Isola Gaetano
Unit of Oral Surgery and Periodontology, Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Via S. Sofia 78, 95124 Catania, Italy.
Antibiotics (Basel). 2020 Feb 22;9(2):95. doi: 10.3390/antibiotics9020095.
In the dental field, the most common oral diseases include periodontitis, apical periodontitis, abscesses, phlegmons and pulpits, all of which are determined by the same aetiological factor, bacterial infections. For these reasons, it is important to choose the right approach through a target antibiotic therapy against oral bacteria. More specifically, during periodontitis, antibiotics are used, often in association with periodontal debridement, to reduce disease-associated periodontopathogens. However, international guidelines are not unanimous in recommending the use of local and/or systemic antimicrobials to reduce infection by oral bacteria, especially in cases in which there is a danger of spreading systemic infection such as cellulitis, diffuse swelling, and abscesses. The lack of consensus is mainly due to the side effects of antibiotic therapy in dentistry, maybe due to recent scientific evidence regarding the development of bacterial resistance to antibiotics. Therefore, the purpose of this editorial is to analyze the therapeutic effects of antibiotics against the main forms of oral and periodontal diseases, and whether there is a significant clinical benefit, especially in the long term, of antimicrobial therapies in dentistry. The most recent evidence regarding antimicrobial agents will also be discussed.
在牙科领域，最常见的口腔疾病包括牙周炎、根尖周炎、脓肿、蜂窝织炎和牙髓炎，所有这些疾病都由相同的病因——细菌感染所决定。基于这些原因，通过针对口腔细菌的靶向抗生素治疗选择正确的方法很重要。更具体地说，在牙周炎期间，抗生素通常与牙周清创术联合使用，以减少与疾病相关的牙周病原体。然而，国际指南在推荐使用局部和/或全身抗菌药物以减少口腔细菌感染方面并不一致，特别是在存在全身感染扩散风险的情况下，如蜂窝织炎、弥漫性肿胀和脓肿。缺乏共识主要是由于牙科抗生素治疗的副作用，这可能是由于最近关于细菌对抗生素耐药性发展的科学证据。因此，这篇社论的目的是分析抗生素对主要口腔和牙周疾病形式的治疗效果，以及抗菌治疗在牙科是否具有显著的临床益处，尤其是长期益处。还将讨论有关抗菌剂的最新证据。
