Tooth Extraction In Patients Research Articles

Outcome of tooth extraction in patients receiving bisphosphonate treatment – surgical protocol and risk factors

Outcome of tooth extraction in patients receiving bisphosphonate treatment – surgical protocol and risk factors

Direct Oral Anticoagulants and Bleeding Management Following Tooth Extractions-A Prospective Cohort Study.

The aim of the present study was to assess the occurrence of intra-, peri-, and post-operative bleeding following tooth extractions in patients treated with direct oral anticoagulants (DOACs). Consecutive patients requiring at least one dental extraction were enrolled. The DOAC regimen was either maintained or suspended. Patients were classified in subgroups depending on the number of teeth extracted per procedure (≤3 or >3), the need for flap elevation, and the performance of osteotomy. Bleeding was recorded intra-operatively; peri-operatively at 20, 40, 60, and 80 min after the procedure; and daily in the first seven days following tooth extractions. Forty-nine patients treated with DOACs (17 with rivaroxaban, 16 with apixaban, 8 with edoxaban, and 8 with dabigatran) were enrolled. Of them, 33 refrained from DOAC administration pre-operatively. The performances of >3 teeth extractions, flap elevation, and osteotomy were significantly associated with higher bleeding rates (p < 0.05). In patients treated with rivaroxaban and apixaban, bleeding episodes were more frequent. Although DOAC treatment may increase the rates of intra-operative, peri-operative, and post-operative bleeding, the recorded episodes were mild and manageable. DOAC suspension may reduce peri-operative bleeding, while no effect could be observed for post-operative bleeding.

What Is the Appropriate Antibiotic Administration During Tooth Extractions in Patients Receiving High-Dose Denosumab?

What Is the Appropriate Antibiotic Administration During Tooth Extractions in Patients Receiving High-Dose Denosumab?

Retrospective analysis of the incidence of chronic periodontitis and gingival recession in patients in Ufa

Abstract Background. Inflammatory periodontal diseases are one of the most pressing problems in modern dentistry and rank second in frequency and prevalence among all dental diseases. The aim of the study is to determine the outcomes of chronic periodontitis treatment, the percentage of relapses and complications based on a comparative retrospective analysis of the incidence of chronic periodontitis for the period 2017 to 2022. Material and methods. To assess the prevalence of inflammatory periodontal diseases, we conducted a retrospective analysis of 1,500 medical records of patients diagnosed with periodontitis who received treatment at Dental Clinic No. 4 in Ufa for the period 2017–2022. Results. As a result of a retrospective analysis of medical records of 1,500 patients with periodontal diseases in the State Budgetary Healthcare Institution of the Republic of Bashkortostan, Dental Clinic No. 4, Ufa, in the period from 2017 to 2022, it was revealed that patients with chronic gingivitis prevailed in the age group of 20-29 years - 90 people (6.01%), CGP LS was detected mainly in the group of 30-39 years - 267 people (17.8%), CGP SS in the group of 40-49 years - 528 people (35.2%), and CGP TS from 50 years and older - 615 people (40.99%). Discussion. Comparative retrospective analysis of outpatient records of patients with periodontal diseases showed low efficiency of the methods used to treat patients with periodontitis, accompanied by a high percentage of relapses and complications, namely: transition from mild to moderate - in 37.2 ± 0.3%; moderate to severe in 28.7 ± 0.1% of cases; exacerbation of periodontitis - in 21.9 ± 0.1%.; tooth extraction in patients with CP LS severity - 1.2 ± 0. %, with CP SS severity - 13.3 ± 0.1%, with CP TS severity - 22.1 ± 0.1%. Conclusion. According to the retrospective analysis, it was found that the need for treatment of inflammatory periodontal diseases is 93% in different age groups. Data analysis states a high (up to 88.6%) prevalence of periodontal diseases in patients seeking dental care.

Longitudinal analysis of microcirculatory parameters in gingival tissues after tooth extraction in patients with different risk profiles for wound healing disorders – a pilot study

ObjectivesWe aimed to establish a risk profile for intraoral wound healing disorders based on measurements of microcirculation in gingival tissues.Materials and methodsOxygen saturation (SO2) and blood flow in gingival tissues were measured with tissue spectrometry and laser doppler spectroscopy in 37 patients before/after tooth extractions. Patients were assigned to four groups: anamnestically and periodontally healthy patients (n = 7), anamnestically healthy but suffering from periodontitis (n = 10), anamnestically healthy but smoking and suffering from periodontitis (n = 10) and suffering from diabetes and periodontitis (n = 10). Measurements were performed at three different time points: Baseline measurement (T0), one day post extractionem (p.e.) (T1) and seven days p.e. (T2).ResultsBaseline SO2 values were higher in control patients (p = .038). This effect was most evident in comparison to smokers suffering from periodontitis (p = .042), followed by diabetics suffering from periodontitis (p = .09). An opposite trend was seen for blood flow. Patients suffering from periodontitis demonstrated higher blood flow values (p = .012). Five patients, which belonged to the group of smokers suffering from periodontitis, showed clinically a delayed wound healing.ConclusionDifferences in SO2 and blood flow of gingival tissue could be detected in different groups of patients with existing periodontitis compared to control patients.Clinical RelevanceLower baseline SO2 values could be a warning signal for possible wound healing disorders after oral surgery.

Risk of bleeding during flapless immediate implant placement after tooth extraction in patients taking antithrombotics

Risk of bleeding during flapless immediate implant placement after tooth extraction in patients taking antithrombotics

Unveiling Medication-Related Osteonecrosis of the Jaw: A Rapid Review of Etiology, Drug Holidays, and Treatment Strategies

This rapid review critically evaluates recent advancements in the management of medication-related osteonecrosis of the jaw (MRONJ) from 2022 to 2023, employing a specific article selection protocol to focus on the latest literature. Initially screening 262 articles and ultimately selecting 22 based on their relevance and uniqueness, the process involved meticulous screening, methodological evaluation, and data extraction by the authors. The findings, organized into epidemiology, treatment effectiveness, and drug holidays, are synthesized following rapid review guidelines. The review addresses the risk of MRONJ associated with tooth extraction in patients undergoing antiresorptive medication therapy, such as bisphosphonates (BPs) and denosumab (DS), and evaluates the effectiveness of drug holidays in reducing this risk. Recent studies suggest that drug holidays may not effectively mitigate MRONJ risks as previously believed. Furthermore, it highlights that conservative treatment can benefit asymptomatic early-stage MRONJ patients, whereas surgical intervention is more effective for those in advanced stages. Ultimately, this review synthesizes current findings to enhance clinical practice, suggesting that while drug holidays may not significantly reduce MRONJ risks, treatment strategies should be tailored, ranging from conservative approaches in early stages to surgical interventions in advanced stages, thereby guiding evidence-based clinical decisions.

A Biodegradable Tissue Adhesive for Post-Extraction Alveolar Bone Regeneration under Ongoing Anticoagulation-A Microstructural Volumetric Analysis in a Rodent Model.

In addition to post-extraction bleeding, pronounced alveolar bone resorption is a very common complication after tooth extraction in patients undergoing anticoagulation therapy. The novel, biodegenerative, polyurethane adhesive VIVO has shown a positive effect on soft tissue regeneration and hemostasis. However, the regenerative potential of VIVO in terms of bone regeneration has not yet been explored. The present rodent study compared the post-extraction bone healing of a collagen sponge (COSP) and VIVO in the context of ongoing anticoagulation therapy. According to a split-mouth design, a total of 178 extraction sockets were generated under rivaroxaban treatment, of which 89 extraction sockets were treated with VIVO and 89 with COSP. Post-extraction bone analysis was conducted via in vivo micro-computed tomography (µCT), scanning electron microscopy (SEM), and energy-dispersive X-ray spectroscopy (EDX) after 5, 10, and 90 days. During the observation time of 90 days, µCT analysis revealed that VIVO and COSP led to significant increases in both bone volume and bone density (p ≤ 0.001). SEM images of the extraction sockets treated with either VIVO or COSP showed bone regeneration in the form of lamellar bone mass. Ratios of Ca/C and Ca/P observed via EDX indicated newly formed bone matrixes in both treatments after 90 days. There were no statistical differences between treatment with VIVO or COSP. The hemostatic agents VIVO and COSP were both able to prevent pronounced bone loss, and both demonstrated a strong positive influence on the bone regeneration of the alveolar ridge post-extraction.

Prevention of medication-related osteonecrosis of the jaw after tooth extraction by local administration of antibiotics and atelocollagen sponge: A preliminary study

Background/purposeMedication-related osteonecrosis of the jaw (MRONJ) often develops after extraction of a tooth with a local infection. Therefore, it is necessary to develop extraction methods that can prevent MRONJ. Before examining whether antibiotics and atelocollagen administered in the extraction socket can prevent the development of MRONJ after tooth extraction, this study was conducted to determine the appropriate antibiotics concentration and to conduct a clinical study with a small number of cases as a preliminary study. Materials and methodsFirst, a mixture of minocycline and atelocollagen at different concentrations was implanted into the bone cavity formed in the rabbit head, and the local minocycline concentration was measured after 24 and 48 h. Next, the incidences of MRONJ after tooth extraction in patients receiving high-dose antiresorptive agents were compared between the atelocollagen and atelocollagen/minocycline mixture groups. A group that did not undergo transplantation was also compared as a historical control. ResultsIn animal studies, a mixture of 10 mg/ml minocycline injected into collagen and implanted into the bone cavity showed sufficiently high antimicrobial concentrations, even after 48 h. Post-extraction MRONJ occurred in 3 of the 13 control groups (23.1%), 3 of the 13 atelocollagen groups (23.1%), and 1 of the 13 atelocollagen/minocycline groups (7.7%). ConclusionAtelocollagen functions as a carrier for retaining antibiotics for a certain period. Although this was a study with a limited number of cases, it suggested that the local administration of atelocollagen/minocycline in the extraction socket may reduce the risk of MRONJ following tooth extraction.

Major evidence of the relationship of cardiovascular disease and tooth extraction: a systematic review

Introduction: Cardiovascular diseases can present a congenital origin, that is present from birth, such as interatrial and interventricular communication, defects of the artery, coronary arteries, or acquired coronary artery anomalies that involve several risk factors such as smoking, alcohol, old age, and sedentary lifestyle. Thus, the acquired ones are the most frequent in the routine of a dental practice, so the dentist should be able to attend to those patients who need special care, regarding the correct use of medications due to the risk of drug interactions, the type of local anesthetic to be used and the management of patients who use anticoagulant therapy. Objective: It was to develop a concise systematic review to highlight the main clinical outcomes of the relationship between cardiovascular diseases and tooth extraction. Methods: The research and development of the work were carried out from December 2023 to February 2024 in the databases Scopus, PubMed, Science Direct, and Scielo, following the PRISMA rules. The quality of the studies was based on the GRADE instrument and the risk of bias was based on the Cochrane instrument (Funnel Plot). Results and Conclusion: A total of 112 studies were found that were subjected to eligibility analysis. The final sample had 36 eligible studies and 21 studies were described in the systematic review. Most studies showed homogeneity in their results, with X2 =63.9% &gt;50%, with p&lt;0.05. It was concluded that the virtual reality technique was effective in controlling blood pressure and heart rate within an acceptable range and can help in the management of blood pressure and heart rate during tooth extraction in patients with hypertension. It is necessary for the dental treatment of these patients with heart disease a good knowledge of the subject and requires medical and dental coordination. Dental surgeons need to be prepared to identify possible medical and dental emergencies and take steps to prevent or treat them effectively and quickly.

Prevalence of dental caries among patients with type 2 diabetes and without diabetes attending an outpatient clinic in a tertiary care hospital

Introduction: Dental caries can be an oral sign of poor glycaemic control in individuals with Diabetes Mellitus. We aim to describe the prevalence of dental caries and the stages of caries and dental extractions between patients with diabetes and without diabetes attending outpatient clinics. We also aim to describe the association of dental caries with the duration of diabetes.Methods: A cross sectional study was conducted from June 2021 to March 2023 using an interviewer administered questionnaire and oral examination at the outpatient medical clinic. Data were analysed under means, standard deviations and chi square. P value was set at .05.Results: Out of 439 in this study group, 50.3% had diabetes 49.7% did not have diabetes. Their respective FBS means(SD) were 7.59 ±2.47) and 5.35 (SD ± .78) which were significant (p&lt; .001). Patients with diabetes (172 had significant prevalence of caries than those without diabetes (151) p= .042). The prevalence of different stages of caries also showed significant differences between patients with diabetes and patients without diabetes (p= .033). Severity of dental caries was not associated with the duration of diabetes (p= .866). Previous tooth extractions in patients with diabetes and patients without diabetes were not significant as participants who had extractions were 213 and 202 respectively (p= .569). Further, patients with diabetes (137) had higher prevalence of unsatisfactory oral hygiene than in those without diabetes (100) participants (p&lt; .001).Conclusions: Prevalence of dental caries was significantly higher in patients with type 2 diabetes than in those without. There was a significant difference in the severity of dental caries between the two groups.

ПРИЧИНЫ УДАЛЕНИЯ ЗУБОВ У ПАЦИЕНТОВ ПСИХИАТРИЧЕСКОГО СТАЦИОНАРА

According to the literature, in a mentally healthy population, the main cause of tooth extraction is complications of caries and periodontitis, mainly in elderly and senile patients. In patients with psychiatric pathology, many authors note the high prevalence of dental diseases and emphasize the need for tooth extraction.&#x0D; The aim of the investigation was to study the structure of dental diseases requiring tooth extraction in psychiatric hospital patients.&#x0D; Material and methods of research. Information was copied from 1812 dental records of patients who were on inpatient treatment at the V.N. Bekhterev RCPB in the period from 2014 to 2016 at the age of 16 to 82 years (879 men and 933 women). The main reason for hospitalization of most patients was the diagnosis of schizophrenia (59%). The statistical software package SPSS 13.0 (1999) was used for statistical processing of the results.&#x0D; The results of the study. During the study period, the dental surgeons of the RCPB received 1812 patients who had 2187 teeth removed. Mostly, the tooth extraction operation was performed for chronic periodontitis (47.2%). The greatest number of removals for periodontitis was observed in elderly patients (57.1%). The smallest number of teeth removed due to periodontitis was observed in the group of middle-aged patients (45–59 years) and amounted to 36.3% of the total number of teeth removed. This is due to the predominance of chronic periodontitis in these patients, which is comparable to the indicators in patients without psychiatric pathology. In the group of elderly and senile patients, tooth extraction surgery for chronic periodontitis was performed in 49.3% of cases.&#x0D; Conclusions. The main reason for tooth extraction in mentally ill patients was chronic periodontitis and its exacerbation – 47.2%. The average age of these patients was 59.16 ± 14.33 years in men and 52.91 ± 11.85 years in women. The predominance of chronic periodontitis in the structure of the causes of tooth extraction in patients of the middle age group indicates an early clinical manifestation of inflammatory and destructive changes in the periodontium.

Oral complications in patients with breast cancer treated with HER2-targeted therapies: A population-based cohort study across the United States.

296 Background: Oral complications resulting from cancer immunotherapies can inflict pain, disrupt nutrition intake, escalate the cost of care, and significantly undermine the quality of life for cancer patients. However, they are frequently under-researched and overlooked due to the perception that they do not directly contribute to mortality risks among individuals with cancer. This study aimed to assess oral complications among adults with breast cancer who initiated human epidermal growth factor receptor inhibitors (HER2i). Methods: Patients with breast cancer treated with or without HER2i between 2008 and 2023 were included from 92 healthcare organizations across the U.S., and propensity score matched on age, comorbidities, metastatic diseases, and previous antineoplastic treatments. Kaplan-Meier analysis and log-rank tests were used to compare outcomes between the cohorts. Hazard ratios (HRs) and 95% confidence intervals (CIs) were obtained using the Cox proportional hazard regression model. Outcomes of interest included stomatitis, dental caries, and tooth extraction. Results: A total of 15,311 HER2i initiators were matched to 15,311 HER2i non-users with breast cancer. HER2i initiators presented with a significantly higher risk for stomatitis (HR, 3.03; 95% CI, 2.51 to 3.67) and dental caries (HR, 1.49; 95% CI, 1.05 to 2.13). Pertuzumab (HR for stomatitis, 8.81; 95% CI 7.77 to 9.98; HR for caries, 3.94, 95% CI 2.83 to 5.50) and trastuzumab (HR for stomatitis, 3.97, 95% CI 3.59 to 4.38; HR for caries, 2.00, 95% CI 1.57 to 2.54) were both significantly associated with higher risks of dental caries and stomatitis. Pertuzumab use was also associated with a 1.9-fold higher risk of tooth extraction (HR 2.92, 95% CI 1.18 to 7.2). Conclusions: HER2i therapy was associated with a significantly higher risk for stomatitis, dental caries, and tooth extraction in patients with breast cancer. These findings imply that an integrated approach to breast cancer patient care should include oral care and involve oral medicine specialists and dentists.

Retrospective analysis of tooth extraction and osteoradionecrosis after low-dose rate brachytherapy for patients with tongue cancer.

This study aimed to investigate the incidence of osteonecrosis of the jawbones (ORN) after tooth extraction in patients undergoing low-dose rate brachytherapy (LDR-BT) and assess its safety. This study retrospectively analyzed 145 patients with tongue cancer treated at Hiroshima University Hospital from 2007 to 2021 with LDR-BT using 192Ir or 198Au alone, LDR-BT and external beam radiotherapy (EBRT) with or without chemotherapy, and LDR-BT with chemotherapy. Patients' mandible and maxilla were protected with spacers. Forty-seven patients underwent tooth extraction, and the incidence, site, and relationship of ORN with tooth extraction were recorded. A subgroup of 26 patients received additional EBRT to the neck after dissection for late cervical lymph node metastases. Of 145 patients, six (4.1%) developed ORN on the same side of the mandible as LDR-BT, and EBRT was performed before and/or after LDR-BT on the sites where ORNs developed. Five of 47 (10.6%) patients who underwent tooth extraction after LDR-BT developed ORN. ORN incidence was 1.8% (2/109) in the LDR-BT and/or chemotherapy group and 11.1% (4/36) in the combination LDR-BT and EBRT and/or chemotherapy group for primary tongue cancer. Different irradiation methods (LDR-BT and/or chemotherapy and combination LDR-BT and EBRT and/or chemotherapy) and the presence or absence of tooth extraction showed significant differences (p = 0.0335 and p = 0.0139, respectively) with or without ORN. Mandibular tooth extraction should be avoided on the side of LDR-BT in combined EBRT cases. However, tooth extraction is feasible using a spacer in LDR-BT and/or chemotherapy.

Risk of healing impairment following tooth extraction in patients administered with antiresorptive and non-antiresorptive polypharmacy

IntroductionLack of evidence existed related to the essential role by which anticancer medications alone or in combination with other polypharmacy would be accountable for wound healing impairment post-dental extraction. The following study was conducted to assess the influence of antiresorptive (AR) and non-antiresorptive (non-AR) drugs and other patient-related risk factors on wound healing status following tooth extraction. Material and methodsA total of 353 patients (age range: 40–90 years, average age: 67.4 years, clinical and radiological follow-up) were recruited. All the patients were divided into three groups, which included, patients used polypharmacy with non-AR drugs, polypharmacy with a combination of AR + non-AR drugs, and the control group. Based on time of healing, the outcome was defined as, normal healing, delayed healing, and Medication-related osteonecrosis of the jaw (MRONJ). The polypharmacy score was categorized depending on the sum of the number of administered medications. ResultsThe odds of delayed healing were significantly higher in 80+ years old patients (OR=6.98, 95 %CI:2.45–19.88, p = < 0.001) administered with AR+ non-AR drugs (OR=14.68, 95 %CI:4.67–46.14, p = < 0.001), having a major polypharmacy score (OR= 15.37, 95 %CI:4.83–48.91, p = < 0.001). On the contrary, patient administered with non-AR drugs (OR=11.52, 95 %CI: 4.45–29.83, p = < 0.001) with hyper polypharmacy (OR=58.86, 95 %CI:25.03–138.40, p = < 0.001) were significantly more likely to develop MRONJ. Smoking and extraction sites showed no significant impact on wound healing impairment. DiscussionWound healing status in patients administered with both non-AR and AR+ non-AR polypharmacy was significantly impaired following tooth extraction. Other risk factors, such as increased age and high polypharmacy scoring, also significantly contributed towards the occurrence of delayed healing and MRONJ.

The Effectiveness and Safety of Autologous Platelet Concentrates as Hemostatic Agents after Tooth Extraction in Patients on Anticoagulant Therapy: A Systematic Review of Randomized, Controlled Trials.

One of the common challenges in oral surgery is dealing with patients who are taking oral anticoagulant/antiaggregant drugs. Several local hemostatic agents have been proposed as an alternative to conventional suturing. Among these, autologous platelet concentrates (APCs) have been widely used to decrease the risk of hemorrhage after dental extraction. Nevertheless, there is a lack of consensus regarding the superiority of any one specific hemostatic agent over the others. This systematic review is aimed at evaluating the effectiveness of APCs as hemostatic agents after tooth extraction in patients on anticoagulant therapy. A literature search was conducted of articles published before March 2023 on PubMed, Scopus, and the Cochrane Central Register of Controlled Trials (CENTRAL). Studies on the use of APCs in patients undergoing dental extractions and being treated with anticoagulant drugs were included. Only randomized, controlled trials (RCTs) published up to March 2023 were included; the outcomes assessed were the time to hemostasis, the presence of post-operative bleeding and pain, and the effectiveness of wound healing. The risk of bias for each RCT was assessed by using the 'risk of bias' tool (RoB 1.0). The research revealed 6 RCTs. The findings indicated that patients on anticoagulant therapy who received APCs without discontinuing their medication experienced a decreased post-operative bleeding, a shorter hemostasis time, reduced pain, and accelerated wound healing. However, due to the high/unclear risk of bias of the studies included, no definitive conclusions can be drawn on the superiority of APCs as hemostatic agents over other similar products. Additional studies are required to validate these findings.

Bleeding during tooth extraction in patients with chronic kidney disease: A cross-sectional pilot study.

This work measures the intra-operative bleeding in end-stage renal disease patients and assesses whether laboratory coagulation tests and nitrogenous compounds are related to a higher bleeding risk. Laboratory tests were performed on the day of surgery and some patients with thrombocytopenia and values above the normal levels of international normalised ratio (INR), thrombin time (TT) and activated partial thromboplastin time (aPTT) were identified. Haemostatic time ranged from 2 to 35 min (mean of 8.51 min) after suture. Bleeding volume ranged from 0.02 to 67.06 mL (mean of 4.38 mL) and the bleeding volume per minute ranged from 0.05 to 2.10 mL/min (median of 0.6 mL/min). Only seven patients (16.27%) had abnormal bleeding (more than 0.6 mL/min). Spearman's coefficient showed weak correlations between bleeding volume (mL/min) and serum urea (r = 0.226), TT (r = 0.227), plasma urea (r = 0.148) and creatinine (r = 146), as well as very weak correlations with all other variables (r < 0.140) such as age, haemodialysis time, glycaemia, glycated haemoglobin, platelets, INR, aPTT and fibrinogen. It was not possible to associate any laboratory test or nitrogenous compounds present in the blood and saliva with an increased bleeding.

Necessity of Antibiotic usage after Simple Tooth Extraction in Patient with Healthy Systemic Condition in Herat, Afghanistan

Background/Purpose: Over-intake of antibiotics like amoxicillin, penicillin, ceftriaxone, gentamycin, ampiclox, metronidazole and last but not least, tetracycline is a practical hazard in aid-supported settings such as Afghanistan where not only one can get access to them easily, but also they are generously being prescribed without consideration for necessity or side effects. Prescribing antibiotics after simple tooth extraction has remained a questionable topic in dental academia, especially in the third world countries. Among dental procedures, extraction is the most common procedure for the prescription of antibiotics. This study is aimed to determine the necessity of using antibiotics after simple tooth extraction in people with a normal systemic condition and establish its role in reducing pain and discomfort, swelling, and dry socket. Materials and Methods: This double-blinded RCT study was performed in two dental surgeries; Erfan Specialized Dental Clinic and Mena Oral and Dental Care Centre. In all 237 patients, selected systematically, randomized, tooth extraction was performed following the same protocols and materials before and after tooth extraction. Two types of prescriptions (one with antibiotics and one without antibiotics) were prepared in a box. After tooth extraction participants were asked to pick one prescription by chance. All data were collected and analyzed with the SPSS-25 program. Results: Among all participants 76.37% were female and 23.63% were male. Regarding reasons that led to tooth extraction, 43.04% of teeth were extracted due to profound caries, making it the most common reason followed by periodontitis 14.77% and root remnants 10.55%. Pain and discomfort peaked in the first 10 hours after extraction and gradually decreased up to 48 hours after extraction. Swelling was observed 2.53% more in antibiotic users than 0.42% in those that didn’t take them and the p-value was significant &lt;0.05. There is no obvious difference between antibiotic usage and dry socket formation, and the p-value was not significant (&gt;0.05). Conclusion: Antibiotics are not necessary after simple tooth extractions in patients with a normal systemic condition, even in countries like Afghanistan where patients overuse antibiotics, nor do they have any role in reducing pain, swelling, and dry socket after simple extractions.

Comparison of Different Antibiotic Regimes for Preventive Tooth Extractions in Patients with Antiresorptive Intake-A Retrospective Cohort Study.

In the present study, the impacts on success rates between three different antibiotic regimes in patients receiving preventive tooth extraction during/after antiresorptive treatment were compared. For the retrospective analysis, we enrolled patients who had undergone tooth extraction from 2009 to 2019 according to the specified preventive conditions under antiresorptive therapy. Three antibiotic regimens were distinguished: (Group 1) intravenous for 7 days, (Group 2) oral for 14 days, and (Group 3) oral for 7 days of application. The primary endpoint was the occurrence of medication-related osteonecrosis of the jaw at 12 weeks after surgery. A total of 760 patients and 1143 extraction regions were evaluated (Group 1 n = 719; Group 2 n = 126; Group 3 n = 298). The primary endpoint showed no significant difference in the development of medication-related osteonecrosis of the jaw between the groups studied (Group 1 n = 50/669 (7%); Group 2 n = 9/117 (7%); Group 3 n = 17/281 (6%); p = 0.746). Overall, the success rate was 93% after intervention when preventive measures were followed. With the same success rate, a reduced, oral administration of antibiotics seems to be sufficient regarding the possible spectrum of side effects, the development of resistance and the health economic point of view.

Major relationships of tooth extraction in patients with cardiovascular diseases: a concise systematic review

Introduction: Cardiovascular diseases (CVD) are the leading cause of death worldwide. The number of tooth extraction patients with cardiovascular disease in our country is increasing year by year. Blood pressure control, determination of cardiac function, recognition of arrhythmias, glycemic control, and use of antiplatelet agents or oral anticoagulants need to be investigated. Objective: It was to carry out a concise systematic review of the main relationships of tooth extraction in patients with cardiovascular diseases, to emphasize the main risk predictors. Methods: The systematic review rules of the PRISMA Platform were followed. The search was carried out from February to March 2023 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases, using articles from 2009 to 2022. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed accordingly, according to the Cochrane instrument. Results and Conclusion: A total of 124 articles were found, 38 articles were evaluated and 24 were included and developed in this systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 26 studies with a high risk of bias and 40 studies that did not meet GRADE. It was concluded that the cardiovascular response of elderly outpatients with systemic diseases during tooth extraction is quite significant. Age, sex, systemic diseases, and some tooth extractions may be risk factors closely associated with cardiovascular response. It is necessary for the dental treatment of these patients with heart disease a good knowledge of the subject and requires medical and dental coordination. Dental surgeons need to be prepared to identify possible medical and dental emergencies and take steps to prevent or treat them effectively and quickly.