Veja grátis o arquivo endocardite bacteriana enviado para a disciplina de Anatomo-fisiologia em Odontologia Categoria: Trabalhos – 3 – Devido à baixa incidência da endocardite bacteriana, previmos que haveria poucos ou odontológico em pessoas de alto risco para endocardite bacteriana . endocardite bacteriana odontologia pdf. Quote. Postby Just» Tue Aug 28, am. Looking for endocardite bacteriana odontologia pdf. Will be grateful.

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Bacteremia; Antibioticoprofilaxia Abstract Several odontological procedures collaborate with bacterial passage to circulation, the bacteremias. Most of the times, the own organic defenses control the process. However, there are predisposable conditions, such as cardiac injury, which can lead to systemic complications, including bacterial endocarditis.

In these cases, the antibiotic prophylaxis is necessary before an odontological treatment that can cause a possible bacteremia. This article intends to review the literature concerning the bacteremias with a buccal origin, and the importance of the antibiotic prophylaxis.

As bacteremias podem ser classificadas em: EmOkabe et al. Segundo Sonis et al. Pacientes de risco elevado: Pacientes de risco significativo: Pacientes de pequeno risco: Pacientes sem aumento de bactdriana Comparative effect of oral doses of clindamycin and erythromycin in the prevention of bacteraemia. Experimental transient bacteraemias in human subjects with varying degrees of plaque accumulation and gingival inflammation. Medical dental prophylaxis of endocarditis.

Braz J Infect Dis. Experimental transient bacteraemias in human subjects with clinically healthy gingivae. Prevention of bacterial endocarditis, recommendations by the American Heart Association.

Detection of bacteraemia after the use of an oral irrigation device in subjects with periodontitis. Factors affecting the occurence of bacteremia associated with tooth extraction.

Int J Oral Maxillofac Surg. Incidence and bacteriology of bacteremia associated with various oral and maxillofacial surgical procedures. Prevention of infective endocarditis: In healthy individuals, the defenses of the own organism are capable to control the process, destroying the bacteria existing in the blood stream.

On the other hand, in individuals with certain predisposing conditions, the bacteremia can cause systemic complications as a consequence. In these cases, a prophylactic drug therapy conducted by the dentist is recommended before an odontological intervention. This research paper is intended to define the role of the drug therapy to combat the buccal originated bacteremia, showing its importance in the prophylaxis of the bacterial endocarditis, disease sometimes lethal.

It happens when the own defenses of the organism destroy the bacteria, before these can cause any type of clinical manifestation. It is associated with traumas by surgical manipulations of located infectious focuses and with other different types of manipulations that promote the entrance of bacteria in the blood stream, as the mastication itself or brushing. Literature review Bacteremia Bacteremia is defined as the transitory and fleeting passage of small number of microorganisms for the blood stream, without general toxic-infectious syndrome3.


The bacteremia can be classified in: Some conditions can facilitate its occurrence: The symptomatic bacteremias can also be classified in transitory, continuous and intermittent. The transitory bacteremia is self-limited and frequently associated with the manipulation of tissues in the initial phase of certain infections and with traumas in a densely colonized mucous membrane.

The continuous bacteremia contains bacteria that stay in the blood for periods superior to 12 hours. Coordinator, Course of Dentistry, University Paulista.

The studies tended to confirm the inflammation severity as the decisive factor of the entrance of microorganisms in the blood steam. InOkabe bactediana al. They also observed that the bacteremia degree increases in accordance to the surgical trauma and tissue offense, as well as with the progressive increase of simultaneously extracted teeth and with the progress of the patient’s age.

Farmacologia aplicada na Odontologia

In patients with untreated periodontitis, even the use of water squirts can provoke systemic bacteremia6. The consequences of bacteremia caused by infections can be: Endocarditis is sometimes a lethal disease, due to the infection of enrocardite layers by bacteria brought by the blood stream — especially Streptococcus Viridians, a bacteria frequently found in the mouth and oropharynx, but also the Staphylococcus Aureus, Enterococos, among other4.

The affected patients’ average age is about 50 years, and the men are two times more affected endocardiite the women The relationship between the fleeting transitory bacteremia that follows the manipulation of the buccal tissues and the subacute endocarditis is clear13; but, for its occurrence, the predisposing heart conditions must exist, such as: Those individuals predisposed to suffer endocarditis should be submitted to antibiotic prophylaxis previously to the odontological manipulation.

Due to the great number of recorded cases of bacterial endocarditis after odontological manipulations11 and due to the gravity of the disease, the emphasis of the prophylactic therapy should be given to such illness2. Antibiotic prophylaxis The antibiotic prophylaxis should use a bactericidal endocarrdite driven against microorganisms commonly found in the oral cavity.

This discovery is due to the fact that the gum channel and, mainly, the endpcardite deffects possess predominantly anaerobic microorganisms9. The antibiotic therapy should be started before the odontological rndocardite, to assure maximum concentration in the osontologia during the procedure, and to continue its effect for some time after this, until bateriana appropriate cicatrisation of the tissues is obtained.

The Endocarite Heart Association AHA did, informal recommendations for the antibiotic procedure for the prevention of Infectious Endocarditis caused by bacteria, in substitution to an old procedure of Amoxicillin was chosen in substitution for the penicillin V, not because its wide action spectrum, but due to its pharmacokinetic pattern that allows swift absorption by the gastrointestinal tract, slow excretion by the kidneys and, consequently, high and lingering blood level 13, continuing its bactericidal character until 10 hours after the first dose The recommended administration method is the oral, except for the higher risk patients.


For patients allergic to the penicillin, the clindamycin appeared as an alternative in substitution to the erythromycin, which sometimes presents intolerable side effects for the patient. Inthe American Heart Association revised the recommendation, modifying it Chart 1.

The main modifications were5: The post-operative dosage previously recommended was omitted, and the reason for that is that the amoxicillin has an enough plasmatic level for an appropriate period of time to prevent endocarditis, being un-necessary a second dose. Erythromycin was completely eliminated as a recommendation for allergic patient because of the provoked gastro-intestinal upset and pharmacokinetic variations. Baxteriana generation Cephalosporins as Cephalexin or Cefadroxil can be used in patients with soft allergy to the penicillin.

The cephalosporins present low toxicity taxes and administration easiness7. Bacteremias in dentistry — antibiotic prophylaxis. According to Sonis et al. Patients without increased risk: Wndocardite patients of this group don’t need antibiotic prophylaxis.

Bacteremias em Odontologia – profilaxia antibiótica

Discussion By the revision of the literature, it is clear ebdocardite the concept that the main cause of buccal origin fleeting bacteremia are the odontological manipulations, being fundamental that the operator takes prophylactics procedures for patients that present predisposing conditions to the development of complications due bacheriana those. The risk of buccal originated bacteremia seems to be related to the extension of the traumatism of the soft tissues produced by the odontological treatment and to the degree of pre-existent local inflammatory disease.

It seems of low probability that bacteremia after oral surgery or other dental procedure can be totally avoided by antibiotic prophylaxis1.

What seems to be true is that the intensity of the bacteremia can be reduced by the use of the several drugs. Conclusions The dentist should adopt these procedures: Do an investigation and previous analyses of all the patients’ general conditions, classifying him by the risk level. Encourage a high level of oral health for the patients and take procedures to improve the local conditions. Contact the doctor that accompanies the patient whenever there are doubts regarding his medical report.

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