Antibioterapia en la prevención de la reabsorción radicular en dientes avulsionados

Abstract

Dental avulsion or exarticulation is the complete displacement of a tooth from its socket in alveolar bone owing to trauma. Immediate replantation ensures the best possible prognosis but is not always possible since more serious injuries may be present, the extraoral period is a determining factor for the prognosis. The success of the reimplanted tooth depends on several factors that contribute to accelerate or minimize the onset of inflammatory root resorption or ankylosis, which are the most frequent and undesirable complications of a reimplanted tooth. The periodontal ligament of an avulsed tooth is quickly contaminated by bacteria present in the oral cavity during the extraoral period as well as the alveolar socket; therefore, systemic administration of antibiotics is recommended to prevent the effects of bacterial contamination. There is a lack of randomized studies assessing how the use of systemic antibiotics could influence tooth healing after inmediate replantation, so we propose to carry out our comparative study of Amoxicillin, Tetracycline and Clindamycin. The main objective of the present study is to determine the effect of the use of systemic antibiotic therapy (Amoxicillin, Tetracycline and Clindamycin) for the prevention of root resorption in avulsed teeth in beagles. The specific objetives are the following: 1.-Quantify the appearance of root resorption (superficial, inflammatory and ankylosis) 2.-Asses the presence of root resorption at the different points of the root surface. 3.-Establish possible differences in the use of antibiotics between dental arches. 4.-Evaluate if the administration of systemic Clindamycin increases the prevention of root resorption against the use of conventional antibiotic therapy (Amoxicillin and Tetracycline). Therefore, 16 beagles dogs were used, the animals were assigned to four groups for the different antibiotics, all the maxillary and mandibular incisors were extracted, then they were reimplanted, obtaining a total of 133 teeth as a study sample. The different antibiotics were administered for a week at the recommended doses and euthanasia was performed at six months for subsequent histological study. Three equal sections were cut perpendicular to the axial axis of the teeth according to the root length, one cervical, middle and apical. In this study only the middle portion was analyzed, the morphometric evaluation was performed and eight registration points were examined on the root surface. Each of these eight points was evaluated and classified with the presence of: normal periodontal ligament, surface resorption, inflammatory resorption or ankylosis, to check which antibiotic increased the rates of periodontal healing and prevented root resorption. In the present study, the presence of different patterns of root resorption (surface resorption, inflammatory resorption and ankylosis) after avulsion and subsequent reimplantation of incisors in beagles dogs has been detected. No significant differences were found in the occurrence of resorption at the different points evaluated on the root surface. When performing the comparative study between arches, no significant differences were found in the occurrence of root resorption. The results have shown that the use of Clindamycin as a systemic antibiotic represents an improvement in cure rates with significant differences, reaching 86.6% compared to Amoxicillin (51%) and Tetracycline (48.45%). In conclusion, we affirm that the systemic administration of Clindamycin for the prevention of root resorption of avulsed teeth in beagles is an antibiotic alternative to the traditional treatment with Amoxicillin and Tetracycline.