and Analgesic Prescription Patterns among Dentists or Management of Dental Pain and Infection during Endodontic Treatment

Maslamani

Sedeqi

2017

Med Princ Pract

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Objective: The aim of this study was to determine prescription patterns of antibiotics and analgesics among dentists in the management of dental pain and infection for medically healthy patients undergoing endodontic management. Materials and Methods: This descriptive cross-sectional survey was based on a structured questionnaire. The questionnaire collected data on age, gender, years of experience, and the qualifications of dentists. Feedback on prescription patterns for antibiotics and analgesics was collected for a number of clinical scenarios. Participants' choices regarding the type, dose, and duration of antibiotics/analgesics were recorded. Completed questionnaires were analyzed using the Statistical Package for Social Sciences (SPSS; version 24) to determine relationships between prescription patterns, age, gender, and educational qualification. Results: Of the 227 participants surveyed, 190 (83.7%) did not prescribe antibiotics for patients complaining of severe pain. There were significant associations between age and years of experience and antibiotic prescription for pain management (p = 0.035 and 0.04, respectively). Of the participants, 199 (87.7%) never prescribed antibiotics for reversible pulpitis with normal periapical area; there was a statistical significance in relation to gender (p = 0.044). Amoxicillin 500 mg was prescribed most of the time (51.5%). Diclofenac K (50 mg) was prescribed by 41% of the participants, while 39.2% of the participants very often prescribed ibuprofen (600 mg). Conclusion: Most dentists prescribed analgesics and antibiotics as recommended, but more education on the proper use of these medicines is needed for dentists and patients.

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Present status and future directions in endodontic microbiology

Cited by 68 publications

References 199 publications

Antibiotics in Endodontics: a review

Antibiotics in Endodontics: a review

Effectiveness and clinical implications of the use of topical antibiotics in regenerative endodontic procedures: a review

Antibiotic and Analgesic Prescription Patterns among Dentists or Management of Dental Pain and Infection during Endodontic Treatment

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