Rahhali Mohamed, Sakout Majid
Department of Conservative Dentistry and Endodontics, Faculty of Dentistry, Mohammed V University, Rabat, Morocco.
Service of Conservative Dentistry and Endodontics, Mohammed V Military Hospital of Rabat, Rabat, Morocco.
Clin Cosmet Investig Dent. 2025 May 11;17:209-215. doi: 10.2147/CCIDE.S526588. eCollection 2025.
With increasing life expectancy, the incidence of degenerative and inflammatory joint diseases continues to rise. These conditions are major indications for orthopedic prostheses, which pose risks of postoperative complications, particularly infections of orthopedic prostheses (IPO). Dental infections have been considered a potential source of these infections, and recommendations regarding the use of antibiotic prophylaxis (AP) during dental procedures have evolved over time. Current guidelines discourage the routine use of AP. This study aims to assess the knowledge, attitudes, and practices (KAP) of private-sector dentists in the cities of Rabat, Temara, and Salé (Morocco) regarding the dental management of patients with orthopedic prostheses, particularly the use of AP.
An anonymous 21-question survey was distributed to 310 dentists practicing in these cities. The collected responses were analyzed using JamoviR software (version 2.3.25), with a significance threshold set at p < 0.05. Chi-square and Fisher's exact tests were employed to compare different groups.
Out of 310 distributed questionnaires, 102 valid responses were retained (response rate: 32.9%). Among respondents, 53.9% considered patients with joint prostheses at risk of infection, yet only 47.1% reported prescribing AP. Female practitioners and those with over 20 years of experience were significantly more likely to prescribe AP (p=0.047 and p=0.002, respectively). Dentists who did not consult guidelines or attend professional conferences were also more prone to prescribing AP during endodontic procedures (p=0.017 and p=0.018).
This study reveals inconsistent knowledge and practices among dentists regarding AP use for patients with joint prostheses. Given the misalignment with current guidelines and the influence of outdated sources of information, targeted educational interventions and updated clinical guidelines are urgently needed to promote evidence-based practices. Clear, standardized guidelines are also essential to prevent the unjustified overprescription of antibiotics and to address the growing concern of antimicrobial resistance.
随着预期寿命的增加，退行性和炎性关节疾病的发病率持续上升。这些病症是骨科假体的主要适应症，而骨科假体存在术后并发症的风险，尤其是骨科假体感染（IPO）。牙科感染一直被认为是这些感染的潜在来源，并且关于在牙科手术期间使用抗生素预防（AP）的建议也随着时间的推移而不断演变。当前指南不鼓励常规使用AP。本研究旨在评估拉巴特、特马拉和萨勒（摩洛哥）市私立牙科医生在骨科假体患者牙科管理方面的知识、态度和实践（KAP），特别是AP的使用情况。
向在这些城市执业的310名牙医发放了一份包含21个问题的匿名调查问卷。使用JamoviR软件（版本2.3.25）对收集到的回复进行分析，显著性阈值设定为p < 0.05。采用卡方检验和费舍尔精确检验来比较不同组。
在分发的310份问卷中，保留了102份有效回复（回复率：32.9%）。在受访者中，53.9%认为关节假体患者有感染风险，但只有47.1%报告开具了AP。女性从业者和有超过20年经验的从业者开具AP的可能性显著更高（分别为p = 0.047和p = 0.002）。未查阅指南或未参加专业会议 的牙医在牙髓治疗过程中也更倾向于开具AP（p = 0.017和p = 0.018）。
本研究揭示了牙医在关节假体患者AP使用方面的知识和实践存在不一致。鉴于与当前指南不一致以及过时信息来源的影响，迫切需要有针对性的教育干预和更新的临床指南来促进循证实践。清晰、标准化的指南对于防止抗生素的不合理过度处方以及应对对抗菌素耐药性日益增长的担忧也至关重要。
