Systemic antibiotics in endodontics-International questionnaire study: Choice of types, dosage, loading and duration.

The aim of the study was to investigate the systematic antibiotics (SAs) prescribing practices in the endodontic practice worldwide. 7500 general practitioners, postgraduate students and endodontists from Israel and the former Soviet Union (FSU) states were invited to fill in an online questionnaire. The first-choice SA was amoxicillin (80.12%) among the Israeli (p < 0.05) and amoxicillin + clavulanic acid (88.92%) among the FSU respondents (p < 0.05). The first-choice SA for patients with penicillin allergy was clindamycin (78.2%) among Israeli and azithromycin (35.96%) among the FSU respondents (p < 0.05). Most of the respondents from Israel as well as from the FSU reported prescribing SA for 5-7 days. Only 6.24% of the former and 2.59% of the latter reported prescribing SA until the symptoms disappeared (p > 0.05). The usage of SAs is often not in accordance with existing international guidelines and differs among different dentist's populations.

International questionnaire study on systemic antibiotics in endodontics. Part 1. Prescribing practices for endodontic diagnoses and clinical scenarios.

OBJECTIVES: Part 1 of this two-part study aims to investigate systemic antibiotics (SA) prescribing practices for various endodontic diagnoses and clinical scenarios by general practitioners, post-graduate students and endodontists in Israel and the former Soviet Union (FSU) states. MATERIALS AND METHODS: A total of 7500 dentists from Israel and FSU states were invited to fill in an online questionnaire. The questionnaire consisted the SA prescribing for endodontic diagnoses and clinical scenarios (post operative pain, post apical surgery and post avulsion). The international guidelines of the European Society of Endodontology and the American Association of Endodontists were used as the standard of correct practice. RESULTS: A total of 1310 dentists (response rate of 17.46%, 498 Israeli and 812 FSU dentists) completed the survey. The rates of prescription SA among the Israeli and the FSU respondents for non-recommended diagnoses and clinical scenarios were 24.75% and 11.42% (P>0.05), 16.57% and 16.17% (P>0.05) respectively. The rates of prescription SA among the Israeli and the FSU respondents for recommended diagnoses and clinical scenarios were 63.39% and 62.9% (P>0.05), 27.2% and 13.9% (P>0.05) respectively. CONCLUSIONS: There are gaps between the recommended protocols for prescribing SA for patients with various endodontic diagnoses and clinical scenarios and the actual practices among Israeli and FSU dentists. Continuing education of dentists must be encouraged in order to improve SA prescription practice according to international guidelines. CLINICAL RELEVANCE: When not indicated, prescription of systemic antibiotics might lead to antimicrobial resistance, while non-prescription, when required, might have negative repercussions on the patient's health. Knowledge of the prescription habits of dentists in the endodontic practice will help prevent harmful situations.

Long-term dental implications of infant oral mutilation: a case series.

Infant oral mutilation (IOM) is a ritual ceremony practised mostly in African cultures, in which the primary tooth bud of the deciduous canine is extracted. Complications and risks of IOM include pain, heavy bleeding and infection that may deteriorate to life-threating conditions. The main long-term consequence of IOM is future dental abnormalities. The scientific literature lacks in-depth analyses of the dental sequelae of this practice among adults who underwent it, and particularly of the aspect of dental treatment. Eight new cases of IOM are presented in this case series, with emphasis on dental diagnosis and treatment modalities. We describe different outcomes of this practice, such as enamel hypoplasia and crown deformations with later necrosis and infection of the root canal system, severe discolouration, immature root apex, impaction of a canine, failure of development and missing lower permanent incisors and canines, an odontoma-like structure, severe periodontal defect and root dilaceration. Familiarity with the practice of IOM is vital in order to identify its manifestations and arrive at the correct diagnosis and optimal course of treatment.

External invasive resorption: Possible coexisting factors and demographic and clinical characteristics.

The purpose of this retrospective study was to identify the coexisting factors for EIR and to characterise EIR clinically and demographically. All cases of EIR that were referred to the endodontic department between 2011 to 2016 and diagnosed by an endodontist were evaluated. Demographic and clinical characteristics were collected and evaluated. Thirty-eight cases of EIR diagnosed between 2011 and 2016 were included in the study. Seventy-one percent of EIR cases were misdiagnosed by general practitioners. The most affected teeth were the maxillary central incisors (29% of cases) and mandibular molars (26%). Sixty-eight percent of EIR cases were diagnosed in teeth with clinically normal pulp. Pulp necrosis was observed mainly in the advanced stages (class 3 and class 4) of EIR (75%) and in teeth with a history of trauma (63%). Histories of previous trauma and orthodontic treatment were reported in 29% and 23% of cases, respectively.