Publications by authors named "Isabel Crespo-Gallardo"

4 Publications

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Correction: Criteria and treatment decisions in the management of deep caries lesions: Is there endodontic overtreatment?

J Clin Exp Dent 2019 Jan 1;11(1):e103. Epub 2019 Jan 1.

MD, DDS, PhD, Department of Stomatology - Endodontic Section, School of Dentistry, University of Sevilla, C/ Avicena S/N, 41009 Sevilla, Spain.

[This corrects the article on p. 751 in vol. 10, PMID: 30305872.].
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http://dx.doi.org/10.4317/jced.532742DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6343993PMC
January 2019

Dentist´s knowledge, attitudes and determining factors of the conservative approach in teeth with reversible pulpitis and deep caries lesions.

J Clin Exp Dent 2018 Dec 1;10(12):e1205-e1215. Epub 2018 Dec 1.

Endodontics Section, Department of Stomatology, (Conservative Dentistry Section), University of Sevilla, Spain.

Background: The aim of this study was to investigate dentists` knowledge, attitudes and factors regarding the conservative approach in the management of deep caries lesions (DCLs) in teeth with reversible pulpitis.

Material And Methods: 187 dentists were contacted directly or by mail, and 125 (67%) were finally included in the study. Dentists were requested to answer an open/discursive questionnaire about the routine approach to the diagnosis and treatment of DCLs, including knowledge-related attitudinal items.

Results: Total caries excavation was the preferred treatment option for more than 80% of dentists in case of DCL with reversible pulpitis. Only a small percentage (8%) chose partial caries removal, leaving some carious dentin close to the pulp to avoid pulp exposure. More than a half (51%) of respondents considered that cariogenic microorganisms must be removed or caries would progress. Dentists teaching at the University strongly disagreed with this statement (OR = 4.6; 95% C.I. = 1.3 - 15.8; = 0.017). Good clinical result was the most chosen reason (83%) to choose a specific treatment. Patient's oral health (84%) and patient's age (70%) were the two patient-related factors most taken into account for the choice of treatment.

Conclusions: Total caries excavation is still the most frequently chosen treatment in teeth with DCL and reversible pulpitis. The joint assessment of the answers given by respondents allows to conclude that the new knowledge and concepts about caries lesions and the more conservative approach to DCLs have not still been incorporated by dentists into their usual clinical practice. Caries, deep caries lesions, dental pulp capping, dental pulp health, dentists, endodontic therapy, reversible pulpitis, treatment decisions.
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http://dx.doi.org/10.4317/jced.55395DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6343973PMC
December 2018

Criteria and treatment decisions in the management of deep caries lesions: Is there endodontic overtreatment?

J Clin Exp Dent 2018 Aug 1;10(8):e751-e760. Epub 2018 Aug 1.

MD, DDS, PhD, Department of Stomatology - Endodontic Section, School of Dentistry, University of Sevilla, C/ Avicena S/N, 41009 Sevilla, Spain.

Background: The aim of this study was to investigate the diagnostic criteria and treatment decisions in the management of deep caries lesions (DCLs). The null hypothesis tested was that DCLs are managed according to the current scientific evidence.

Material And Methods: A total of 288 dentists were contacted directly or by mail, and 125 (43%) were included in the study. Dentists were requested to answer a questionnaire about the routine approach to the diagnosis and treatment of DCLs. Logistic regression analyses were carried out to calculate odds ratios (OR).

Results: Pulp sensitivity tests were used by 65% of dentists when assessing pulpal health in cases of DCLs, particularly those who had followed courses in cariology (OR = 3.8; = 0.005). Dentine hardness was the most frequent criterion used during DCLs excavation (98%). Two thirds of the respondents (65%) removed carious tissue until they felt hard dentine, and feeling hard dentine correlated with caries removal even at the risk of pulpal exposure (OR = 15.8; = 0.0000). Acute transient pain or sensitivity to cold or heat (reversible pulpitis) were considered by 58% of respondents as a reason to provide endodontic therapy.

Conclusions: The null hypothesis tested is rejected. The evidence-based more conservative approach on the management of DCLs is not being translated to clinical dentistry. Root canal treatment is being indicated in cases of DCLs in which the diagnosis is reversible pulpitis. Likewise, it can be concluded that non-conservative management of DCLs, with endodontic overtreatment, could be occurring. Deep caries lesions, dental pulp capping, dental pulp health, dentists, endodontic therapy, pulpal diagnosis, reversible pulpitis, treatment decisions.
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http://dx.doi.org/10.4317/jced.55050DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6174009PMC
August 2018

Worldwide pattern of antibiotic prescription in endodontic infections.

Int Dent J 2017 Aug 17;67(4):197-205. Epub 2017 Apr 17.

Department of Stomatology (Comprehensive Dentistry), School of Dentistry, University of Sevilla, Sevilla, Spain.

Background: Odontogenic infections, and especially endodontic infections, are polymicrobial, involving a combination of Gram-positive and Gram-negative facultative anaerobes and strictly anaerobic bacteria. Therefore, antibiotics can be used as an adjunct to endodontic treatment. However, most chronic and even acute endodontic infections can be successfully managed by disinfection of the root-canal system, which eliminates the source of infection, followed by abscess drainage or tooth extraction, without the need for antibiotics. The literature provides evidence of inadequate prescribing practices by dentists. The aim of this concise review was to analyse the worldwide pattern of antibiotic prescription in endodontic infections.

Methods: Comprehensive searches were conducted in MEDLINE/PubMed, Wiley Online Database, Web of Science and Scopus. The databases were searched up to 13 March 2016 for studies in which dentists used systemic antibiotics to treat endodontic lesions and which reported data on the type of antibiotic prescribed and on the diagnosis of the endodontic disease treated.

Results: The electronic and hand searches identified 69 titles, of which 25 were included in the final analysis. Amoxicillin was reported as the drug of choice for endodontic infections in most countries, and clindamycin and erythromycin were the choice for patients allergic to penicillin. Dentists worldwide prescribe antibiotics for non-indicated conditions, such as pulpitis.

Conclusion: Antibiotics are overprescribed for the management of endodontic infections. It is necessary to improve antibiotic-prescribing habits in the treatment of endodontic infections, as well as to introduce educational initiatives to encourage the coherent and proper use of antibiotics in such conditions.
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http://dx.doi.org/10.1111/idj.12287DOI Listing
August 2017