Antibiotics in Endodontics

The widespread use of antibiotics presumably cause antibiotic‐resistant bacterial strains. This is also important in terms of the oral microbiota and the use of antibiotics to deal with oral and dental infections. The aim of this speech is to review the current literature on the indications and contraindications use of antibiotics and give some recommendations to endodontists for prevent overuse of antibiotics. Endodontic infections, resulting in pulpitis, apical periodontitis or apical abscess, are polymicrobial, involving a combination of gram-positive, gram-negative, facultative anaerobes and strict anaerobic bacteria. Most endodontic infections are confined within the tooth and can be successfully managed by root canal treatment. Antibiotics are unnecessary in irreversible pulpitis, necrotic pulps and localized acute apical abscesses. However, when there is systemic involvement and rapid, and diffuse spread of infection, antibiotics may be used as an adjunct to root canal treatment. The use of topical antibiotics during root canal treatment is not supported by the evidence. Prevention of bacterial contamination in traumatic injuries especially avulsion affects the prognosis of the affected teeth. Current guidelines recommend systemic antibiotic therapy for patients with avulsion of a permanent tooth, which is replanted. For the other traumatic injuries, such as fracture or luxation injuries, antibiotic administration does not necessary. In healthy individuals, any bacteraemia generated by endodontic treatments are rapidly scavenged and cause no complications, but antibiotics should be prescribed in patients having systemic diseases with compromised immunity or patients with infective endocarditis, prosthetic cardiac valves or recent prosthetic joint replacement.

Prof. Dr. Hakki Sunay

He was born in 1973 in Tarsus/ Turkey. He obtained his dental degree from Istanbul University in 1997. He continued his post-graduate training in Endodontics Department of Istanbul University, Faculty of Dentistry where he received his PhD degree in 2004.
He was appointed as an Assistant Professor in the Endodontics Department of Yeditepe University, Faculty of Dentistry in 2007 and he became Associated Professor in 2012. He also served as Advisor to the Dean, from 2007 to 2015 in Yeditepe University, Faculty of Dentistry.
Prof. Sunay, started working at Altinbas University in 2015 where he was also in charge of in the foundation of the Faculty of Dentistry. After working as the Vice Dean from 2015 to 2017, he was appointed as Professor and the Dean in 2017. Currently, he serves as full time Professor in the Endodontics Department and as the Dean of Faculty of Dentistry, Altinbas University.

Prof. Hakki Sunay is a member Turkish Endodontic Society where he held administrative positions as the Treasurer and General Secretary.
In 2008, he is a co-opted member of European Society of Endodontology (ESE), where he served as Treasurer from 2009 to 2017.
He also served as a member of the organizing committee of scientific meetings and congresses. Among the scientific meetings and congresses he organized, ESE meeting which was held in Istanbul in 2007 is still recognized as one of the memorable and well-organized ESE meetings.


Memberships:
Member of American Assosiation of Endodontists
Member of European Society of Endodontology
Member of Turkish Endodontic Society