Evidence based dentistry
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Evidence based dentistry - abstracts 2 Evidence based dentistry
abstracts 1
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1 No evidence to link prosthetic joint infections with dental procedures

Evidence-Based Dentistry (2008) 9, 103 104. doi:10.1038/sj.ebd.6400609

No evidence to link prosthetic joint infections with dental procedures

In people who have hip and knee replacements, is antibiotic prophylaxis
necessary for invasive dental procedures?

Address for correspondence: Professor D Pittet, University of Geneva
Hospitals and Faculty of Medicine, 24 Rue Micheli-du-Crest,
1211 Geneva 14, Switzerland.
Jennifer Rodgers1 and Derek Richards1
1Department of Public Health, NHS Forth Valley, Carseview House,
Castle Business Park, Stirling, Scotland, UK

UÁkay I, Pittet D, Bernard L, Lew D, Perrier A, Peter R. Antibiotic
prophylaxis before invasive dental procedures in patients with
arthroplasties of the hip and knee. J Bone Joint Surg Br 2008; 90:833 838


Data Sources: Medline and bibliographies of relevant papers were used to
source relevant studies. Case reports and references to relevant conference
presentations were also included. Animal and in-vitro studies were excluded.
Publications in English, French and German were included.

Study selection: All relevant articles including case studies and
references to abstracts of conference presentations were considered.
Data extraction and synthesis: A qualitative summary was made of relevant

Results: Of 144 articles retrieved, there were 23 prospective studies but
no randomised or comparative trials. Twenty-seven reports (18.8%) favoured
prophylaxis for special circumstances, 11 publications (7.6%) did not
perceive any benefit and 106 (73.6%) took no clear position.

Conclusions: Infections of total hip or knee replacements because of
haematogenous seeding following dental intervention are very rare. The
scientific rationale for systemic or local antimicrobial prophylaxis is
very weak at best.

This nonsense has perhaps less scientific support than the sbe prophylaxis
regimens we endured over the past few decades which finally were shot down
based on evidence based reality.  Unfortunately, the orthopedic community
has not done the same.  So we continue to create superflora of resistant
organisms because of dogma.  Ainít it great? - gary

Cases by:
Ahmad Tehrani
Fred Barnett
Glenn Van As
Marga Ree
Mark Dreyer
Noemi Pascual
Sashi Nallapati
Terry Pannkuk
Winfried Zeppenfeld

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