Table 5.

Characteristics of the included studies: first author, year and journal of publication, reference number, title, and design. Synthesis of the main conclusion(s) about antimicrobial resistance in dentistry reported in the included studies.

Antimicrobial Resistance in Dentistry
Study Characteristics	Title	Conclusion(s)
Abe, 2022 Front Microbiol [81] Systematic Review with Meta-Analysis	“Antimicrobial resistance of microorganisms present in periodontal diseases: A systematic review and meta-analysis”	No evidence was found for the presence of specific antibiotic resistance profiles in microorganisms implicated in periodontal disease. The highest antibiotic resistance recorded was for ampicillin, while the lowest was for ciprofloxacin.
Abe, 2018 Medicine [82] Systematic Review	“Resistance profile to antimicrobial agents in the main circulating bacteria isolated from acute periodontal and endodontic infections in Latin America (MICROBE- DENT) A systematic review protocol”	Further studies are needed to assess the prevalence of antimicrobial resistance in endodontics and periodontics in Latin America.
Almeida, 2020 PLoS One [83] Cross-sectional	“Bacterial diversity and prevalence of antibiotic resistance genes in the oral microbiome”	No significant differences were found between the taxonomies of healthy or diseased oral microbiomes. However, healthy subjects showed a more diverse microbiological community. At least one antibiotic resistance gene was found in 72.7% of the samples.
Alzahrani, 2020 Risk Manag Healthc Policy [84] Retrospective	“Inappropriate Dental Antibiotic Prescriptions: Potential Driver of the Antimicrobial Resistance in Albaha Region, Saudi Arabia”	Misuse and abuse of antibiotic prescriptions have been found among dentists in Saudi Arabia. The inappropriate use of antibiotics could lead to the development of antibiotic resistance phenomena.
Groppo, 2005 Gen Dent [85] Clinical Trial	“Antimicrobial resistance of Staphylococcus aureus and oral streptococci strains from high-risk endocarditis patients”	Microorganisms causing bacterial endocarditis have shown high rates of antimicrobial resistance to antibiotics commonly used for prophylaxis in dentistry.
Irshad, 2020 Antibiotics (Basel) [86] Clinical Trial	“Characterization and Antimicrobial Susceptibility of Pathogens Associated with Periodontal Abscess”	The study showed that several bacterial species isolated from periodontal abscesses had high rates of antimicrobial resistance to amoxicillin, tetracyclines, and metronidazole, while azithromycin was not associated with antimicrobial resistance in these cases.
Kiros, 2022 Biomed Res Int [87] Cross-sectional	“Bacterial Profile, Antimicrobial Susceptibility Pattern, and Associated Factors among Dental Caries-Suspected Patients Attending the Ayder Comprehensive Specialized Hospital and Private Dental Clinic in Mekelle, Northern Ethiopia”	The study recorded multidrug resistance of 40.4% of microorganisms associated with dental caries. The highest resistance rate was found for penicillin and tetracyclines.
Lang, 2016 Int J Antimicrob Agents [88] Systematic Review with Meta-Analysis	“Resistance profiles to antimicrobial agents in bacteria isolated from acute endodontic infections: systematic review and meta-analysis”	The study showed that the antibiotic resistance profiles of bacteria causing acute endodontic infections were lower for amoxicillin. In addition, resistance rates increased when multiple cycles of antibiotics were given.
Laumen, 2021 Front Microbiol [89] Clinical Trial	“Sub-Inhibitory Concentrations of Chlorhexidine Induce Resistance to Chlorhexidine and Decrease Antibiotic Susceptibility in Neisseria gonorrhoeae”	The frequent use of chlorhexidine led to an increased rate of resistance of Neisseria gonorrhoeae to chlorhexidine itself and other antibiotics.
Rodrigues, 2004 J Clin Periodontol [90] Clinical Trial	“Antibiotic resistance profile of the subgingival microbiota following systemic or local tetracycline therapy”	Local or systemic administration of tetracycline in subjects with chronic periodontitis resulted in the transient selection of subgingival microorganisms intrinsically resistant to tetracycline itself.
Santos, 2002 Anaerobe [91] Clinical Trial	“Susceptibility of Prevotella intermedia/Prevotella nigrescens (and Porphyromonas gingivalis) to propolis (bee glue) and other antimicrobial agents”	Prevotella intermedia and Prevotella nigrescens were susceptible to penicillins, meropenem, erythromycin, and metronidazole, while a smaller percentage were susceptible to tetracyclines and a considerable number were resistant to clindamycin. Propolis was an effective alternative to periodontal pathogens.
van Winkelhoff, 2000 J Clin Periodontol [92] Comparative Study	“Antimicrobial resistance in the subgingival microflora in patients with adult periodontitis. A comparison between The Netherlands and Spain”	The increased use of antibiotics in Spain has led to a higher rate of antibiotic resistance of subgingival microorganisms in adult subjects with periodontitis. The resistance rate was found to be much lower among Dutch patients.
Vijayashree, 2018 J Clin Diagnostic Res [93] Retrospective	“Enterococcus faecalis an Emerging Microbial Menace in Dentistry-An Insight into the In silico Detection of Drug Resistant Genes and Its Protein Diversity”	Enterococcus Faecalis has been associated with endodontic and periodontal infections. The study showed that the bacterial genome hosts one or more genes encoding resistance to the most common antibiotics used in dentistry.