Systemic Antibiotics in Endodontic Infections

Fouad, Ashraf F.

doi:10.1002/9781119080343.ch12

Cited by 8 publications

(9 citation statements)

References 52 publications

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“…Pulp samples were collected under strict aseptic conditions as described previously. 11 , 17 Exactly 6 filing stokes from each tooth (RC) were done. If a tooth had more than one root, sampling was done from the more diseased root.…”

Section: Methodsmentioning

confidence: 99%

Oxidative stress in patients with endodontic pathologies

Vengerfeldt

Mändar

Saag

et al. 2017

JPR

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BackgroundApical periodontitis (AP) is an inflammatory disease affecting periradicular tissues. It is a widespread condition but its etiopathogenetic mechanisms have not been completely elucidated and the current treatment options are not always successful.PurposeTo compare oxidative stress (OxS) levels in the saliva and the endodontium (root canal [RC] contents) in patients with different endodontic pathologies and in endodontically healthy subjects.Patients and methodsThe study group of this comparison study included 22 subjects with primary chronic apical periodontitis (pCAP), 26 with posttreatment or secondary chronic apical periodontitis (sCAP), eight with acute periapical abscess, 13 with irreversible pulpitis, and 17 healthy controls. Resting saliva samples were collected before clinical treatment. Pulp samples (remnants of the pulp, tooth tissue, and/or previous root filling material) were collected under strict aseptic conditions using the Hedström file. The samples were frozen to −80°C until analysis. OxS markers (myeloperoxidase [MPO], oxidative stress index [OSI], 8-isoprostanes [8-EPI]) were detected in the saliva and the endodontium.ResultsThe highest MPO and 8-EPI levels were seen in pCAP and pulpitis, while the highest levels of OSI were seen in pCAP and abscess patients, as well as the saliva of sCAP patients. Controls showed the lowest OxS levels in both RC contents and saliva. Significant positive correlations between OxS markers, periapical index, and pain were revealed. Patients with pain had significantly higher OxS levels in both the endodontium (MPO median 27.9 vs 72.6 ng/mg protein, p=0.004; OSI 6.0 vs 10.4, p<0.001; 8-EPI 50.0 vs 75.0 pg/mL, p<0.001) and saliva (MPO 34.2 vs 117.5 ng/mg protein, p<0.001; 8-EPI 50.0 vs 112.8 pg/mL, p<0.001) compared to pain-free subjects.ConclusionOxS is an important pathomechanism in endodontic pathologies that is evident at both the local (RC contents) and systemic (saliva) level. OxS is significantly associated with dental pain and bone destruction.

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Section: Methodsmentioning

confidence: 99%

Oxidative stress in patients with endodontic pathologies

Vengerfeldt

Mändar

Saag

et al. 2017

JPR

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“…The latter are responsible for direct damage to pulp tissue, whereas structural components of the bacterial cell, such as lipopolysaccharides (LPS) and lipoteichoic acid (LTA), can injure tissues indirectly by activation of an immune response. 50 LPS, or endotoxin, is a major constituent of the cell wall of gram-negative bacteria and is secreted in vesicles by growing organisms or released during the disintegration of bacteria after their death. Endotoxin is one of the most important virulence factors involved in the development of periapical inflammation and bone destruction, activating immunocompetent cells and leading to the release of a variety of proinflammatory mediators.…”

Section: Bacterial Virulence Factorsmentioning

confidence: 99%

Etiologic role of root canal infection in apical periodontitis and its relationship with clinical symptomatology

2018

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Evidence shows the polymicrobial etiology of endodontic infections, in which bacteria and their products are the main agents for the development, progression, and dissemination of apical periodontitis. Microbial factors in necrotic root canals (e.g., endotoxin) may spread into apical tissue, evoking and supporting a chronic inflammatory load. Thus, apical periodontitis is the result of the complex interplay between microbial factors and host defense against invasion of periradicular tissues. This review of the literature aims to discuss the complex network between endodontic infectious content and host immune response in apical periodontitis. A better understanding of the relationship of microbial factors with clinical symptomatology is important to establish appropriate therapeutic procedures for a more predictable outcome of endodontic treatment.

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“… 24 An incision for drainage and adequate cleaning and shaping of the root canal system or tooth extraction are the appropriate treatments for this condition. 9 , 25 There is no need for systemic antibiotic therapy for symptomatic apical periodontitis with localized swelling in healthy patients. 25 The majority of infections with an endodontic source can be treated without antibiotics.…”

Section: Discussionmentioning

confidence: 99%

“…9 , 25 There is no need for systemic antibiotic therapy for symptomatic apical periodontitis with localized swelling in healthy patients. 25 The majority of infections with an endodontic source can be treated without antibiotics. 1 Antibiotics are indicated when the signs and symptoms suggest systemic involvement, such as high fever, malaise, cellulitis, unexplained trismus, and persistent and progressive infections, and for patients who are immunologically compromised.…”

Section: Discussionmentioning

confidence: 99%

Antibiotic abuse during endodontic treatment in private dental centers

Alrahabi

Abuong

2017

SMJ

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Objectives:We evaluated antibiotic prescription practices during root canal treatments among general dentists in private dental clinics in Al-Madinah Al Munawarah, Saudi Arabia.Methods:A self-administered, questionnaire about antibiotic used during root canal treatment was distributed to 75 randomly selected general dental practitioners working in private dental clinics in Al-Madinah Al-Munawarah, Saudi Arabia, between March and April 2016. The questionnaires were collected one week later. To compare results of the collected data, Chi-square test was used.Results:The results revealed that 60% of the dentists prescribed amoxicillin with clavulanic acid as the first choice treatment for endodontic pathosis. Clindamycin (51.6%) was the first choice for patients who were allergic to penicillin. Forty-five percent of the general practitioners prescribed antibiotics for 5 days. Approximately 83.3% of general practitioners prescribed antibiotics for acute apical abscesses. Prophylactic antibiotics were prescribed for cases with a history of infective endocarditis (65.5%), non-controlled diabetes (60.3%), placement of a prosthetic joint in the previous 2 years (46.6%), congenital heart disease (36.2%), and kidney dialysis shunts (34.5%).Conclusion:This study reveals antibiotic abuse in endodontic treatment practice in private dental clinics in Al-Madinah Al Munawarah, Saudi Arabia. General dental practitioners are lacking knowledge regarding the prescription of antibiotics in endodontic treatment and situations requiring prophylactic antibiotics.

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Systemic Antibiotics in Endodontic Infections

Cited by 8 publications

References 52 publications

Oxidative stress in patients with endodontic pathologies

Oxidative stress in patients with endodontic pathologies

Etiologic role of root canal infection in apical periodontitis and its relationship with clinical symptomatology

Antibiotic abuse during endodontic treatment in private dental centers

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