1
|
Vilela N, Gurgel BCV, Bruzos CD, Duarte WR, da Silva HDP, Pannuti CM, Duarte PM. Preloading peri-implant crestal bone loss: A retrospective study of incidence and related factors. J Periodontol 2024; 95:963-976. [PMID: 38923568 DOI: 10.1002/jper.24-0028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 03/06/2024] [Accepted: 04/17/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND The aim of this study was to evaluate the incidence of preloading crestal bone loss (PLCBL) and to identify the patient-related and implant-related factors associated with PLCBL. METHODS This retrospective cohort examined the dental records of patients who received at least one dental implant. PLCBL was defined as a reduction ⩾0.5 mm and severe PLCBL (primary variable) as a reduction ⩾1.5 mm in mesial and/or distal bone level, measured from the day of implant placement to uncovering or abutment installation/crown delivery. The incidence of PLCBL and patient and implant variables were recorded. Bivariate analysis and binary logistic regression identified factors associated with PLCBL ⩾0.5 mm and ⩾1.5 mm. RESULTS A total of 746 dental implants placed in 361 patients from January 2011 to July 2021 was included in the analyses. Of the implants assessed, 24.4% (n = 182) exhibited PLCBL ⩾ 0.5 mm and 10.5% (n = 78) presented severe PLCBL (i.e., ⩾1.5 mm). Males (odds ratio [OR] = 1.85, 95% confidence interval [CI] = 1.11-3.07), patients with diabetes (OR = 3.33, 95% CI = 1.73-6.42), and those allergic to penicillin (OR = 3.13, 95% CI = 1.57-6.22) were more likely to experience severe PLCBL (p < 0.05). Implants placed in the anterior area (OR = 2.08, 95% CI = 1.16-3.73), with bone-level platform-abutment connection (OR = 4.73, 95% CI = 1.94-11.49) and inserted supracrestally (OR = 3.77, 95% CI = 1.84-7.72), presented a greater risk of developing severe PLCBL (p < 0.05). Implants placed in a previously grafted area presented a lower likelihood of developing severe PLCBL (OR = 0.489, 95% CI = 0.28-0.84). CONCLUSION The incidence of PLCBL ⩾ 0.5 mm and ⩾1.5 mm was 24.4% and 10.5%, respectively. Male sex, diabetes, allergy to penicillin, anterior location, bone-level platform-abutment connection, and supracrestal implant placement are potential risk factors for severe PLCBL. A previously grafted area is a potential protective factor.
Collapse
Affiliation(s)
- Nathalia Vilela
- Department of Stomatology, Division of Periodontology, School of Dentistry, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Bruno C V Gurgel
- Department of Dentistry, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Carlos De Bruzos
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, Florida, USA
| | - Wagner R Duarte
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, Florida, USA
| | - Hélio D P da Silva
- Department of Dentistry, Dental Research Division, Guarulhos University, Guarulhos, São Paulo, Brazil
| | - Claudio M Pannuti
- Department of Stomatology, Division of Periodontology, School of Dentistry, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Poliana Mendes Duarte
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, Florida, USA
| |
Collapse
|
2
|
Manciocchi E, Xhajanka E, D'Addazio G, Tafuri G, Santilli M, Rexhepi I, Caputi S, Sinjari B. Antibiotic prescribing patterns among dentists in Italy and Albania: A comparative questionnaire analysis. Heliyon 2024; 10:e33575. [PMID: 39040368 PMCID: PMC11261076 DOI: 10.1016/j.heliyon.2024.e33575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 06/11/2024] [Accepted: 06/24/2024] [Indexed: 07/24/2024] Open
Abstract
Objective To investigate the therapeutic and prophylactic use of antibiotics in dentistry in two countries. Methods This study used questionnaires to examine the prescribing habits of dentists in Italy (9th country in Europe for systemic antibiotic administration) and Albania an Extra European Union Country. A total of 1300 questionnaires were sent to Italian and Albanian dentists. Results In total, 180 Italian and 180 Albanian dentists completed the questionnaire. Penicillin use was higher in Italy (96.6 %) than Albania (82.8 %). Only 26.1 % of Italian dentists and 32 % of Albanian dentists followed the national guidelines for antibiotic administration. Conclusions Dentists tend to overprescribe antibiotics for treating existing conditions or as prophylaxis. They also highlighted a lack of adherence to established guidelines for antibiotic use. In addition, factors such as age, nationality, and sex appeared to influence the choice of antibiotics. Clinical significance Recently, the growth of antibiotic-resistant bacteria has become a global concern. The authors of this article highlight how dentists often prescribe antibiotics without a real need. Limiting the use of antibiotics in this category may help mitigate antibiotic resistance.
Collapse
Affiliation(s)
- Eugenio Manciocchi
- Unit of Prosthodontics, Department of Innovative Technologies in Medicine and Dentistry, University “G. d’Annunzio” Chieti-Pescara, Via dei Vestini, 31, 66100, Chieti, Italy
- Electron Microscopy Laboratory, University “G. d'Annunzio” Chieti-Pescara, Via dei Vestini, 31, 66100, Chieti, Italy
| | - Edit Xhajanka
- Department of Dental Medicine, Medical University of Tirana, Rruga E Dibres, 1001, Albania
| | - Gianmaria D'Addazio
- Unit of Prosthodontics, Department of Innovative Technologies in Medicine and Dentistry, University “G. d’Annunzio” Chieti-Pescara, Via dei Vestini, 31, 66100, Chieti, Italy
- Electron Microscopy Laboratory, University “G. d'Annunzio” Chieti-Pescara, Via dei Vestini, 31, 66100, Chieti, Italy
| | - Giuseppe Tafuri
- Unit of Prosthodontics, Department of Innovative Technologies in Medicine and Dentistry, University “G. d’Annunzio” Chieti-Pescara, Via dei Vestini, 31, 66100, Chieti, Italy
- Electron Microscopy Laboratory, University “G. d'Annunzio” Chieti-Pescara, Via dei Vestini, 31, 66100, Chieti, Italy
| | - Manlio Santilli
- Unit of Prosthodontics, Department of Innovative Technologies in Medicine and Dentistry, University “G. d’Annunzio” Chieti-Pescara, Via dei Vestini, 31, 66100, Chieti, Italy
- Electron Microscopy Laboratory, University “G. d'Annunzio” Chieti-Pescara, Via dei Vestini, 31, 66100, Chieti, Italy
| | - Imena Rexhepi
- Unit of Prosthodontics, Department of Innovative Technologies in Medicine and Dentistry, University “G. d’Annunzio” Chieti-Pescara, Via dei Vestini, 31, 66100, Chieti, Italy
- Electron Microscopy Laboratory, University “G. d'Annunzio” Chieti-Pescara, Via dei Vestini, 31, 66100, Chieti, Italy
| | - Sergio Caputi
- Unit of Prosthodontics, Department of Innovative Technologies in Medicine and Dentistry, University “G. d’Annunzio” Chieti-Pescara, Via dei Vestini, 31, 66100, Chieti, Italy
- Electron Microscopy Laboratory, University “G. d'Annunzio” Chieti-Pescara, Via dei Vestini, 31, 66100, Chieti, Italy
| | - Bruna Sinjari
- Unit of Prosthodontics, Department of Innovative Technologies in Medicine and Dentistry, University “G. d’Annunzio” Chieti-Pescara, Via dei Vestini, 31, 66100, Chieti, Italy
- Electron Microscopy Laboratory, University “G. d'Annunzio” Chieti-Pescara, Via dei Vestini, 31, 66100, Chieti, Italy
| |
Collapse
|
3
|
Petrac L, Gvozdanovic K, Perkovic V, Petek Zugaj N, Ljubicic N. Antibiotics Prescribing Pattern and Quality of Prescribing in Croatian Dental Practices-5-Year National Study. Antibiotics (Basel) 2024; 13:345. [PMID: 38667021 PMCID: PMC11047605 DOI: 10.3390/antibiotics13040345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 03/24/2024] [Accepted: 04/08/2024] [Indexed: 04/29/2024] Open
Abstract
PURPOSE Antibiotic resistance is one of the biggest threats to global health today. The aim of this study was to analyze antibiotic prescribing patterns and quality of prescribing in Croatian dental practices over a 5-year period. METHODS This is a retrospective observational study based on the analysis of the electronic prescriptions (medicines in ATC groups J01 and P01) from dental practices in Croatia prescribed from 1 January 2015 to 31 December 2019. Prescriptions were retrieved from the Croatian Health Insurance Fund (HZZO). The analyses included the number of prescriptions, type and quantity of prescribed drugs, indication, and the patient's and prescriber's characteristics. RESULTS The consumption increased from 1.98 DID in 2015, to 2.10 DID in 2019. The most prescribed antibiotic was Amoxicillin with clavulanic acid followed by Amoxicillin, Clindamycin, Metronidazole and Cefalexin. The analyses showed that 29.79% of antibiotics were not prescribed in accordance with the contemporary guidelines for the proper use of antibiotics. Additionally, 22% of antibiotics were prescribed in inconclusive indications. CONCLUSION The research showed an increase in antibiotic consumption over five years along with unnecessary prescribing of antibiotics in cases with no indications for its use. The development of national guidelines for antibiotic use is necessary.
Collapse
Affiliation(s)
- Lucija Petrac
- School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | | | - Vjera Perkovic
- Department of Orthodontics, Faculty of Dental Medicine, University of Rijeka, 51000 Rijeka, Croatia
| | | | - Neven Ljubicic
- Department of Internal Medicine, Clinical Hospital Sisters of Mercy, 10000 Zagreb, Croatia;
| |
Collapse
|
4
|
Hughes AM, Evans CT, Fitzpatrick MA, Kale IO, Vivo A, Boyer TL, Solanki PA, Gibson G, Jurasic MM, Sharp LK, Echevarria KL, Suda KJ. A qualitative approach to examining antimicrobial prescribing in the outpatient dental setting. ANTIMICROBIAL STEWARDSHIP & HEALTHCARE EPIDEMIOLOGY : ASHE 2022; 2:e102. [PMID: 36483419 PMCID: PMC9726505 DOI: 10.1017/ash.2022.242] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 05/17/2022] [Accepted: 05/18/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVE To understand barriers and facilitators to evidence-based prescribing of antibiotics in the outpatient dental setting. DESIGN Semistructured interviews. SETTING Outpatient dental setting. PARTICIPANTS Dentists from 40 Veterans' Health Administration (VA) facilities across the United States. METHODS Dentists were identified based on their prescribing patterns and were recruited to participate in a semistructured interview on perceptions toward prescribing. All interviews were recorded, transcribed, and double-coded for analysis, with high reliability between coders. We identified general trends using the theoretical domains framework and mapped overarching themes onto the behavior change wheel to identify prospective interventions that improve evidence-based prescribing. RESULTS In total, 90 dentists participated in our study. The following barriers and facilitators to evidence-based prescribing emerged as impacts on a dentist's decision making on prescribing an antibiotic: access to resources, social influence of peers and other care providers, clinical judgment, beliefs about consequences, local features of the clinic setting, and beliefs about capabilities. CONCLUSIONS Findings from this work reveal the need to increase awareness of up-to-date antibiotic prescribing behaviors in dentistry and may inform the best antimicrobial stewardship interventions to support dentists' ongoing professional development and improve evidence-based prescribing.
Collapse
Affiliation(s)
- Ashley M. Hughes
- Department of Biomedical and Health Information Sciences, University of Illinois Chicago, Chicago, Illinois
- Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr. VA Hospital, US Department of VA, Hines, Illinois
| | - Charlesnika T. Evans
- Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr. VA Hospital, US Department of VA, Hines, Illinois
- Department of Preventive Medicine and Center for Health Services & Outcomes Research, Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Margaret A. Fitzpatrick
- Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr. VA Hospital, US Department of VA, Hines, Illinois
- Division of Infectious Diseases, Department of Medicine, Stritch School of Medicine, Loyola University Chicago, Maywood, Illinois
| | - Ibuola O. Kale
- Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr. VA Hospital, US Department of VA, Hines, Illinois
| | - Amanda Vivo
- Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr. VA Hospital, US Department of VA, Hines, Illinois
| | - Taylor L. Boyer
- Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, US Department of Veterans’ Affairs, Pittsburgh, Pennsylvania
| | - Pooja A. Solanki
- Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr. VA Hospital, US Department of VA, Hines, Illinois
| | - Gretchen Gibson
- Oral Health Quality Group, Veterans Health Administration, Office of Dentistry, Washington, D.C.
| | - M. Marianne Jurasic
- Boston University Henry M. Goldman School of Dental Medicine, Boston, Massachusetts
- VA Center for Healthcare Organization & Implementation Research, Edith Nourse Rogers Memorial Veterans’ Hospital, Bedford, Massachusetts
| | - Lisa K. Sharp
- Department of Pharmacy Systems Outcomes and Policy, University of Illinois Chicago, Chicago, Illinois
| | | | - Katie J. Suda
- Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, US Department of Veterans’ Affairs, Pittsburgh, Pennsylvania
- College of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| |
Collapse
|
5
|
Lollobrigida M, Pingitore G, Lamazza L, Mazzucchi G, Serafini G, De Biase A. Antibiotics to Prevent Surgical Site Infection (SSI) in Oral Surgery: Survey among Italian Dentists. Antibiotics (Basel) 2021; 10:949. [PMID: 34438999 PMCID: PMC8388912 DOI: 10.3390/antibiotics10080949] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/03/2021] [Accepted: 08/04/2021] [Indexed: 12/14/2022] Open
Abstract
The benefit of an antibiotic prophylaxis for most oral surgical procedures is controversial. The aim of this study was to collect information on the prescribing habits of a sample of Italian dentists with respect to the role of antibiotic prophylaxis in preventing surgical site infections (SSI). An anonymous questionnaire was prepared and made accessible online by sharing a Google Forms link. General anagraphic data and educational background information were collected to obtain a profile of the participants. Different clinical scenarios were then proposed, with the participants asked to choose whether they would prescribe an antibiotic prophylaxis and with which dosage regimens. In total, 169 dentists participated in the questionnaire and the obtained data were assessed through a percentage report. The results showed a substantial agreement in antibiotics prescription, but only in a limited number of clinical scenarios, such as deciduous teeth extraction or simple extractions in healthy adult patients. Discordant responses were found for several clinical cases, particularly for cases of comorbidities, surgical or multiple extractions, implant placement and abscess drainage. The answers obtained from the survey sample were notably heterogeneous, indicating that the choice to prescribe an antibiotic prophylaxis to prevent SSIs is often discretionary. Moreover, the dosage regimen of prophylaxis is also controversial. The results of this study demonstrate the need for specific guidelines on antibiotics in dentistry and, specifically, on antibiotic prophylaxis in oral surgery. Such guidelines would help to avoid unnecessary prescriptions.
Collapse
Affiliation(s)
- Marco Lollobrigida
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, 00161 Rome, Italy; (G.P.); (L.L.); (G.M.); (G.S.); (A.D.B.)
| | | | | | | | | | | |
Collapse
|