Antibiotic prescription in the management of endodontic infections amongst Iraqi final-year undergraduate dental students

Aim This study aimed to examine the prescription of antibiotics for endodontic infections among undergraduate dental students. Methods Two government Iraqi dental schools [(the University of Baghdad (UOB) (n=99) and University of Babylon (UB) (n=70)], and one private dental school [Osouldeen University College (OUC) (n=103)] were included in this survey study. A paper-based questionnaire composed of seven questions was distributed to students, and collected. A chi-square test was used for data analysis, and the level of significance was set at 0.05 (P=0.05). Results A statistically significant difference (P<0.05) was identified between students' answers in the three dental schools regarding antibiotic selection for endodontic infections in which patients had no known allergies (P=0.001). In comparison to other dental schools, a statistically significantly higher proportion of respondents from UOB (32%) favored Azithromycin 500mg for treating patients with penicillin hypersensitivity (P=0.003). A high percentage of participants (62.1%) selected antibiotic prescription in cases with necrotic pulp and symptomatic apical periodontitis (with swelling and moderate/severe preoperative symptoms). However, there were no significant differences between the 3 dental schools (P>0.05). Conclusion In conclusion, a significantly greater percentage of UB chose amoxicillin for the treatment of endodontic infection in patients with no medical allergies. Azithromycin 500mg was selected by UOB as the preferred option in patients who were sensitive to penicillin. Our findings support the need for the implementation of strategies to raise awareness of good antibiotic prescribing practices among dentists in Iraq.

Unusual Deviation of the Main Foramen from the Root Apex

Abstract The relationship of the main foramen to the anatomic root apex has been the subject of several studies. Although they are anatomically close, they rarely coincide, and their distance can vary according to age or tooth type, ranging from 0.2 to 3.0 mm. The aim of this short communication was to evaluate the distance between the main foramen of independent middle mesial canals (MMCs) and the anatomical mesial root apex of mandibular first molars using the micro-computed tomography. Twenty-five mandibular first molars with MMCs were scanned (resolution of 9.9 µm), and the distance from its main foramen to the anatomical apex was evaluated. Overall, the distance ranged from 0.2 to 2.4 mm; however, in 3 specimens the distance was greater than 3 mm. This report demonstrates that the exit of the main foramen of the MMC varies considerably and could approach a substantial distance from the anatomical apex greater than previously reported in the literature.

Resumo A relação do forame principal com o ápice anatômico da raiz tem sido objeto de vários estudos. Embora estejam anatomicamente próximos, eles raramente coincidem, e a sua distância pode variar de acordo com a idade ou o tipo de dente, oscilando entre 0,2 e 3,0 mm. O objetivo deste artigo é relatar que a saída foraminal do canal mediano (MMC), presente na raiz mesial de molares inferiores, pode apresentar variações significativas, atingindo distâncias acima de 3 mm do ápice anatômico. Vinte e cinco primeiros molares inferiores com MMC foram escaneados (resolução de 9,9 mm) e a distância do forame principal ao ápice anatômico avaliada. Em geral, a distância mostrou variações consideráveis; no entanto, em 3 espécimes esta distância ficou acima de 3 mm. Este estudo teve como objetivo relatar que a saída do forame principal de canais medianos de primeiros molares inferiores pode apresentar variações consideráveis, podendo atingir distâncias maiores do que as relatadas previamente na literatura.