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Prescribing systemic antibiotics when replanting avulsed teeth
Question: Do systemic antibiotics prescribed at the time of replantation of an avulsed permanent tooth improve the chances of periodontal healing?
Address for correspondence: Professor Louise Brearley Messer, School of Dental Science, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, 720 Swanston Street, Victoria 3010, Australia.
E-mail:
هذا البريد محمى من المتطفلين , تحتاج إلى تشغيل الجافا سكريبت لمشاهدته
Dafydd Evans1
1 Preventive and Children's Section, Dundee Dental Hospital and School, Park Place, Dundee, Scotland, UK
Hinckfuss SE, Messer LB. An evidence-based assessment of the clinical guidelines for replanted avulsed teeth. Part 1. Timing of pulp extirpation. Dent Traumatol 2009; 25: 32-42.
Abstract
Data sources
Four databases were searched for relevant citations: Ovid Medline, Cochrane Library, PubMed and ISI Web of Science.
Study selection
Studies were included if they were conducted on human permanent anterior teeth and they reported systematic antibiotic use and periodontal healing outcomes. Only English language papers were considered.
Data extraction and synthesis
A meta-analysis was conducted using a random-effects model. Heterogeneity was assessed using Cochran Q test and I2 statistic.
Results
Three studies were included in the meta-analyses involving, in total, 326 teeth: 247 (76%) of these were treated with systemic antibiotics, whereas 79 (24%) had no systemic antibiotic therapy following replantation. There was no statistically significant difference between prescribing or not prescribing antibiotics for acceptable periodontal healing without progressive root resorption (common odds ratio, 0.90; standard error of the mean, 0.29; 95% confidence intervals, 0.51-1.58).
Conclusions
There was inconclusive evidence for an association between systemic antibiotic therapy and an increased likelihood of acceptable periodontal healing. Pending future research to the contrary, dentists are recommended to follow current guidelines in prescribing systemic antibiotic therapy when replanting avulsed teeth .
Aggressive periodontitis in children: a 14-19-year follow-up
Sara Thorbert Mros 1 and Tord Berglundh 1
1 Department of Periodontology, The Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
Correspondence to Address:
Tord Berglundh
Department of Periodontology
The Sahlgrenska Academy at University of Gothenburg
Box 450 SE 405 30 Göteborg sweden
E-mail:
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Conflict of interest and source of funding statement
The authors declare that there are no conflicts of interest. This study was supported by grants from TUA research, Göteborg and Swedish Dental Society, Stockholm, Sweden.
ABSTRACT
Aim
The objective was to assess the recurrence of disease in subjects with a history of localized aggressive periodontitis (LAP).
Material and Methods
Initially, 11 children (7-13 years) with LAP were examined. Samples from the subgingival microbiota and soft tissue biopsies were obtained. Non-surgical periodontal therapy was performed and the affected deciduous and two permanent molars were extracted. The subjects were enrolled in a recall programme within the public dental services. Fourteen to 19 years after the initial examination, the subjects were recalled for clinical and radiographic examinations.
Results
The re-examination disclosed that two of the subjects exhibited recurrence of disease with probing pocket depth 6 mm and bone loss of 3-4 mm at several teeth, while another two subjects presented a limited number of sites with the disease. While bleeding on probing was a general finding in the group, no further loss of attachment was detected in seven subjects. Advanced attachment loss at the deciduous teeth as well as the presence of Aggregatibacter actinomycetemcomitans and its specific clone JP at the initial examination did not correlate with the recurrence of disease at the 14-19-year follow-up.
Conclusion
Children treated for LAP do not always exhibit recurrence of periodontitis in the absence of supportive periodontal therapy over periods of 14-19 years.
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Accepted for publication 24 November 2009
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