[Antibiotic prophylaxis in patients with joint prostheses]. / AB-profylaxe bij patiënten met een gewrichtsprothese.

A systematic literature review was carried out in order to formulate a new Dutch guideline regarding policies for patients with a joint prosthesis who are to undergo a dental procedure. The research question was: Is antibiotic prophylaxis indicated in patients with a joint prosthesis who undergo dental procedures? The literature comprised studies in which patients with joint prostheses underwent a dental procedure resulting in hematogenous periprosthetic joint infection or in which a correlation between prophylactic antibiotics and hematogenous periprosthetic joint infection were described. The GRADE/AGREE II method was used to determine the strength of the evidence. A supplementary review of literature to gain further insight into pathophysiology, risk factors and risk intervention was carried out. The included studies did not provide any conclusive evidence that the use of antibiotic prophylaxis reduces the incidence of dental hematogenous periprosthetic joint infection. The results of the supplementary review of literature also supported the conclusion that antibiotic prophylaxis should be discouraged in dental procedures.

[The medical-dental interactions scanner: an Electronic Health Record-integrated quality and safety module for medical-dental interactions]. / De MTI-scanner: een EPD-geïntegreerde kwaliteits- en veiligheidsmodule voor medisch tandheelkundige interacties.

Dental professionals will be confronted more frequently with medically compromised patients due to an increasing life expectancy in Western countries. The patients' systemic diseases and medication usage can both have consequences for oral health and dental treatment. It is often impossible to have all medical-dental interactions handy in the dental practice. To support the dental professional in providing safe healthcare, a tool has been developed. The medical-dental interactions scanner supports both patients and dental professionals in taking a patient's medical history and linking that information to the available literature. By that means, it is possible for the caregiver to provide patient-specific recommendations concerning possible adverse effects of medicaments,intra-oral manifestations of systemic diseases and measures to prevent medical emergencies.

Antibiotic prophylaxis is not indicated prior to dental procedures for prevention of periprosthetic joint infections

Background and purpose: To minimize the risk of hematogenous periprosthetic joint infection (HPJI), international and Dutch guidelines recommended antibiotic prophylaxis prior to dental procedures. Unclear definitions and contradictory recommendations in these guidelines have led to unnecessary antibiotic prescriptions. To formulate new guidelines, a joint committee of the Dutch Orthopaedic and Dental Societies conducted a systematic literature review to answer the following question: can antibiotic prophylaxis be recommended for patients (with joint prostheses) undergoing dental procedures in order to prevent dental HPJI? Methods - The Medline, Embase, and Cochrane databases were searched for randomized controlled trials (RCTs), reviews, and observational studies up to July 2015. Studies were included if they involved patients with joint implants undergoing dental procedures, and either considered HPJI as an outcome measure or described a correlation between HPJI and prophylactic antibiotics. A guideline was formulated using the GRADE method and AGREE II guidelines. Results - 9 studies were included in this systematic review. All were rated "very low quality of evidence". Additional literature was therefore consulted to address clinical questions that provide further insight into pathophysiology and risk factors. The 9 studies did not provide evidence that use of antibiotic prophylaxis reduces the incidence of dental HPJI, and the additional literature supported the conclusion that antibiotic prophylaxis should be discouraged in dental procedures. Interpretation - Prophylactic antibiotics in order to prevent dental HPJI should not be prescribed to patients with a normal or an impaired immune system function. Patients are recommended to maintain good oral hygiene and visit the dentist regularly

Oral complications in hematopoietic stem cell recipients: the role of inflammation.

Hematopoietic stem cell transplantation (HSCT) is widely used as a potentially curative treatment for patients with various hematological malignancies, bone marrow failure syndromes, and congenital immune deficiencies. The prevalence of oral complications in both autologous and allogeneic HSCT recipients remains high, despite advances in transplant medicine and in supportive care. Frequently encountered oral complications include mucositis, infections, oral dryness, taste changes, and graft versus host disease in allogeneic HSCT. Oral complications are associated with substantial morbidity and in some cases with increased mortality and may significantly affect quality of life, even many years after HSCT. Inflammatory processes are key in the pathobiology of most oral complications in HSCT recipients. This review article will discuss frequently encountered oral complications associated with HSCT focusing on the inflammatory pathways and inflammatory mediators involved in their pathogenesis.

[Painful submandibular swelling appears to be a rare odontogenic tumour]. / Pijnlijke submandibulaire zwelling blijkt zeldzame odontogene tumor.

A 15-year-old girl was referred to an oral and maxillofacial surgeon due to a painful submandibular swelling that had been present for 4 to 5 months. After surgical excision and histopathological examination it appeared to be a relatively rare adenomatoid odontogenic tumour. Approximately 4.6% of all odontogenic tumours are adenomatoid odontogenic tumours. This type of tumour is mainly diagnosed between the ages of 10 and 30. Surgical excision is an effective treatment and the adenomatoid odontogenic tumour has a favourable prognosis. The most recent article in Dutch literature on the adenomatoid odontogenic tumour dates back to 1975.