Antibiotics for dental infections – Short or long duration courses?

Many drugs are licensed for use in Generalised Anxiety Disorder (GAD), but it is unclear what works best.

This review comparing short (3–5 days) or longer courses (≥7 days) of antibiotics for the treatment of dental infections in general practice only included one small RCTs. No differences were seen between short an dlong courses but the findings should be interpreted cautiously becaise of the limited data available.

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Metronidazole for treatment of non-periodontal dental infections

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This review of whether metronidazole used as monotherapy or in addition to a β-lactam antibiotic offers any additional benefit over β-lactam monotherapy in non- periodontal dental infections includes 3 RCTs. The findings suggest that metronidazole does not provide superior clinical results compared to β-lactam antibiotics for the treatment of non-periodontal dental infections. However the evidence is limited and of low quality.

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Third molar surgery and antibiotics to prevent infection

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This review and infection of dry socket after third molar surgery identified 58 RCTs of whihc 34 contributed to a meta-analyses. The findings indicated that metronidazle and amoxicillin did reduce infection but the findings were of low certainty.

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Periodontitis: Adjunctive amoxicillin and metronidazole with full-mouth scaling and root planing

This review of whether amoxicillin and metronidazole used as an adjunct to full-mouth scaling and root planing improved clinical outcomes included 11 RCTs. While the findings indicate significant improvements in clinical attachment level and pocket probing depth they may not be clinically important.

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Chronic periodontitis: Efficacy of adjunctive antimicrobials

Many drugs are licensed for use in Generalised Anxiety Disorder (GAD), but it is unclear what works best.

This review of the efficacy of antimicrobials adjunctive to scaling and root planing (SRP) in the treatment of chronic periodontitis. 21 RCTs were included with the findings showing that amoxicillin and metronidazole had the largest statistical benefit. Whether this benefit is a clinically important benefit is a wider question.

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Periodontitis: Systemic antimicrobials as an adjunct to non-surgical treatment

Periodontal disease
Periodontitis

This Cochrane review of the effects of systemic antimicrobials as an adjunct to scaling and root planing (SRP) for the non-surgical treatment of patients with periodontitis identified 45 RCTs. However the evidence is of very low certainty to inform tclinicians and patients if adjunctive antibiotics are beneficial.

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Periodontal treatment to prevent or manage cardiovascular disease

gum disease, scale and polish

Two small RCTs at high risk of bias were included in this Cochrane systematic review looking at the effects of periodontal therapy for primary or secondary prevention of CVD in people with chronic periodontitis.

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Guideline: Antibiotics for Dental Pain and Swelling

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This new guideline from the American Dental Association is about the the appropriate use of systemic antibiotics for the urgent management of symptomatic irreversible pulpitis with or without symptomatic apical pulpitis, pulp necrosis and symptomatic apical periodontitis and pulp necrosis and localized acute apical abscess.

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Dental implant placement: which antibiotic protocol?

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This review of the the effectiveness of different antibiotic protocols to prevent early dental implant failure includes 9 RCTs showing that antibiotics were protective against early implant failures.

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Diabetic patients: does periodontal treatment improve glycaemic control?

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91 diabetic patients were randomised to non-surgical scaling and root planing and amoxicillin or control. While periodontal status significantly improved at 3 months there was no no significant effects on
glycaemic control.

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