Oral Infections and Antibiotic Therapy

We aimed to describe and analyze the epidemiologic and clinical variables associated with, treatment for, and development of cervicofacial infection (CFI).

We retrospectively examined 201 patients older than 14 years who had met the CFI diagnostic criteria and whose treatment required hospitalization and intervention under general anesthesia at our hospital. We performed chi-square tests to compare proportions in categorical variables and either the Student t test or the Wilcoxon signed-rank test to compare quantitative variables. We performed an analysis of variance to compare 3 or more categories and either Pearson or Spearman correlation coefficient analysis to examine the correlations between quantitative variables.

The majority (85.07%) of the CFIs were of odontogenic origin. The mean hospitalization length was 4.58 days. Patients with diabetes who used tobacco and/or alcohol had a significantly longer length of hospitalization and several postoperative complications.The most common symptoms were pain, trismus and toothache. Symptoms of fever and nausea were associated with longer hospitalization. The most affected anatomic spaces were submandibular and pterygomandibular. Buccal and infraorbital, temporal, and parotid spaces were associated with longer hospitalization.

Most CFIs are of odontogenic origin. Diabetes and tobacco and alcohol use are important risk factors. Treatment should be surgical and target the cause of infection. Timely referrals are important when patients present symptoms compatible with CFI for immediate treatment.

Dentistry is a field where biopolymers can be applied in different treatments. Due to the specific conditions of the oral environment, dental biomaterials are required to deal with innumerous adversities, like mechanical stresses, high humidity and acidic pH, food residues, and microbial contamination. Biopolymeric films and membranes are efficient alternatives employed mainly in endodontic treatments, periodontics, and bone and dental regeneration. In this chapter, a systematic review is performed of the available literature, focusing on the trends and the most innovative strategies to obtain functional membranes and films by different techniques. The natural and synthetic biopolymers used in their production—collagen, chitosan, gelatin, cellulose, and others—including some blends and composites are listed as examples of dental applications. Also, drug delivery systems are explored because of their importance to the administration of medicines with antibiotic, antiinflammatory, and anesthetic activity.

Baicalein is one of the major flavonoids in Scutellaria baicalensis Georgi, which has long been used in Asia as herbal medicine. Several biological effects of baicalein, such as antiviral, anti-inflammatiom, anti-hepatotoxicity, and anti-tumour properties, have been reported.

In this study, the antibacterial activities of baicalein were investigated in combination with ampicillin and/or gentamicin against oral bacteria.

Baicalein was determined with MIC and MBC values ranging from 80 to 320 and 160 to 640 μg/mL against oral bacteria. The range of MIC₅₀ and MIC₉₀ were 20–160 μg/mL and 80–320 μg/mL, respectively. The combination effects of baicalein with antibiotics were synergistic (FIC index <0.375–0.5 and FBCI <0.5) against oral bacteria. Furthermore, a time-kill study showed that the growth of the tested bacteria was completely attenuated after 1–6 h of treatment with the MIC₅₀ of baicalein, regardless of whether it was administered alone or with ampicillin or gentamicin.

These results suggest that baicalein combined with other antibiotics may be microbiologically beneficial and not antagonistic.