Antibiotics for treatment of apical periodontitis, indication or contraindication

Abstract

AbstractBackgroundApical periodontitis as an endodontic diagnosis has attracted attention for the close relationship between the periodontal nature and the endodontic nature that this pathology represents. The appearance of pathology in periodontal tissues, but originating from the infected canal of the affected tooth, is caused by the passage of pulpal infection–inflammation products only between the apical foramen toward the periodontal tissues positioned at the exit of the tooth canal. Depending on the morphology of the canal, it can be one inflamed area, or several that form a whole, if the pulp has terminal branches, like “river delta,” in its apical exit.Main body of the abstractThe study aims to evaluate the clinical significance whether to treat or not with antibiotics of apical periodontitis. This study aims to look at this pathology from the perspective of the articles already published in the literature and after processing the conclusions of all the articles, come up with current recommendations on the treatment or not with antibiotics of the clinical cases presented with the pathology of the apical periodontium.ResultsThe classification of apical periodontitis occurs depending on the clinical signs visible with radiographs and the objective and subjective complaints of the patient. Regardless of subclassifications of apical periodontitis, the cause is bacteria or symbiosis of bacteria causing pulpitis, so as in any bacterial infection there is a tendency to treat them with antibiotics locally rather than in a systemic way, as long as the infection does not cause systemic symptoms such as fever, or massive swelling of the affected area.Short conclusionFrom the analysis of the collected information, it is clear that the trend for treatment of apical periodontitis in the future does not lie in the application of antibiotics, but rather in irrigation solutions or the use of devices for the purpose of disinfecting the canal affected by the pathology. However, in no case is it indicated to eliminate the mechanochemical canal cleaning protocol before applying any type of treatment methodology.