Assuntos
Infecções por Klebsiella , Doenças Dentárias , Adulto , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Feminino , Humanos , Klebsiella/efeitos dos fármacos , Klebsiella/isolamento & purificação , Klebsiella/patogenicidade , Klebsiella/fisiologia , Infecções por Klebsiella/diagnóstico , Infecções por Klebsiella/tratamento farmacológico , Infecções por Klebsiella/microbiologia , Doenças Dentárias/diagnóstico , Doenças Dentárias/tratamento farmacológico , Doenças Dentárias/microbiologia , ViscosidadeRESUMO
Las infecciones odontogénicas son una de las principales causas de consulta en la práctica odontológica, afectando a individuos de todas las edades.(1, 2) Estas patologías ocasionan considerable dolor y molestias que en caso de no tratarse pueden provocar la pérdida de las piezas dentarias y desencadenar procesos infecciosos más graves, como abscesos de los espacios aponeuróticos de cabeza y cuello, los cuales pueden comprometer la vida del paciente.(3, 4) Estas infecciones se manifiestan principalmente por dolor agudo que provoca una demanda espontánea de atención. El diagnóstico de estas infecciones consta de la evaluación clínica e imagenológica, las herramientas imagenológicas son de ayuda para lograr el diagnóstico definitivo y definir el manejo del paciente. Inicialmente la radiografía periapical y/o panorámica puede ayudar en la evaluación de la fuente de la infección, determinando las piezas dentarias y estructuras maxilares afectadas. En casos de una infección más avanzada, el uso de la tomografía computarizada juega un papel importante en la detección de cambios óseos y reacciones periósticas así como en la valoración de la extensión a tejidos blandos (e involucra a los distintos espacios aponeuróticos). La resonancia magnética es otra técnica que puede ser de utilidad para el diagnóstico de infecciones de tejidos blandos por su alta resolución espacial y buen contraste.(5) Sin embargo existen pocos estudios que hayan comparado su precisión diagnóstica con la tomografía de Cone Beam para el diagnóstico de infecciones odontogénicas. El absceso dentoalveolar agudo es una infección localizada con material purulento que afecta a los tejidos periapicales. Esta infección puede agravarse formándose un cuadro de celulitis, la cual se caracteriza por ser una infección difusa e indurada a la palpación que se extiende por los espacios faciales a través de los tejidos celular subcutáneo. La celulitis a su vez puede agravarse y convertirse en un absceso cervicofacial al formarse pus.
Assuntos
Humanos , Doenças Dentárias/terapia , Doenças Dentárias/tratamento farmacológico , Extração Dentária , Corticosteroides/uso terapêuticoRESUMO
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.
Assuntos
Infecções/cirurgia , Doenças Dentárias/cirurgia , Extração Dentária/métodos , Doença Aguda , Adolescente , Adulto , Idoso , Antibacterianos/uso terapêutico , Infecções Assintomáticas/terapia , Alvéolo Seco/etiologia , Feminino , Humanos , Infecções/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Doenças Dentárias/tratamento farmacológico , Extração Dentária/efeitos adversos , Odontalgia/cirurgia , Resultado do Tratamento , Adulto JovemRESUMO
Odontogenic infections are associated with a variety of microorganisms. antibiotics are commonly used for the management of various dental infections and have a proven role in decreasing morbidity and mortality caused by infectious diseases. the frequent and over usage of antibiotics has been associated with a number of consequences such as the selection of drug resistant strains, and the formation of antibiomas. antibiomas are characterized by the formation of a localized pathology surrounded by thick fibrous tissues in response to long term antibiotics use. an established antibioma is characterized by a tough fibrous swelling accompanied by painful or painless swelling, intermittent fever and constitutional symptoms. in this article, we are reporting the case of a facial antibioma formed due to prolonged use of antibiotics prescribed for a residual periapical infection following endodontic treatment. in addition, the association of using antibiotics in this context is discussed.
Assuntos
Humanos , Feminino , Adulto , Doenças Dentárias/tratamento farmacológico , Infecções/tratamento farmacológico , Antibacterianos/efeitos adversos , Cirurgia Bucal , Periodontite Crônica/tratamento farmacológico , Gengivite/tratamento farmacológicoRESUMO
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.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Idoso , Adulto Jovem , Doenças Dentárias/cirurgia , Extração Dentária/métodos , Infecções/cirurgia , Doenças Dentárias/tratamento farmacológico , Extração Dentária/efeitos adversos , Odontalgia/cirurgia , Doença Aguda , Estudos Prospectivos , Resultado do Tratamento , Alvéolo Seco/etiologia , Infecções Assintomáticas/terapia , Infecções/tratamento farmacológico , Pessoa de Meia-Idade , Antibacterianos/uso terapêuticoRESUMO
PURPOSE: Odontogenic infections are a common problem in dentistry, and their treatment often requires the use of antibiotics besides the removal of the source of infection, which frequently makes it more difficult for clinicians to make a decision regarding the choice of antibiotic. This study aimed to answer the following questions through the Patient, Intervention, Comparison, Outcome (PICO) format: When should antibiotics be used in dental infections (DIs)? Which are the most effective drugs? How long should antibiotics be administered? MATERIALS AND METHODS: This was a systematic review using the PubMed, Scopus, and Cochrane databases without restriction as to the period researched. The variables analyzed in each article were the number of odontogenic infections in each study, type of study, surgical intervention performed, antibiotics administered, statistical differences between groups studied, and patients' evolution after treatment. RESULTS: The search included 1,109 articles. After the full reading of 46 articles, 16 were included in the final review and 30 were excluded. A sample of 2,197 DI cases was obtained, in which 15 different antibiotics were used, with a 98.2% overall cure rate. CONCLUSIONS: The studies showed that antibiotics were prescribed only in situations of regional and/or systemic body manifestations. In the case of DIs, once drainage has been performed and/or the cause of infection has been removed, all antibiotics tested are equally effective with respect to clinical cure, and the choice of antibiotics is not as successful as the local intervention treatment procedure. When the real need for antibiotic therapy is detected, antibiotics should be used for the shortest time possible until the patient's clinical cure is achieved.
Assuntos
Antibacterianos/uso terapêutico , Infecções/tratamento farmacológico , Doenças Dentárias/tratamento farmacológico , Tomada de Decisão Clínica , Pesquisa Comparativa da Efetividade , Esquema de Medicação , Humanos , Resultado do TratamentoRESUMO
A brain abscess may result when dental infection reaches the brain through contiguous anatomic cavities such as the maxillary sinus, the ethmoid sinus and the orbital cavity. It is an important complication and should be treated aggressively. Such treatment would include the excision of the etiological factor, drainage and adjuvant antibiotic therapy. The present case concerns a 23 year old woman who presented at the General Hospital of Nova Iguaçu with complaints of pain in the right side of the face and was diagnosed with acute sinusitis. Antibiotics and analgesics were prescribed to treat the disease. However, after 10 days, she returned to the emergency room, presenting with proptosis of the right eyeball, subconjunctival haemorrhage, ophthalmoplegia and intense pain in the right orbit, in addition to headaches. After computed tomography was performed, she was diagnosed with a brain abscess in the frontal lobe with the involvement of the maxillary right first molar, the maxillary sinus, the ethmoid sinus and the orbital cavity. With culturing of the secretion, the growth of Pseudomonas aeruginosa colonies was evident. Treatment consisted of a craniotomy to drain the brain abscess, a Caldwell-Luc procedure to drain the right maxillary sinus, dental extraction and aggressive antibiotic therapy. After 6 weeks, the patient was discharged with no neurological sequelae.
Assuntos
Abscesso Encefálico/microbiologia , Infecções Oculares Bacterianas/microbiologia , Infecção Focal Dentária/microbiologia , Sinusite Maxilar/microbiologia , Doenças Orbitárias/microbiologia , Infecções por Pseudomonas/microbiologia , Antibacterianos/uso terapêutico , Abscesso Encefálico/diagnóstico , Abscesso Encefálico/terapia , Craniotomia , Drenagem , Infecções Oculares Bacterianas/diagnóstico , Infecções Oculares Bacterianas/terapia , Feminino , Infecção Focal Dentária/diagnóstico , Infecção Focal Dentária/terapia , Lobo Frontal , Humanos , Sinusite Maxilar/diagnóstico , Sinusite Maxilar/terapia , Doenças Orbitárias/diagnóstico , Doenças Orbitárias/terapia , Infecções por Pseudomonas/diagnóstico , Infecções por Pseudomonas/terapia , Pseudomonas aeruginosa/isolamento & purificação , Tomografia Computadorizada por Raios X , Doenças Dentárias/tratamento farmacológico , Extração Dentária , Adulto JovemRESUMO
BACKGROUND: Bacterial resistance to antibiotics is a health problem in many parts of the world. The aim of this study was to identify bacteria from dental infections and determine bacterial resistance to antibiotics used in dental care in the primary dentition. METHODS: This cross-sectional study comprised 60 children who presented for dental treatment for active dental infections in the primary dentition. Samples from dental infections were collected and bacteria were identified by polymerase chain reaction (PCR) assay. Bacterial resistance to antibiotics was determined by colony forming units on agar plates containing amoxicillin, clindamycin and amoxillicin-clavulanic acid (A-CA) tested at 8 µg/ml or 16 µg/ml. RESULTS: Clindamycin in both concentrations tested (8 µg/ml and 16 µg/ml) showed the highest bacterial resistance (85.9%), followed by amoxicillin (43.7%) and A-CA (12.0%). All comparisons among the three antibiotics used in the study exhibited statistical significance (p = <0.05) in both concentrations tested (8 µg/ml and 16 µg/ml), and under aerobic and anaerobic conditions. The most prevalent resistant species identified by PCR in primary dentition infections were: Streptococcus oralis and Prevotella intermedia (75.0%); Treponema denticola and Porphyromonas gingivalis (48.3%); Streptococcus mutans (45.0%); Campylobacter rectus; and Streptococcus salivarius (40%). CONCLUSIONS: This study demonstrated that A-CA exhibited the lowest bacterial resistance for clinical isolates in primary dentition infections.
Assuntos
Combinação Amoxicilina e Clavulanato de Potássio/administração & dosagem , Amoxicilina/administração & dosagem , Antibacterianos/administração & dosagem , Infecções Bacterianas/tratamento farmacológico , Clindamicina/administração & dosagem , Farmacorresistência Bacteriana Múltipla , Doenças Dentárias/tratamento farmacológico , Doenças Dentárias/microbiologia , Dente Decíduo/microbiologia , Biofilmes/crescimento & desenvolvimento , Criança , Pré-Escolar , Contagem de Colônia Microbiana , Estudos Transversais , Placa Dentária/microbiologia , HumanosRESUMO
OBJECTIVE: The aim of this study was to investigate the effects of photodynamic therapy (PDT) on endodontic pathogens by evaluating the decrease in numbers of Enterococcus faecalis colonies in the canals of extracted human teeth. BACKGROUND DATA: Failure in endodontics is usually related to inadequate cleaning and disinfection of the root canal system. This is due to the establishment of microorganisms in areas where the instruments and chemical agents used during root canal preparation cannot eliminate them. PDT is a complementary therapeutic method that could be used to eliminate these remaining bacteria. PDT is a process in which radiation acts on a dye that is applied to the target organism, resulting in bacterial death. MATERIALS AND METHODS: Forty-six uniradicular teeth had their canals contaminated with bacteria and were incubated for 48 h at 35 degrees C. After that, the teeth were divided into a control group (CG) and a test group (TG). The 23 CG teeth did not undergo any intervention, whereas in the TG the teeth received a solution of 0.0125% toluidine blue for 5 min followed by irradiation using a 50-mW diode laser (Ga-Al-As) at a wavelength of 660 nm. Bacterial samples were taken before and after irradiation. In each of the samples, the number of colony-forming units (CFU) was counted. RESULTS: The mean decrease in CFU was 99.9% in the TG, whereas in the CG an increase of 2.6% was observed. CONCLUSION: PDT was effective as a bactericidal agent in Enterococcus faecalis-contaminated root canals.
Assuntos
Cavidade Pulpar/microbiologia , Enterococcus faecalis , Infecções por Bactérias Gram-Positivas/tratamento farmacológico , Fotoquimioterapia , Ensaio de Unidades Formadoras de Colônias , Humanos , Técnicas In Vitro , Preparo de Canal Radicular/métodos , Doenças Dentárias/tratamento farmacológicoRESUMO
AIM: To evaluate the influence of mineral trioxide aggregate (MTA) on apexification and periapical healing of teeth in dogs with incomplete root formation and previously contaminated canals and to verify the necessity of employing calcium hydroxide paste before using MTA. METHODOLOGY: Twenty premolars from two 6-month old dogs were used. After access to the root canals and complete removal of the pulp, the canal systems remained exposed to the oral environment for 2 weeks. Canal preparation was then carried out using Hedström files, under irrigation with 1% sodium hypochlorite, 1 mm short of the radiographic apex. After drying, the canals of two premolars in each dog were left empty (control group). The other eight teeth in each animal were divided into two experimental groups. The apical thirds of the canals of group 1 were filled with MTA. In the teeth of group 2, the canals were dressed with a calcium hydroxide-propylene glycol paste. After 1 week, the paste was removed and the apical third was filled with MTA. All teeth were restored with reinforced zinc oxide cement (IRM) and amalgam. The animals were killed 5 months later, and blocks of the teeth and surrounding tissues were submitted to histological processing. The sections were studied to evaluate seven parameters: formation of an apical calcified tissue barrier, level of barrier formation, inflammatory reaction, bone and root resorption, MTA extrusion, and microorganisms. Results of experimental groups were analysed by Wilcoxon's nonparametric tests and by the test of proportions. The critical value of statistical significance was 5%. RESULTS: Significant differences (P < 0.05) were found in relation to the position of barrier formation and MTA extrusion. The barrier was formed in the interior of the canal in 69.2% of roots from MTA group only. In group 2, it was formed beyond the limits of the canal walls in 75% of the roots. MTA extrusion occurred mainly in roots from group 2. There was similarity between the groups for the other parameters. CONCLUSIONS: Mineral trioxide aggregate used after root canal preparation favoured the occurrence of the apexification and periapical healing. The initial use of calcium hydroxide paste was not necessary for apexification to occur, and has shown to be strongly related to the extrusion of MTA and formation of barriers beyond the limits of the root canal walls.
Assuntos
Compostos de Alumínio/farmacologia , Compostos de Cálcio/farmacologia , Óxidos/farmacologia , Materiais Restauradores do Canal Radicular/farmacologia , Tratamento do Canal Radicular/métodos , Silicatos/farmacologia , Ápice Dentário/efeitos dos fármacos , Cicatrização/efeitos dos fármacos , Animais , Hidróxido de Cálcio/farmacologia , Cães , Combinação de Medicamentos , Radiografia , Preparo de Canal Radicular/métodos , Ápice Dentário/diagnóstico por imagem , Doenças Dentárias/diagnóstico por imagem , Doenças Dentárias/tratamento farmacológicoRESUMO
Este estudio corresponde a una serie de 20 casos donde se utilizó el compuesto trióxido mineral MTA para tratar distintos casos de apexificación. Se seleccionaron pacientes que presentaban piezas permanentes superiores, no vitales, con antecedentes de traumatismo, e interrupción del desarrollo radicular, cuyas edades fluctuaban entre los diez y catorce años. El propósito de este estudio fue conocer las propiedades, ventajas e indicaciones del MTA y la viabilidad del protocolo utilizado en estos tratamientos. De acuerdo al protocolo del tratamiento, los conductos radiculares fueron irrigados con hipoclorito de sodio al 2.5 por ciento y medicados con una pasta de hidroxido de calcio por 15 días. Seguidamente, la porción apical fue sellada con MTA (3mm) y la porción remanente con gutapercha y cemento Grossman. Estos casos, que tradicionalmente fueron tratados con hidróxido de calcio por extensos períodos de tiempo, al ser sellados con MTA, fueron dados de alta en una sola sesión, y completaron el cierre radicular en un plazo de 6 a 8 meses. Sin embargo, son necesarios nuevos ensayos clínicos que prueben la efectividad de este material.
Assuntos
Adolescente , Humanos , Criança , Ápice Dentário , Hidróxido de Cálcio/uso terapêutico , Obturação do Canal Radicular/métodos , Doenças Dentárias/tratamento farmacológico , Materiais Restauradores do Canal Radicular , Fraturas dos Dentes/tratamento farmacológico , Tratamento do Canal Radicular/métodosRESUMO
A general overview upon most used products in odontopediatrics is presented; the factors which influence the determination of the adequate doses in children and some useful recommendations in dental clinical practice are described. The most prescribed products in pediatric odontology are summarized into two groups: a) benzodiazepine, for anxiety and lidocaine, aspirin and acetaminophen, dipirone and naproxen, for pain; and b) penicillin, erythromycin, for treatment of infections. Doses, pharmacologic effects, clinical indications, side effects and contraindications of the chemicals mentioned are described. Also, the article presents some of the aspects which justify the use, in our country, of certain medicaments prescribed in other nations reporting, the recommendations in order to prevent the use of other chemicals because of their lack of therapeutical advantages over the ones of first choice.
Assuntos
Analgésicos , Antibacterianos , Criança , Assistência Odontológica , Humanos , Doenças da Boca/tratamento farmacológico , Doenças Dentárias/tratamento farmacológicoRESUMO
Estudo multicéntrico, aberto, näo comparativo, realizado de março de 1985 a novembro de 1986. Um total de 4027 pacientes, portadores de afecçöes odontológicas, foi avaliado por 888 odontólogos. As afecçöes relatadas foram classificadas em cinco grupos: endodônticas, dentárias, periodônticas, traumáticas e outras. De modo geral, todos os sintomas apresentaram melhoras, sendo que a avaliaçäo global da eficácia terapêutica mostrou resultados exelentes ou bons em 94,7 por cento dos casos. Apenas 9,6 por cento dos pacientes relataram a ocorrência de efeitos colaterais, sendo que destes, 93,3 por cento eram de natureza leve ou moderada. Na avaliaçäo global da tolerabilidade, esta foi considerada boa ou excelente em 93,8 por cento dos pacientes. A ocorrência de efeitos colaterais foi maior na presença de medicaçöes concomitantes do que durante o emprego isolado do diclofenaco potássico, sendo esta diferença estatisticamente significativa (P < 0,01). Conclui-se que o diclofenaco potássico consistiu uma opçäo segura para o tratamento das afecçöes odontológicas acompanhadas de processsos inflamatórios e/ou dolorosos