Drugs In Dentistry Research Articles

Are Mouthwashes Really Effective against Candida spp.?

Oral candidiasis is an opportunistic infection caused by fungi of the genus Candida. Nystatin, fluconazole, and miconazole are the most widely used antifungal drugs in dentistry, but in recent years, they have been shown to be less effective due to the increase in the resistance to antifungal drugs. The growing challenge of antifungal resistance emphasizes the importance of exploring not only alternative strategies in the fight against Candida spp. infections but also supportive treatment for pharmacological treatment for oral candidiasis. This review aims to evaluate and compare the in vitro reports on antifungal efficacy against Candida spp. exhibited by mouthwashes distributed on the European market. The research question was elaborated through the PEO framework recommended by PRISMA 2020. A bibliographic search strategy was developed for the scientific online databases Pubmed and ScienceDirect. According to the eligibility criteria, 21 papers were included in this study over a 27-year period. Mouthwashes containing chlorhexidine digluconate, cetylpyridinium chloride, hexetidine, and fluorine compounds among others, and natural antimicrobials, such as menthol, thymol, eucalyptol, and Glycyrrhiza glabra extracts, have demonstrated antifungal effectiveness. Nonetheless, the methodological variance introduces ambiguity concerning the comparative efficacy of distinct molecules or mouthwash formulations and complicates the evaluation and the comparison of results between studies. Some mouthwashes commercially available in Europe have the potential to be used in anti-Candida therapy and prevention since they have shown antifungal effect.

A Review of Preclinical and Clinical Studies in Support of the Role of Non-Steroidal Anti-Inflammatory Drugs in Dentistry.

Patient pain is a common problem faced by dentists and oral and maxillofacial surgeons. Craniofacial pain may be caused not only by inflammation in the teeth, but also various oral, facial, and nerve-related diseases, as well as tumors. Non-steroidal anti-inflammatory drugs (NSAIDs) constitute the basis of the analgesic ladder. According to the World Health Organisation (WHO), NSAIDs are the first-line drugs in relieving pain and inflammation of oral conditions. NSAIDs have been used in almost every field of dentistry. These drugs are applied in conservative dentistry and endodontics, dental surgery, orthodontics, periodontology, and oral mucosal diseases, as well as head and neck oncology. Some of the NSAIDs exhibit additional therapeutic effects, such as inhibition of nuclear factor kappa B (NF-kappaB) and inducible nitric oxide synthase (iNOS), and reduction of oxidative stress or leukocyte passage to the site of inflammation, which further reduces inflammation in tissues. The topical use of NSAIDs in dentistry is worthy of attention and further research as it will significantly reduce the adverse effects of systemic administration. This article aims to review the preclinical and clinical studies that have supported the role of NSAIDs in dentistry.

<i>In vitro</i> Evaluation of Antibiofilm Activity of Methanolic Leaf Extract of <i>Azadirachta indica</i> on Cariogenic <i>Streptococcus mutans</i>

Dental caries is a biofilm-dependent disease, and Streptococcus mutans is the primary etiological agent involved in the initiation of the disease. The extensive use of a limited range of antimicrobial drugs in dentistry has led to the development of drug-resistant bacteria. There is an increasing need to find new alternatives against drug-resistant bacteria. Globally, there is a continuous effort towards identifying natural anti-caries agents for the prevention and better management of caries. The objective of the present study was to evaluate the antibiofilm potential of Azadirachta indica leaf methanolic (ALM) extract against S. mutans biofilm. The study employed a standard reference strain of S. mutans MTCC 497, for in vitro standardisation of biofilm by microtiter plate assay. The antibiofilm activity of the ALM extract was evaluated against the S. mutans strain, and the same was confirmed by light and scanning electron microscopy (SEM). The in vitro biofilm standardisation results demonstrated that 50 µl/ml of S. mutans inoculum concentration exhibited a much superior biofilm formation than the other concentrations employed. Light microscopy and SEM images revealed that ALM extract at 100 mg/ml concentration significantly inhibited the S. mutans biofilm. To conclude, the study reports that the A. indica leaf extract is a potential source to inhibit the S. mutans biofilm. Further studies are warranted to identify the phytochemicals responsible for the antibiofilm activity of ALM extract against S. mutans biofilm that aid in the design of natural anti-caries products.

Magnitude and determinants of inappropriate prescribing of antibiotics in dentistry: a nation-wide study

BackgroundDentist play an important role in misuse of antibiotics. Identification of the dental activities linked to the misuse of antibiotics is important for improving dentists’ prescribing quality. The aim of the study was to quantify the magnitude of inappropriate antibiotic prescribing by dentists in Spain and identify the characteristics, knowledge and attitudes that influence prescribing quality.Material and methodsWe conducted a cross-sectional, questionnaire-based study on dentists in Spain, assessing prescribing quality (dependent variable) on the basis of their responses about the prescription of antibiotics in 14 clinical situations. As the independent variables, we assessed professional characteristics and attitudes (lack of knowledge, fear, complacency, scheduling problems, and economic benefit) measured on a Likert scale. Odds Ratios (OR) (95%CI) were calculated using logistic regression.ResultsA total of 878 participants were included in the analysis. Half of all dentists displayed inappropriate antibiotic prescribing habits in more than 28.6% (10/14) of the clinical situations posed (interquartile range 57–79%). Prescribing quality increased when resistance was perceived as a public health problem (OR 0.88, 95% CI: 0.79–0.97), and decreased in response to fear (OR 1.12, 95% CI:1.07–1.18) or the pursuit of economic benefit (OR 1.07, 95% CI 1.01–1.14). Having over 30 years’ experience (OR 4.58, 95% CI:1.80–12.48) and/or practising in the field of prosthodontics as opposed to endodontics (OR 2.65, 95% CI:1.26–5.71) were associated with worse prescribing quality.ConclusionsAntibiotics are the most commonly prescribed drugs in dentistry, and in many cases this prescription is inappropriate. Our findings shows that modifiable factors influence prescribing quality among dentists in Spain. These may be use for designing educational and training programmes for dentists.

Prospects for the Use of Selenium-Containing Drugs in Dentistry

Prospects for the Use of Selenium-Containing Drugs in Dentistry

Analgesic drugs in dentistry: a narrative review

Analgesic drugs in dentistry: a narrative review

Management of patients treated with antithrombotic drugs in dentistry: Comparison of SFCO and BAOS recommendations

Management of patients treated with antithrombotic drugs in dentistry: Comparison of SFCO and BAOS recommendations

The use of non-steroidal anti-inflammatory drugs in dentistry in patients with pathology of the cardiovascular system: a review

The use of non-steroidal anti-inflammatory drugs in dentistry in patients with pathology of the cardiovascular system: a review

Dentistry and Drug Adverse Events: Between Responsibilities and Regulations.

The purpose of this paper is to renew interest and attention to the medical history, prescription, and/or use of drugs during dental practice. The work analyzes the issue of the use of drugs in dentistry from both a clinical and a medical-legal point of view. The laws governing the matter were also taken into consideration, relating them to the roles of prescriber and user that the dentist can acquire. Analysis of various aspects of this matter demonstrates that it is necessary for dentists to know the drugs and medical substances, their characteristics and properties, related effects, and interactions in order to use them appropriately and adequately. Knowledge of interferences, reactions, and adverse events or complications helps to reduce errors and protect patients' health. Furthermore, knowledge of the national and international reference standards relating to the use of drugs leads to a reduction in medico-legal questions. In conclusion, knowledge and adequate and appropriate use of drugs reduces the possibility of accidents, adverse events, medico-legal consequences, and disputes with patients. Documented and traceable choices allow the analysis and valuation of professional conduct. Authors perceived the topic of informed consent of patients as relevant to the adequate procedure of prescribing drugs related to dentistry practice; therefore, representative conditions of patients at risk should be illustrated in practice. Legal duties related to physician drug prescription and use must be considered and carefully checked.

Вибір антибактеріальних препаратів у стоматології з урахуванням мікробіому ротової порожнини

У статті наведені сучасні дані про особливості мікробіому порожнини рота та його медичне значення при призначенні системної антибактеріальної терапії інфекційно-запальних процесів порожнини рота. Наведені основні мікробні асоціації в нормі та при хворобах пародонта й апікальному періодонтиті. Використання антибактеріальних препаратів у стоматології направлене на усунення етіологічного чинника патогенної мікрофлори порожнини рота. Ефективність лікування залежить від інформованості лікаря про основні збудники та мікробні асоціації при генералізованому пародонтиті, періодонтиті, а також від вибору оптимального антибактеріального засобу, дотримання показань і протипоказань при призначенні.

Фармакотерапія у стоматології: аналіз застосування лікарських засобів у стоматології в 2021 році

Актуальність. Щорічно фармацевтичний ринок України поповнюється новими, сучасними лікарськими засобами, а раціональність їх використання залишається актуальною проблемою для лікарів у всьому світі. Впровадження на фармацевтичний ринок та застосування у практиці лікарів-стоматологів великої кількості лікувальних засобів актуалізується у наданні медичним фахівцям своєчасної та повної інформації не тільки щодо клінічної ефективності медичного препарату, а й особливостей застосування, безпечності у використанні та виникнення можливих побічних реакцій. Мета дослідження: проведення моніторингу, порівняльного аналізу результатів призначень фармацевтичних препаратів і засобів догляду за ротовою порожниною лікарями-стоматологами України у 2021 році. Матеріали та методи. Опитування лікарів-стоматологів та аналіз результатів дослідження проводились під егідою громадської організації «Асоціація стоматологів України», групи компаній «MedExpert» та Української рейтингової агенції. До участі у дослідженні було залучено 4026 респондентів — лікарів-стоматологів з усіх областей України. Серед опитаних було 70,25 % жінок і 29,75 % чоловіків. За демографічним розподілом найбільша кількість респондентів була з міста Києва (1003 особи), Львівської (577 осіб), Київської (482 особи) областей, найменша — з Кіровоградської (16 осіб) та Луганської (14 осіб) областей. Дослідження було проведено поетапно, шляхом заповнення анкети-опитувальника, підготовленої ГО «Асоціація стоматологів України», під час науково-практичних заходів, конференцій фахових шкіл для стоматологів в онлайн-режимі у першій половині 2021 року. Предметом дослідження було визначення призначень основних фармацевтичних лікарських препаратів і засобів догляду за порожниною рота. Респондентами виступали лікарі-стоматологи різних спеціальностей, здебільшого терапевтичного та хірургічного профілю. Результати. Дослідження показали, що лікарі-стоматологи широко використовують фармацевтичні препарати в своїй щоденній практиці; значна кількість лікарів-стоматологів регулярно призначають антибактеріальні препарати, а саме комбіновані антибіотики — ципрофлоксацин з тинідазолом (48,36 %), пеніциліни (40,86 %), метронідазол (34,53 %). Для лікування больового синдрому велика частка лікарів-стоматологів використовують нестероїдні протизапальні засоби групи німесулідів (85,89 %). Практично всі стоматологи у своїй щоденній практиці застосовують засоби для місцевого лікування інфекційно-запальних процесів: хлоргексидин (82,51 %), метрогіл дента (67,51 %), місцеві протизапальні препарати (холісал) (47,54 %). Проведений аналіз призначень засобів догляду за порожниною рота — зубних паст, ополіскувачів, зубних щіток. ­Висновки. Результати аналізу призначень фармацевтичних препаратів і засобів догляду за порожниною рота свідчать про їх широке впровадження в щоденну практику лікарів-стоматологів, інформування лікарів-стоматологів про сучасні фармацевтичні препарати і засоби догляду за порожниною рота, дані щодо їх показань і протипоказань, ймовірну взаємодію фармацевтичних препаратів, що впливатимуть на досягнення високоефективних результатів лікування.

The marketing study of the pharmaceutical market of Ukraine in the segment of antihemorrhagic agents to stop dental bleeding

Aim. To conduct the marketing research of the Ukrainian market in the segment of antihemorrhagic agents used in dentistry.Materials and methods. The study was performed using the structural analysis, logical and graphical methods, marketing analysis methods.Results. The state of the Ukrainian market of drugs of this group has been determined. The market structure has been revealed in the number of names, brands, in forms of production, manufacturers, composition. Despite the sufficient number of registered drugs at the market (26 positions), a rather small arsenal of active substances (4) and dosage forms (3) can be observed. The market is characterized by a limited amount of drugs with a certain pharmacodynamics combining a rapid hemostatic effect, safety in use, the ability to suppress bacterial flora, and without the effect on healthy tissues. However, a positive moment should be noted: by the structure of manufacturer countries the market remains domestic (60 : 40).Conclusions. The Ukrainian pharmaceutical market is characterized by a sufficient assortment of hemostatic agents, but the use of these drugs in dentistry has its limitations. Dental doctors have certain problems with the occurrence of capillary bleeding and require a sufficient amount of effective and fastacting drugs for local application. Therefore, the search and creation of new drugs with a similar action at this stage remains a relevant scientific issue.

ANTI-INFLAMMATORIES AND ANALGESICS IN PAEDIATRIC DENTISTRY

Analgesics are used to reduce pain, which is the main symptom experienced in dental inflammatory pathologies. Painkillers are among the most used drugs in dentistry, along with anti-inflammatories and antibiotics. A lack of knowledge regarding well-defined prescription protocols has been observed. The aim of this study was to revise and update the prescription of anti-inflammatories and analgesics according to the latest guidelines. We performed electronic research of selected databases: PubMed, Google Scholar, AAPD, from 2010-2020, in order to identify the most frequent anti-inflammatories and analgesics used in paediatric dentistry. Approximately 25% of all adverse drug reactions are the consequences of treatments with anti-inflammatory drugs. This paper focuses on both the correct and wrong prescription of medication in paediatric dentistry, as well as on the short and long-term side-effects of this prescription.

The role of local anaesthesia in intra-operative pain management in dental practice

Intra-operative pain management with the means of local anaesthesia is an important of dental practice. Local anaesthetics are drugs the most commonly used drugs in dentistry, being, at the same time, the safest and most effective pain preventing and pain relieving agents known to medicine.The mechanism of action of local anaesthetics involves interruption of the conduction of nerve impulses. These agents show high affinity for the voltage-dependent sodium channels (Nav), they block them, thus preventing the influx of sodium cations through the membranes of the neuron. The potential threshold is not reached and the potential itself is not present. The potency of local anaesthetic drugs depends primarily on the concentration of the solutions used, while possible side effects depend on the dose. In this paper the characteristics of local anaesthetics used in dental practice were presented as well as characteristics of vasoconstrictors added to anaesthetic solutions. The historical outline, the mechanism of action of local anaesthetics and the currently used both basic and additional methods of anaesthesia are discussed. Possible strategies for improving the effectiveness of anaesthesia by the means of physical and chemical methods were explained. General and local adverse reactions of dental anaesthetics were also discussed, along with ways to prevent and treat them.

Pharmacotherapeutics In Prosthodontics – An Overview

Pharmacology is the science of drugs. Drug is the single active chemical entity present in a medicine that is used for diagnosis, prevention, treatment of a disease. Pharmacology deals with interaction of exogenously administered chemical molecules (drugs) with living systems. The two main aspects of concern are the effects of drugs on biological systems and the effect of biological systems on efficacy and metabolism of drugs. Drugs play an important role in improving the response of the patient in both pre-treatment and post-treatment phases. Drugs in dentistry act as a primary treatment modality as well as facilitator of dental procedures. With phenomenal growth of information on the mechanism of action and clinical application of drugs as well as rapid introduction of new drugs, pharmacology has become increasingly important to all dentists. Prosthodontics is that specialty of dentistry which deals with patients of all ages, hence making it more important to know about the local and systemic effects of drugs and their side effects.
 

Applications of corticosteroids in oral diseases: A review

Steroids being one of the most broadly used drugs in dentistry which readily act as immunosuppressive agents. Corticosteroids have modernized the treatment protocol of several disease conditions inclusive of many oral diseases. These are strong and effective anti-inflammatory drugs resembling cortisol (inherently formed hormone by the body). Their function is to decrease inflammation, particularly when the body inaccurately activates inflammatory system. Oral and maxillofacial disease may be either local or occur due to the expression of any systemic problem. There are many oral and maxillofacial clinicians who apply the usage of corticosteroids established on their effectiveness to control consequences of any dental procedure or surgery and also to produce and render a contented post-operative period. Hence, the present review highlights and focuses on the pharmacology, uses, contraindications and side-effects of corticosteroids application in oral diseases. Keywords: Glucocorticoids, Cosrticosteroids, Antiinflammatory, Immunosuppression.

Pilot Randomized Clinical Trial Study: Comparative Study of 10% Lidocaine Hydrochloride Solution with Lidocaine Prilocaine Emulsion Prior to Local Anesthetic Injection

Background: The pain caused by the injection of local anesthetic has been reported as one of the main complaints of dental patients. Topical anesthetics are widely used drugs in dentistry, mainly to control pain associated with the needle penetration in the administration of local anesthesia. Objective: The present study aimed to evaluate (5%,7.5% and 10%) concentrations of lidocaine/prilocaine agent, compared to the common 10% lidocaine hydrochloride spray in the oral cavity. Materials and Methods: This was a split-mouth double-blind, randomized clinical trial pilot study. We randomized 15 patients, ages 35 to 64 years, with American Society of Anesthesiologists I and II with severe chronic periodontitis who were referred to the dental clinic for surgery, to receive 4 topical anesthetics (5%, 7.5%, and 10%) lidocaine prilocaine emulsion and 10% lidocaine hydrochloride topical anesthetic agent before local infiltration. Primary outcomes were assessing drug safety and pain level that measured by assessment of visual analog scale (VAS) scores of pain during LA injection in the first premolar and second molar in each maxillary quadrant in 15 patients corresponding to the posterior superior alveolar nerve (PSA) and secondary outcome was the relationship between age and gender regarding pain perception, and a total of 60 regions were analyzed. Results: Results revealed that there was no statistically significant difference between lidocaine hydrochloride and (5%,7.5% and 10%) lidocaine prilocaine in terms of pain reduction when the 4 different compounds were compared. According to Spearman's rank correlation coefficient and Friedman test, the age and gender of the patients had an insignificant correlation with the anesthetic effects of the four studied solutions. Conclusion: Based on these results, age and gender have insignificant effects on the pain scores and it can be said that the four solutions do not have significant differences regarding their anesthetic effects; also, we did not find any adverse reactions by using 7.5% and 10% lidocaine/prilocaine agent.

Utilização de fitoterápicos na Odontologia: revisão integrativa

O objetivo do presente estudo foi analisar a literatura acerca do uso de fitoterápicos na odontologia. Trata-se de uma revisão integrativa da literatura que utilizou os descritores: cirurgião-dentista, etnofarmacologia, medicamentos fitoterápicos, separadamente e posteriormente cruzando-os através do operador boleano AND. As bases de dados consultadas foram o Scientific Electronic Library Online (SciELO) e Medical Literature Analysis and Retrievel System online (MEDLINE). Foram analisados 13 artigos indexados na íntegra. Os resultados apontam que os fitoterápicos têm ganhado espaço no setor odontológico, principalmente após a aprovação da Política Nacional de Práticas Integrativas e Complementares (PNPIC) no SUS e do Conselho Federal de Odontologia, e mesmo com comprovação científica da eficácia farmacológica dessa terapêutica, existe uma resistência quanto à indicação e prescrição de fitoterápicos por alguns cirurgiões-dentistas, justificado na maioria das vezes por falta de conhecimento técnico dessa terapêutica. O uso dessa prática pelo cirurgião-dentista tem sido realizada principalmente em metrópoles, com ênfase na região sul do Brasil e mesmo que alguns profissionais afirmem não praticar a fitoterapia por desconhecimento técnico, percebe-se que esta vem sendo bastante utilizada por profissionais que atuam na Estratégia de Saúde da Família.

Adverse reaction to local anaesthetics: Is it always allergy?

Local anaesthetics are very commonly used drugs in dentistry, and people who undergo procedures with local anaesthetics often refer adverse reactions that are not of allergic origin. Considering that in dentistry contact with allergens is very frequent, it is essential to assess the real incidence of allergy to local anaesthetics. We evaluated a group of 159 patients in whom adverse reaction occurred after procedures with local anaesthetics. The reactions between allergy to local anaesthetic (immediate and delayed) and certain symptoms presented by patients were investigated. Allergy to latex and chlorexidine were investigated in all patients. Only one patient, who previously presented a constant erythema at the wrist after procedure with local anaesthetics, was positive to Mepivacaine patch test. Two patients were positive to latex and one to chlorexidine. The main finding of this study was that a reaction registered in the medical history and reported by a patient is rarely allergic but the use of vasoconstrictors or emotional factors may account for it. However, a complete allergological investigation is necessary for a correct diagnosis and future management.

ANALYSIS AND PREVENTION OF ADVERSE RESPONSES TO DRUGS USED IN DENTISTRY

Drug preparations, a substance or a mixture of substances of synthetic or natural origin, are used for the prevention, diagnosis, and treatment of various diseases. Along with the benefits, drug prepararions can also have adverse side effects, identifying the causes of which is quite problematic in the practice of a dentist because of the diversity of the clinical picture. The rational use and optimal choice of a drug among a wide range of drugs depend on the profile of its effectiveness and safety, drug interaction, individual characteristics of the patient (genetic polymorphism), and other concomitant diseases. Nowadays, the practice of a dentist is impossible to imagine without the use of drugs. Drug preparations allow doctors providing quality medical care that meets international standards, but do not forget that when prescribing a drug is extremely important to consider how rationally and necessary to use it to achieve a positive result in treatment. Therefore, the study of the prevention of the development of unwanted adverse reactions of drugs in dentistry is an important topic that requires close attention. Based on the analysis of the literature on the RSCI, Scopus, Web of Science, MedLine databases, the most commonly prescribed groups of drugs in dentistry were found to be as follows: non-steroidal anti-inflammatory drugs (NSAIDs), topically anesthetizing, antimicrobial, antiseptic, and drugs. The aim of the study: On the basis of the analysis of modern information about undesirable reactions of drugs, often used in dentistry, to optimize approaches to rational use and prevention of undesirable side effects.