Antibiotska terapija u endodonciji

master's thesis

• Title (english): Antibiotic therapy in endodontics
• Author: Ana Banožić
• Mentor: Paris Simeon (mentor)
• Committee member: Paris Simeon (predsjednik povjerenstva)
• Committee member: Eva Klarić Sever (član povjerenstva)
• Committee member: Lana Bergman (član povjerenstva)
• Granter: University of Zagreb; School of Dental Medicine; (Department of Endodontics and Restorative Dentistry); Zagreb
• Defense date and country: 2017-11-24, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Dental Medicine; Endodonics and Restorative Dentistry

Abstract

Antibiotici su antimikrobni lijekovi koji se koriste u liječenju infekcija kada imunološki sustav domaćina nije u stanju savladati infekciju i eliminirati mikroorganizme. U endodontskoj terapiji upotreba antibiotika može biti sistemska, lokalna i profilaktička. Većina je odontogenih infekcija ograničena unutar zuba i može se uspješno kontrolirati lokalno: trepanacijom zuba uzročnika, incizijom i uspostavom drenaže ili ekstrakcijom. Sistemska upotreba antibiotika u terapiji odontogene upale je samo pomoćna, u situacijama kada je potrebno prevenirati sistemsko širenje infekcije. Uz provedenu primarnu terapiju, dodatno će se sistemski propisati antibiotici u slučaju povišene tjelesne temperature, regionalnog limfadenitisa, prodora infekcije kroz kortikalis i u slučaju širenja infekcije kroz meka tkiva. Lokalna primjena antibiotika indicirana je regenerativnim endodontskim postupcima i u terapiji avulzije zuba, kada je uputno ordinirati antibiotik i sistemski. Najčešće primjenjivani antibiotik u terapiji endodontskih infekcija je amoksicilin, samostalno ili u kombinaciji s klavulanskom kiselinom. U slučaju potvrđene alergije na penicilin, lijek izbora je klindamicin. U lokalnoj terapiji najzastupljeniji su tetraciklini. Profilaktička sistemska terapija indicirana je u medicinski kompromitiranih pacijenata koji su skloniji razvoju komplikacija od odontogene upale. Rizični su pacijenti oni s nekontroliranim sistemskim bolestima, imunosuprimirani i imunokompromitirani, pacijenti s umjetnim srčanim zaliscima, preboljelim infektivnim endokarditisom i pacijenti s nedavno transplantiranim umjetnim zglobom. Profilaksa se primjenjuje u jednoj dozi 30-60 minuta prije invazivnih stomatoloških zahvata.

Abstract (english)

Antibiotics are antimicrobial drugs used to treat infections when the immune system of the host is unable to overcome infection and eliminate microorganisms. In endodontic therapy, the use of antibiotics may be systemic, local, and prophylactic. Most of the odontogenic infections are confined within the tooth and can be successfully treated locally: by trepanation of the tooth, by incision and by establishing drainage or tooth extraction. The systemic use of antibiotics in the treatment of odontogenic inflammation is only adjuvant in situations where it is necessary to prevent systemic spread of infection. In addition to the primary therapy administered, antibiotics will be systematically prescribed in the case of elevated body temperature, regional lymphadenitis, spread of infection through the cortical bone and through the soft tissues. Topical application of antibiotics is indicated in regenerative endodontic procedures and in replantation of avulsed teeth, where systemic antibiotics should also be considered. Amoxicillin, by itself or in combination with clavulanic acid, is the most common antibiotic used to treat endodontic infection. In the case of confirmed penicillin allergy, the drug of choice is clindamycin. In local therapy, on the other hand, tetracycline is the most common. Antibiotic prophylaxis is indicated in medically compromised patients who are more likely to develop complications from odontogenic infection, i.e. patients with uncontrolled systemic diseases, with supressed immunity, patients with prosthetic cardiac valves, infective endocarditis, and patients with recent prosthetic joint replacement. The prophylaxis is applied in a single dose 30-60 minutes prior to invasive dental procedures.

• Keywords: antibiotici; odontogena upala; antibiotska profilaksa
• Keywords (english): antibiotics; odontogenic infection; antibiotic prophylaxis
• Language: croatian
• URN:NBN: urn:nbn:hr:127:531885
• Study programme: Title: dental medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica dentalne medicine (doktor/doktorica dentalne medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2018-01-22 12:39:46