Peri-implantitis: little evidence that particular non-surgical treatments are better than debridement alone

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This Bayesian network meta-analysis only included 11 small studies of overall low quality. While the greatest reduction in PPD was seen with debridement in conjunction with antibiotics the difference are small so it is difficult to conclude that any particular non-surgical treatment for peri-implantitis performs better than debridement alone

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Insufficient evidence to determine the effect of systemic antibiotics on adults with symptomatic apical periodontitis or acute apical abscess

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The recommended treatment for apical periodontitis or acute apical abscess is removal of the source of inflammation or infection by local, operative measures ie tooth extraction or pulp extirpation possibly in combination with the incision and drainage of any swelling present. Antibiotics are only recommended where there is evidence of spreading infection or systemic symptoms.   [read the full story…]

Limited evidence for best antibiotic regimens to prevent postoperative infections after orthognathic surgery

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Orthognathic surgery for the correction of dentofacial and craniofacial deformities has become a common a common procedure. Postoperative infection rates have been reported between 2-33%. The aim of this review was to provide evidence-based recommendations on the efficacy of different antibiotic regimens in preventing postoperative infections after orthognathic surgery Searches were conducted in Embase, Ovid [read the full story…]

Review finds only a small benefit from antibiotic use in patients with acute sinusitis

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Sinusitis is one of the commonest reasons for visiting the doctor accounting for 15% to 21% of all adult outpatient antibiotic prescriptions. Patients may also present at dental practices, as pain from upper posterior teeth can be indistinguishable from sinusitis.  Typical signs and symptoms are purulent nasal discharge, postnasal drip, sinus pain at palpation, nasal [read the full story…]

D-cycloserine does not improve CBT for social anxiety disorder, but may accelerate early treatment gains

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Clinical trials in the field of social anxiety to date have primarily focussed on the effect of either anxiolytic medication or cognitive behavioural therapy (CBT). At best these trials have demonstrated only moderate efficacy for either treatment independently (Davidson et al, 2004; Clark et al, 2003; Heimberg et al, 1998; Stein et al, 1998), and [read the full story…]

No evidence on whether antibiotic prophylaxis is effective or ineffective against bacterial endocarditis in people at risk who need invasive dental procedures

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Bacteraemia is common following dental procedures and it was believed that this could lead to bacteria endocarditis a severe infection of the lining of the chambers of the heart with a high mortality rate.  Until 2008 when National Institute for Health and Care Excellence (NICE) recommended that antibiotics were not required guidelines in many countries [read the full story…]

Review suggests that antibiotics are beneficial for reducing failure of dental implants

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With the increasing popularity of dental implants and the difficulties of managing infections around them it is important to know whether the use of prophylactic antibiotics is beneficial or not. This review is an update of a Cochrane review originally published in 2008 and last updated in 2010. The aim of the review was to [read the full story…]

Some evidence that prophylactic antibiotics reduce implant failures

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Dental implants are being used increasingly and some implant failures may be due to bacterial contamination at insertion.  Prophylactic antibiotic regimens have been proposed to minimise infection. The aim of this review was to address the question, does the use of antibiotics, when compared with a control group, reduce the frequency of implant failure and [read the full story…]

Limited evidence available of the caries risk in children and adolescents with cystic fibrosis

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Cystic fibrosis (CF) is a genetic disorder that leads to the overproduction and accumulation of mucus in the lungs, which can result in airway obstruction and life-threatening bacterial.   Four risk factors related to CF are considered to increase the risk of dental caries; a 20- fold increase in intraoral Streptococcus mutans levels; gastroesophageal reflux disease [read the full story…]

ADA-EBD summary on amoxicillin/metronidazole therapy for chronic periodontitis

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This ADA-EBD critical summary  looks at  systematic review by Sgolastra et al from 2012 that addressed  the question of whether the use of amoxicillin/metronidazole (AMX/MET)  as an adjunct to scaling and root planning (SRP) was more effective than SRP alone in the treatment of chronic periodontitis. The appraisers considered that searching an analysis of the [read the full story…]