Dental caries, pulpal necrosis, trauma, and periodontal diseases can result in dental infections which could have severe consequences that affect both soft and hard tissues of the oral cavity. Dental infections commonly present with symptoms of pain, fever, and swelling. Surgical and endodontic treatments are the early management of infected teeth, followed by antibiotic therapy. Some alternative methods also exist for treating infection such as low-level laser therapy and photodynamic therapy. Antibiotics are generally used in dental procedures to treat odontogenic infections, nonodontogenic infections, local infection, focal infection, and prophylaxis. Antibiotic prophylaxis is prescribed for patients with immunosuppressed conditions, infective endocarditis, metabolic disorders, and patients with prosthetic joints. To reduce the complications of unnecessary antibiotic prescriptions especially bacterial resistance, comprehensive guidelines should be established. It has been noted that only about 12% of dentists adequately and correctly prescribe antibiotics, which shows the importance of comprehensive guidelines. Antibiotics prescription may result in some adverse effects such as hypersensitivity reactions and dermatological and allergic disorders. Furthermore, unnecessary prescription of antibiotics could result in several serious sequelae, for example, bacterial resistance, gastric and hematological problems, and diversion of bacterial microbiota. The present review attempts to summarize the indications of antibiotic therapy in dentistry and discuss the common types of antibiotics that are routinely used in dental practice based on pharmacologic classes. Moreover, types of antibiotics that are considered safe during pregnancy and childhood are also reviewed.
5 January 2009 in International Journal of Pharmaceutics
Purpose: Cartilage regeneration by using polymeric scaffolds is a new option for treatment of osteoarthritis. A good scaffold for tissue engineering should copy the characteristics of natural extracellular matrix. The purpose of this study was to make a dosage form with proper reliability and stability for cartilage repair. Methods: Hybrid scaffolds containing different ratios of hyaluronic acid (HA) and collagen were prepared and loaded with prednisolone as anti-inflammatory agent. Two different dosage forms (lyophilized implantable disk and thermo-sensitive gels) were examined. A scaffold of cross-linked HA was used as control. Different characterization tests were considered including differential scanning calorimetry (DSC), scanning electron microscopy, mechanical evaluations, and drug release. Results: The physical and chemical performance of hybrid-scaffolds was better than HA scaffold. Increasing the concentration of HA and collagen improved the physical and chemical characteristics. Regarding the mechanical properties of the hybrid scaffold, the pore size was 20-200µm, compressive modulus was 54.77±0.31 kPa, more than 1200% water uptake was observed after 4 days, gelation temperature was 32±0.16°C, gelation time was 2.4±0.1 min, and drug release was controlled for 5 days by Higuchi release kinetic model. Conclusion: It seems that this porous hybrid scaffold could be a suitable choice in cartilage regeneration as well as a controlled-release system for delivery of prednisolone in osteoarthritis.