ABSTRACT
Concerns regarding increasing antibiotic resistance raise the question of the most appropriate oral antibiotic for empirical therapy in dentistry. The aim of this systematic review was to investigate the antibiotic choices and regimens used to manage acute dentoalveolar infections and their clinical outcomes. A systematic review was undertaken across three databases. Two authors independently screened and quality-assessed the included studies and extracted the antibiotic regimens used and the clinical outcomes. Searches identified 2994 studies, and after screening and quality assessment, 8 studies were included. In addition to incision and drainage, the antibiotics used to manage dentoalveolar infections included amoxicillin, amoxicillin/clavulanic acid, cefalexin, clindamycin, erythromycin, metronidazole, moxifloxacin, ornidazole and phenoxymethylpenicillin. Regimens varied in dose, frequency and duration. The vast majority of regimens showed clinical success. One study showed that patients who did not receive any antibiotics had the same clinical outcomes as patients who received broad-spectrum antibiotics. The ideal choice, regimen and spectrum of empirical oral antibiotics as adjunctive management of acute dentoalveolar infections are unclear. Given that all regimens showed clinical success, broad-spectrum antibiotics as first-line empirical therapy are unnecessary. Narrow-spectrum agents appear to be as effective in an otherwise healthy individual. This review highlights the effectiveness of dental treatment to address the source of infection as being the primary factor in the successful management of dentoalveolar abscesses. Furthermore, the role of antibiotics is questioned in primary space odontogenic infections, if drainage can be established.
ABSTRACT
Purpose: Dental implant care and maintenance is of critical importance as implants grow in popularity as a tooth replacement option. The purpose of this study was to investigate the implant-related training and clinical practices of oral health practitioners (OHPs) in Australia regarding oral hygiene instructions (OHI) and maintenance protocols, and to better understand their role in providing peri-implant services.Methods: A 42-item web-based survey was forwarded to the members of the Dental Hygienists Association of Australia and the Australian Dental and Oral Health Therapists' Association. Survey items included participant's demographics, types of peri-implant services provided in the workplace, implant-related information sources, peri-implant diagnostic preferences, implant maintenance protocols and oral hygiene instructions (OHI) for dental implants. Descriptive statistics were used to analyse the data. Comparisons were made with a similar survey of the implant maintenance preferences of general dentists in Australia.Results: One hundred fifty-four Australian OHPs completed the electronic survey (n=154). Nearly all respondents (96.7%) considered implant home hygiene and peri-implant health to be strongly associated. Dental qualification (64.9%) and association-sponsored professional development courses (50.6%) were the most common sources of implant assessment/management information. Brushing (88.7%) and the use of an interdental brush (78.1%) were the most popular implant-specific OHI provided. All of the respondents reported performing oral hygiene assessments around dental implants; 94.0% performed supragingival cleaning, 67.5% subgingival cleaning, 55.0% treated peri-implant mucositis and 38.4% peri-implantitis. Dental floss (80.9%), rubber-cup prophylaxis (59.6%), plastic/carbon curettes (52.5%) and plastic-tipped ultrasonics (43.3%) were the most common devices used for implant maintenance.Conclusion: Australian OHPs reported providing peri-implant services generally in agreement with the current literature and demonstrated a greater focus on prevention as compared with Australian dentists. Oral health practitioners in Australia expect to be highly involved in dental implant maintenance care and provide the majority of preventive, periodontal and OHI services in their workplaces.
Subject(s)
Dental Implants , Australia , Humans , Hygiene , Oral Health , Surveys and QuestionnairesABSTRACT
INTRODUCTION: Implant treatments and peri-implant maintenance continue apace, while the evidence for implant maintenance and home hygiene continues to be developed. Information sources for dental practitioners and patients in peri-implant health maintenance and disease management are generally not known. This study investigated the implant maintenance topics taught, the discipline backgrounds of convenors and presenters and information delivery methods within implant dentistry teaching in Australia. MATERIALS AND METHODS: An online survey was distributed to 56 convenors of implant dentistry and maintenance education programmes in Australia, garnering responses from 24 individuals which outlined 43 different education programmes. RESULTS: Lectures were the main delivery method for implant maintenance information across the different course types. Peri-implant diagnostics were generally taught according to current literature recommendations, but coverage varied in topics where the evidence is yet to be established (eg home hygiene, professional maintenance and implant review). Some educators reported awareness of limitations in their programmes. CONCLUSION: Implant dentistry education programmes in Australia vary widely in teaching implant maintenance, coverage of which should be current and evidence-based at all education levels. The structure of implant dentistry teaching at the continuing professional development level requires further development.
