Elsevier

Dental Abstracts

Volume 60, Issue 3, May–June 2015, Pages 131-133
Dental Abstracts

The Big Picture
Best practices

https://doi.org/10.1016/j.denabs.2015.03.012Get rights and content

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Background

The American Dental Association Council on Scientific Affairs (ADA CSA) has developed an evidence-based clinical practice guideline (CPG) in 2014 that sets forth information regarding the use of prophylactic antibiotics for patients with prosthetic joints who are undergoing dental procedures. These antibiotics were given to protect against the development of prosthetic joint infection (PJI) related to bacteremia produced by the dental procedure. The purpose of this CPG is to clarify the

Methods

The ADA CSA document is based on the literature search results used for the joint effort study along with those obtained through an updated literature search. Four case-control studies were included in the more recent review.

Results

The original publication found there was no evidence justifying the use of prophylactic antibiotics for patients with prosthetic joints who are undergoing dental procedures. In the update, the current best evidence did not find any relationship between dental procedures and PJIs (Box). Thus the use of prophylactic antibiotics before dental procedures is not generally recommended for patients with prosthetic joint implants.

The CPG is designed to assist practitioners as they seek to decide

Discussion

Evidence does not show an association between the bacteremia related to dental procedures and the development of PJIs. Coupled with the potential harm related to antibiotic-resistant bacteria, adverse effects associated with antibiotics, and cost factors, the use of antibiotics before dental procedures in patients with prosthetic joints is not recommended.

Clinical Significance

The latest review provides information consistent with the results of the 2013 publication. Three of the four studies

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Sollecito TP, Abt E, Lockhart PB, et al: The use of prophylactic antibiotics prior to dental procedures in patients with prosthetic joints: Evidence-based clinical practice guideline for dental practitioners—a report of the American Dental Association Council on Scientific Affairs. J Am Dent Assoc 146:11-16, 2015

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