Systemic Antibiotics therapy in delayed replantation of avulsed tooth- A Systematic Review

Abstract

Aim - This systematic review aimed to analyse the practising trends of clinicians on using Systemic Antibiotic Therapy (SAT) in delayed replantation of avulsed permanent anterior teeth. Materials and Method - A search was performed for case reports and case series related to delayed replantation of avulsed permanent anterior teeth on databases like Medline/PubMed, Google Scholar, and Cochrane from 2000 to 2020. Articles were selected after applying inclusion and exclusion criteria for this systematic review. The Prisma guidelines 2009 were followed, and the protocol was registered on Prospero. Data were extracted and analysed. Results- In this study, four case reports showed the primary use of systemic Penicillin, and others reported different antibiotic combinations. In comparison, only 1 case said the use of tetracycline as SAT, despite it being the drug of choice as per the guidelines. Five case reports observed Ankylosis, resorption, and infra-occlusion as procedural complications. Successful treatment outcome was highly variable, ranging from no complication in 6 months to 2 years. Conclusion- This study could conclude that the clinicians prescribed the same antibiotics for delayed replantation, similar to use in routine endodontics. The use of antibiotics in case of avulsion could be attributed to their easy availability and knowledge of clinicians regarding these antibiotics. However, the follow-up period for most of the cases was insufficient to observe the complications. Thus, the effect of antibiotics on treatment outcome of delayed replantation of an avulsed tooth mandates more studies with more extended follow-up period. Keywords- Antibiotics, Avulsion, Ankylosis, Amoxicillin, Phenoxy penicillin, Sytematic Review, Tetracycline.