Role of antibiotics in paediatric endodontics.

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Gurusamy Kayalvizhi

Role of antibiotics in paediatric endodontics

Gurusamy Kayalvizhi

Key words

antibiotics, drugs, infected tooth, irreversible pulpitis, prophylactic, root canal treatment, systemic, topical

Bacteria have been implicated in the pathogenesis and progression of pulpal and periapical diseases. The primary aim of endodontic treatment is to remove as many bacteria as possible from the root canal system and then create an environment in which remaining microorganisms cannot survive. Antibiotics form an important part of routine endodontic practice. They have been used routinely in children as an adjunct in a number of ways: systemically, locally and prophylactically. Systemic antibiotics have been used in clinical practice far more than is necessary. As topical agents they have been used as an intra-canal pulpotomy/pulpectomy medicament and root canal irrigant. Although their inadvertent use raises concern, the most important decision in antibiotic therapy should not be about which antibiotic should be used but whether antibiotics should be used at all. This paper reviews the role of antibiotics in paediatric endodontics by highlighting their effects and concerns in detail.

n Introduction Over a century ago, Miller wrote that bacteria are connected in some manner with pulpal diseases, and he raised the hypothesis that they are the causative factor for diseases of endodontic origin. This hypothesis has been proved, as bacteria have been implicated in the pathogenesis and progression of pulpal and periapical diseases1. The child with an infected pulp presents a unique challenge to the clinician. Bacterial composition of an infected root canal is complex, mainly consisting of the obligate

anaerobes and facultative aerobes2. The primary aim of endodontic treatment is to remove as many bacteria as possible from the root canal system and then create an environment in which the remaining microorganisms fail to thrive3. Antibiotics play an important role as an adjunct to paediatric endodontics. They are compounds that act to kill or inhibit the growth of bacteria. Penicillin and other antibiotics were viewed as ‘miracle drugs’ owing to their ability to cure life-threatening diseases during World War II4. This paper highlights their systemic, topical and prophylactic role in paediatric endodontics.

ENDO (Lond Engl) 2010;4(1):41–48

Department of Pedodontics and Preventive Dentistry, M. R. Ambedkar Dental College and Hospital, Bangalore, India Correspondence to: Gurusamy Kayalvizhi Department of Pedodontics and Preventive Dentistry No 9, 8th Maruthi Cross, Post Office Road Ramamurthy Nagar Bangalore 560016, Karnataka, India Tel: (0091) 988 612 0559 Email: drfisheyes22@gmail.com


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