Medical Emergencies · single question
A patient has infective endocarditis history. For which condition do we NOT need to give antibiotic prophylaxis?
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Correct answer: B. Class I restoration (simple composite/amalgam)
- A. Intraligamentary (periodontal ligament) injections DO require prophylaxis in high-risk patients because they directly inject into the periodontal ligament which can cause bacteremia.
- B. AHA/ADA 2007 guidelines: antibiotic prophylaxis is NOT needed for restorative procedures (fillings, crown placement) that do NOT involve gingival manipulation or periapical tissue penetration. A CLASS I RESTORATION (simple cavity prep in enamel/dentin not involving the gingival sulcus) does NOT require prophylaxis.
- C. Orthodontic band PLACEMENT (which manipulates gingival tissue during band seating) DOES require prophylaxis. ⚠️ Note: routine orthodontic adjustments do NOT require prophylaxis.
- D. Scaling and root planing (periodontal procedures manipulating subgingival tissue) DO require prophylaxis in high-risk patients.
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