Evidence-Based Antibiotic Protocols and Digital Innovation in Oral Infection Management: Optimizing Use Through Teledentistry and Modern Diagnostics

A special issue of Antibiotics (ISSN 2079-6382). This special issue belongs to the section "Antibiotics Use and Antimicrobial Stewardship".

Deadline for manuscript submissions: 31 July 2026 | Viewed by 2729

Special Issue Editor


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Guest Editor
Department of Innovative Technologies in Medicine and Dentistry, University “G.d’Annunzio” of Chieti-Pescara, Chieti, Italy
Interests: digital dentistry; CAD-CAM; oral health; prosthodontics; oral surgery; dental implant

Special Issue Information

Dear Colleagues,

The global burden of oral diseases is growing, and is associated with significant impacts on patients’ quality of life. The presence of plaque-associated biofilm, along with rising antibiotic resistance, poses a substantial challenge in both the prevention and management of oral infections. Early and accurate diagnosis plays a key role in improving clinical outcomes and reducing the risk of infection recurrence. Depending on the patient’s clinical condition and the characteristics of the resident oral microbiota, the required treatment may involve systemic antibiotic therapy either alone or in combination with dental procedures. There are multiple antibiotic regimens currently in use, with the choice and duration of treatment varying based on the severity and extent of the infection. Timely antibiotic intervention is essential to prevent biofilm formation, which can exacerbate inflammatory responses and promote dysbiosis. A combined approach which integrates systemic antibiotics alongside localized delivery may provide an enhanced solution to oral infections. The selection and dosage of antibiotics must be carefully evaluated, with consideration of their synergistic or antagonistic interactions and their effects on the host’s microbiota.

While antibiotics remain a valuable adjunct in the treatment of oral infections, their use also presents challenges. In the post-SARS-CoV-2 era, antibiotic stewardship has become increasingly important, influencing clinical decision-making and protocols for anticipating and managing potential secondary infections.

Modern dentistry is progressively integrating digital tools to enhance both disease prevention and care delivery. Technologies such as teledentistry and telemedicine are playing an increasingly relevant role in early diagnosis, patient education, follow-up, and therapeutic monitoring, particularly in underserved or remote areas. These innovations not only facilitate access to dental care, but also support clinicians in adopting more targeted and timely antibiotic strategies, ultimately reducing unnecessary prescriptions and limiting the development of resistance.

This Special Issue invites contributions of original research articles, reviews, and clinical reports exploring innovative, evidence-based approaches to antibiotic use in oral healthcare. Topics of interest include, but are not limited to, the following:

  • Antimicrobial stewardship in dental settings;
  • Qualitative and quantitative research on the determinants of antibiotic use and resistance;
  • Rational antibiotic use related to oral and maxillofacial infections;
  • Novel diagnostic tools and methods for assessing antibiotic resistance;
  • Patterns of antibiotic misuse and their implications for resistance;
  • Drug–drug interactions and pharmacotherapeutic considerations in dentistry;
  • Antibiotic intake and its role in secondary infections of oral origin;
  • Clinical signs and adverse effects of inappropriate antibiotic use in dental practice;
  • The role of digital health, telemedicine, and teledentistry in infection prevention and antibiotic management.

Dr. Manlio Santilli
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

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Keywords

  • antibiotics
  • dental infections
  • oral infections
  • antibacterial resistance
  • telemedicine
  • teledentistry
  • antimicrobial management
  • AI-related

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Published Papers (2 papers)

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Research

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13 pages, 253 KB  
Article
Study on the Importance of Hygienic Hand Disinfection of Dental Practitioners and Students as an Infection Control Measure in Dental Practice
by Veselina Kondeva, Velina Stoeva, Yordan Kalchev and Rumyana Stoyanova
Antibiotics 2026, 15(2), 205; https://doi.org/10.3390/antibiotics15020205 - 13 Feb 2026
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Abstract
The hands of dental students and practitioners are a key epidemiological factor in the transmission of infections associated with dental care. Strict adherence to the established hand hygiene protocols, combined with regular training and monitoring the quality of the performed hygienic hand disinfection, [...] Read more.
The hands of dental students and practitioners are a key epidemiological factor in the transmission of infections associated with dental care. Strict adherence to the established hand hygiene protocols, combined with regular training and monitoring the quality of the performed hygienic hand disinfection, is crucial for ensuring safe dental practice. Objectives: The aim of the study is to assess the quality of hand antisepsis performed with alcohol-containing preparation among dental students and practicing dentists. Methods: A prospective epidemiological and microbiological study was conducted on 225 people—149 students from the 4th, 5th and 6th year of training at the Faculty of Dental Medicine, Plovdiv, and 76 dentists. The skin antiseptic was applied according to the “six steps” method with alcohol-based antiseptics. The samples were taken with a dry sterile swab. Results: The comparison between students and practicing dental medical doctors shows that the latter have a higher relative share of samples with microbiological growth 12 (15.8%), including coagulase-negative staphylococci (CoNS) above 105 CoNS, compared to students 6 (4.0%), (p = 0.004). Gram-negative microbiological isolates indicate a statistically significant gender dependence (p = 0.016)—15 in men (15.8%), compared to 7 in women (5.4%). Growth of fungi (yeasts and mols) is statistically significant depending on gender (p = 0.015) and is observed only in men. Conclusions: The presence of significant microbial counts of CoNS is an indicator of insufficiently effective hygienic hand disinfection. The recovery of Gram-negative enteric bacteria is unacceptable and suggests serious shortcomings in the hygienic disinfection of some of the samples studied. Students demonstrated superior hand antisepsis performance compared to practicing dentists. Full article

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21 pages, 878 KB  
Systematic Review
Over-Prescription of Antibiotics for Pulpitis: A Systematic Review and Meta-Analysis of Cross-Sectional Surveys
by Vanessa Delgado-Giugni, María León-López, Isabel Crespo-Gallardo, Juan J. Saúco-Márquez, Paloma Montero-Miralles, Jenifer Martín-González, Daniel Cabanillas-Balsera and Juan J. Segura-Egea
Antibiotics 2026, 15(1), 13; https://doi.org/10.3390/antibiotics15010013 - 20 Dec 2025
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Abstract
Background: Pulpitis requires operative dental treatment, and antibiotics are not indicated. Nevertheless, inappropriate antibiotic prescribing persists worldwide. This systematic review and meta-analysis evaluated the prevalence of antibiotic prescription for pulpitis among dentists. Methods: A systematic search of MEDLINE/PubMed, Web of Science, Scopus, Embase, [...] Read more.
Background: Pulpitis requires operative dental treatment, and antibiotics are not indicated. Nevertheless, inappropriate antibiotic prescribing persists worldwide. This systematic review and meta-analysis evaluated the prevalence of antibiotic prescription for pulpitis among dentists. Methods: A systematic search of MEDLINE/PubMed, Web of Science, Scopus, Embase, and ProQuest (2015–2025) was performed according to PRISMA guidelines. Observational studies reporting the proportion of dentists prescribing systemic antibiotics for pulpitis were included. Random-effects meta-analyses estimated pooled prevalence for all clinicians, general dental practitioners (GDPs), and endodontists (ENs). Risk of bias was assessed using a modified Newcastle–Ottawa Scale, and certainty of evidence was rated with GRADE. Results: Twelve cross-sectional studies met the inclusion criteria, including 3189 dentists. The overall pooled prevalence of antibiotic prescribing for pulpitis was 19.2% (95% CI: 10.4–32.6%), with very high heterogeneity (I2 = 98%). GDPs exhibited significantly higher prescribing rates (26.9%, 95% CI: 14.9–43.5%; I2 = 98%) compared with ENs (5.1%, 95% CI: 1.2–19.2%; I2 = 92%). Sensitivity analysis excluding two high-prevalence studies reduced the pooled estimate to 13.3% (95% CI: 8.0–21.3%) but heterogeneity remained substantial (I2 = 95%). Most studies showed moderate-to-high risk of bias, and the certainty of evidence was graded as very low due to inconsistency, indirectness, imprecision, and potential publication bias. Conclusions: Approximately one in five dentists prescribe antibiotics for pulpitis, despite strong guideline recommendations against their use. However, certainty of evidence was very low. Marked variability across regions and clinical profiles highlights persistent gaps in diagnostic accuracy, access to emergency dental care, and antibiotic stewardship. Targeted education, improved urgent care pathways, and strengthened antimicrobial stewardship programs are needed to reduce unnecessary antibiotic use in pulpitis. Full article
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