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Zahiu SG, Fratila O. Assessment of Systemic Condition and Smoking Impact Over Incidence of Apical Periodontitis. Cureus 2024; 16:e55250. [PMID: 38558659 PMCID: PMC10981472 DOI: 10.7759/cureus.55250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/29/2024] [Indexed: 04/04/2024] Open
Abstract
This study aimed to assess the prevalence of apical periodontitis in a subset of the population of south-eastern Romania and to analyze the overall health status of the group of patients with apical periodontitis. The medical and dental history, including age, gender, background, presence of smoking, level of education, the total number of teeth present and with apical periodontitis, and the general health status were recorded from a total of 200 patients. The periapical status was analyzed using an orthopantomogram and periapical radiographs of teeth that were diagnosed with periapical lesions by the same dental professional. The periapical status was classified according to the periapical index (PAI), with apical periodontitis being present if the PAI score ≥3. The majority of patients were female (58.5%), with secondary or higher education from urban areas and the mean number of teeth with apical periodontitis was 2.29 ± 1.26, with a median of 2 teeth. A total of 17.1% of patients were smokers, these patients had two more teeth with periapical pathology, and 16% of all patients had general diseases, the most common of which was cardiovascular disease (8.2%). Compared with those without the disease, these patients had a higher number of teeth with apical periodontitis (median = 2.5, IQR = 2-4 vs. median = 2, IQR = 1-3). As a result, this scientific research suggests an association between smoking, cardiovascular disease, and gastritis with apical periodontitis, but no association could be demonstrated between apical periodontitis and other systemic diseases.
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Affiliation(s)
- Sorina G Zahiu
- Doctoral School of Biomedical Sciences, University of Oradea, Oradea, ROU
| | - Ovidiu Fratila
- Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, Oradea, ROU
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Ullah M, Irshad M, Yaacoub A, Carter E, Thorpe A, Zoellner H, Cox S. Dental Infection Requiring Hospitalisation Is a Public Health Problem in Australia: A Systematic Review Demonstrating an Urgent Need for Published Data. Dent J (Basel) 2023; 11:dj11040097. [PMID: 37185475 PMCID: PMC10136976 DOI: 10.3390/dj11040097] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 03/11/2023] [Accepted: 03/28/2023] [Indexed: 04/07/2023] Open
Abstract
Background: The aim of this systematic review was to analyse the published literature on dental infections leading to hospitalisations in Australia. It was hoped that understanding the patterns and trends would form a basis for improved preventive and management policies. Methods: An electronic search was performed using Web of Science, Medline via Ovid and Google Scholar. Inclusion and exclusion criteria were applied. The included studies were analysed for demographics, aetiology, management, length of hospital stay and outcome of dental infections requiring hospitalisation. Results: Nine retrospective studies were eligible for inclusion. A total of 2196 cases of dental infections leading to hospitalisations were reported, with a male predominance (55–67%). Mental health issues, illicit substance abuse and immunosuppression were the main associated comorbidities (up to 58%). Dental caries (59–90%) and pericoronitis (10–19%) were the leading causes of dental infections. Empirical antibiotics were utilised in up to 75% of cases prior to hospital presentation. Six mortalities were reported. Conclusions: The available published data show that dental infection is a significant public health problem. However, only general conclusions were possible due to the variably small sample size and data collection that was inconsistent and incomplete across studies. Improved data collection is required to develop policies for prevention and management.
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Affiliation(s)
- Mafaz Ullah
- Discipline of Oral Surgery, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2750, Australia
- Nepean Centre for Oral Health, Nepean Hospital, Nepean Blue Mountains Local Health District, Kingswood, NSW 2747, Australia
| | - Muhammad Irshad
- Department of Oral Pathology, Rehman College of Dentistry, Peshawar 25000, Pakistan
- Specialised Dental Center, Ministry of Health, Sakaka Aljouf 72345, Saudi Arabia
| | - Albert Yaacoub
- Discipline of Oral Surgery, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2750, Australia
- Nepean Centre for Oral Health, Nepean Hospital, Nepean Blue Mountains Local Health District, Kingswood, NSW 2747, Australia
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia
| | - Eric Carter
- Discipline of Oral Surgery, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2750, Australia
- Nepean Centre for Oral Health, Nepean Hospital, Nepean Blue Mountains Local Health District, Kingswood, NSW 2747, Australia
| | - Andrew Thorpe
- Discipline of Oral Surgery, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2750, Australia
| | - Hans Zoellner
- Biomedical Engineering, Faculty of Engineering, The University of Sydney, Sydney, NSW 2006, Australia
- Graduate School of Biomedical Engineering, University of NSW, Kensington, NSW 2052, Australia
- Strongarch Pty Ltd., Pennant Hills, NSW 2120, Australia
| | - Stephen Cox
- Discipline of Oral Surgery, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2750, Australia
- Nepean Centre for Oral Health, Nepean Hospital, Nepean Blue Mountains Local Health District, Kingswood, NSW 2747, Australia
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Jespersen FVB, Hansen SUB, Jensen SS, Omland LH, Helweg-Larsen J, Bjarnsholt T, Nielsen CH, Ziebell M, Bodilsen J, Markvart M. Cerebral abscesses with odontogenic origin: a population-based cohort study. Clin Oral Investig 2023:10.1007/s00784-023-04976-6. [DOI: 10.1007/s00784-023-04976-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 03/21/2023] [Indexed: 04/03/2023]
Abstract
Abstract
Objectives
Recent studies have indicated that cerebral abscess (CA) patients with odontogenic origin are on the rise. However, CA patients are often poorly characterized and with an unknown etiologic background. The purpose of this study is to identify and characterize CA patients that may have an odontogenic origin based on microbiologic, radiographic, and/or clinical findings.
Materials and methods
This is a population-based cohort study analyzing retrospective and prospective data from CA patients. Radiographic examinations of panoramic radiographs (PRs) or computed tomography (CT) scans were conducted. CA patients characterized with odontogenic origin required the fulfilment of the following criteria on admission: (1) Oral pathologic conditions were the only bacterial infections present, (2) oral microorganisms were isolated in the purulent exudate from the brain, and (3) radiographically and/or clinical recordings of oral pathologic conditions.
Results
A total of 44 patients could be included in this study of which 25 (57%) were characterized as having CA with a likely odontogenic origin. Type two diabetes (T2D) (p = 0.014) and microorganisms of the Streptococcus anginosus group (SAG) (p < 0.01) were overrepresented in patients with CAs of odontogenic origin.
Conclusions
Odontogenic infections may cause CAs to a greater extent than previously assumed. T2D was overrepresented among patients with odontogenic CA. When microorganisms of the SAG were isolated from the brain pus, CA patients had a predisposing odontogenic or sinus infection.
Clinical relevance
The identification of patients with a likely odontogenic CA will contribute to understanding the etiology of the infectious disease and highlighting the importance of preserving oral health.
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EKİCİ Ö. Epidemiological Analysis and Management of Patients with Facial Space Infections of Odontogenic Origin: A Retrospective Evaluation of Two Years. CLINICAL AND EXPERIMENTAL HEALTH SCIENCES 2022. [DOI: 10.33808/clinexphealthsci.994256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2023]
Abstract
Objective: Odontogenic infections are one of the most common pathologies in the oral and maxillofacial regions. The spread of odontogenic infections after unsuccessful or late treatment can lead to serious complications. The aim of this study is to examine the epidemiological features and treatment management of patients with odontogenic facial abscesses.
Methods: This retrospective study included 88 patients with odontogenic facial area abscesses treated at Afyonkarahisar health sciences university, faculty of dentistry’s maxillofacial surgery clinic between 2019-2021. The socio-demographic, socio-economic characteristics and clinical examination findings of the patients and treatment methods for odontogenic abscess were analyzed comprehensively. Data were
evaluated using SPSS-20 and the level of significance was set at p < .05.
Results: In the two-year period between 2019 and 2021, 88 patients (44 male and 44 female, mean age was 39.72±16.42) were treated for diffuse facial infections of odontogenic origin. The most commonly involved area was the submandibular area (38.6%), the most affected tooth was mandibular 1st molar and mandibular 3rd molars (18.2%), and the most common cause was dental caries (65.90%). Incision and drainage were performed in half of the patients (36.4% intraoral, 13.6% extraoral). The most commonly used drugs were clindamycin (36.4%), amoxicillin-clavulanate, and ornidazole combination (27.3%).
Conclusion: The results of this study confirm that odontogenic abscesses can heal without complications with timely and effective basic interventions such as incision and drainage. In this study, successful results were obtained with the parenteral clindamycin, and a combination of oral amoxicillin-clavulanate and ornidazole in the treatment of odontogenic abscesses.
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Affiliation(s)
- Ömer EKİCİ
- AFYONKARAHİSAR SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, DİŞ HEKİMLİĞİ FAKÜLTESİ, KLİNİK BİLİMLER BÖLÜMÜ, AĞIZ, DİŞ VE ÇENE CERRAHİSİ ANABİLİM DALI
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Evolution of the treatment of severe odontogenic infections over 50 years: A comprehensive review. J Taibah Univ Med Sci 2022; 18:225-233. [PMID: 36817218 PMCID: PMC9926117 DOI: 10.1016/j.jtumed.2022.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 07/25/2022] [Accepted: 08/30/2022] [Indexed: 11/23/2022] Open
Abstract
Objectives Severe odontogenic infections remain a challenge for maxillofacial surgeons. The aim of this work is to review the literature to provide an update of knowledge on the topic. Methods A comprehensive review of articles in PubMed, Web of Science and Africa Journals Online was performed through searching for "severe odontogenic infections." No language restrictions were applied. Only articles pertaining to treatment options were retrieved. Articles from the past 50 years were included. Results A total of 84 articles from 39 countries worldwide were included. Severe odontogenic infections are not unique to low- and middle-income countries but also pose challenges in developed countries. Surgical management and antibiotic therapy for this type of infection is discussed. Some immunocompromised patients have high risks of complications and mortality rates. A world map of publications on the topic is provided. Conclusions Several important aspects of managing severe odontogenic infections are discussed. Predictors of severity in addition to recommended antibiotic choice have been debated. Diabetes mellitus is a poor predictor of the prognosis of odontogenic infections.
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Parara E, Krasadakis C, Toursounidis I, Tsekoura K, Mourouzis C, Rallis G. Significant rise in neck infections progressing to descending necrotizing mediastinitis during the COVID-19 pandemic quarantine. J Craniomaxillofac Surg 2021; 49:1182-1186. [PMID: 34246538 PMCID: PMC8254394 DOI: 10.1016/j.jcms.2021.06.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 06/05/2021] [Accepted: 06/30/2021] [Indexed: 12/23/2022] Open
Abstract
To present five patients with DNM, who were treated during the first quarantine for Coronavirus disease 2019 (Covid-19). Five patients with DNM were treated in our department during the first lockdown. The mean age of the patients was 42,2 years and four were male. Two patients were immunocompromised. Repeated surgical drainage was performed in all patients, whereas four were also subjected to elective tracheostomy during their first operation. The mean hospitalization duration was 55,4 days and mortality was 40%. During the first lockdown for the Covid-19, a rise in the ratio of DNM cases to the overall incidence of cervicofacial infections was observed in our department. All patients with DNM were operated on an emergency basis and were subsequently admitted to the ICU. We consider the effect of the quarantine as a decisive factor for this escalation, because according to the department archives, there had not been any cases of DNM originating from a dental infection, for the past 5 years. Additionally, past studies from the same department reported no more than 6 cases over a 10 year period.
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Affiliation(s)
- Eleni Parara
- Oral and Maxillofacial Surgery Department, KAT General Hospital of Attica, 2 Nikis street, 14561, Attica, Greece.
| | - Christos Krasadakis
- Oral and Maxillofacial Surgery Department, KAT General Hospital of Attica, 2 Nikis street, 14561, Attica, Greece
| | - Iordanis Toursounidis
- Oral and Maxillofacial Surgery Department, KAT General Hospital of Attica, 2 Nikis street, 14561, Attica, Greece
| | - Konstantina Tsekoura
- Oral and Maxillofacial Surgery Department, KAT General Hospital of Attica, 2 Nikis street, 14561, Attica, Greece
| | - Constantinos Mourouzis
- Oral and Maxillofacial Surgery Department, KAT General Hospital of Attica, 2 Nikis street, 14561, Attica, Greece
| | - George Rallis
- Oral and Maxillofacial Surgery Department, KAT General Hospital of Attica, 2 Nikis street, 14561, Attica, Greece
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Caruso SR, Yamaguchi E, Portnof JE. Update on Antimicrobial Therapy in Management of Acute Odontogenic Infection in Oral and Maxillofacial Surgery. Oral Maxillofac Surg Clin North Am 2021; 34:169-177. [PMID: 34728145 DOI: 10.1016/j.coms.2021.08.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
This article focuses on the antimicrobial therapy of head and neck infections from odontogenic origin. Odontogenic infections are among the most common infections of the oral cavity. They are sourced primarily from dental caries and periodontal disease (gingivitis and periodontitis). Many odontogenic infections are self-limiting and may drain spontaneously. However, these infections may drain into the anatomic spaces adjacent to the oral cavity and spread along the contiguous facial planes, leading to more serious infections. Antibiotics are an important aspect of care of the patient with an acute odontogenic infection. Antibiotics are not a substitute for definitive surgical management.
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Affiliation(s)
- Sam R Caruso
- Department of Oral & Maxillofacial Surgery, Broward Health Medical Center, Nova Southeastern University College of Dental Medicine, 1600 S. Andrews Avenue, Fort Lauderdale, FL 33301, USA.
| | - Elena Yamaguchi
- Private Practice, Infectious Diseases, 13550 South Jog Rd, Suite 202A, Delray, FL 33446, USA
| | - Jason E Portnof
- Department of Oral & Maxillofacial Surgery, Nova Southeastern University College of Dental Medicine, 3200 S. University Dr., Davie, FL 33314, USA; Private Practice, Oral & Maxillofacial Surgery, Surgical Arts of Boca Raton, 9980 North Central Park Bvld, Suite #113, Boca Raton, FL 33428, USA
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8
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Formulas, Algorithms and Examples for Binomial Distributed Data Confidence Interval Calculation: Excess Risk, Relative Risk and Odds Ratio. MATHEMATICS 2021. [DOI: 10.3390/math9192506] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Medical studies often involve a comparison between two outcomes, each collected from a sample. The probability associated with, and confidence in the result of the study is of most importance, since one may argue that having been wrong with a percent could be what killed a patient. Sampling is usually done from a finite and discrete population and it follows a Bernoulli trial, leading to a contingency of two binomially distributed samples (better known as 2×2 contingency table). Current guidelines recommend reporting relative measures of association (such as the relative risk and odds ratio) in conjunction with absolute measures of association (which include risk difference or excess risk). Because the distribution is discrete, the evaluation of the exact confidence interval for either of those measures of association is a mathematical challenge. Some alternate scenarios were analyzed (continuous vs. discrete; hypergeometric vs. binomial), and in the main case—bivariate binomial experiment—a strategy for providing exact p-values and confidence intervals is proposed. Algorithms implementing the strategy are given.
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Juncar RI, Precup AI, Juncar M. Immediate implant-prosthetic dental rehabilitation of patients with diabetes using four immediately loaded dental implants: a pilot study. J Int Med Res 2021; 48:300060519897195. [PMID: 32228306 PMCID: PMC7133089 DOI: 10.1177/0300060519897195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Objectives Type 2 diabetes mellitus (T2DM) involves endocrine changes that cause a persistent increase in blood glucose. Many disorders are associated with T2DM, including disorders that affect the oral cavity. Oral cavity disorders interfere with a patient’s capacity to follow a correct diet, which results in worsening systemic disease. Oral rehabilitation is necessary for patients with T2DM. Therefore, this prospective study was performed to evaluate the immediate dental rehabilitation capacity of patients with T2DM using four immediately loaded dental implants. Methods In this prospective study, four implants each were placed in four patients with T2DM and loaded within 24 hours. Demographic characteristics were assessed at baseline; systemic and oral health parameters were assessed at baseline and at 6 months after implant placement. Results The mean glycated hemoglobin (HbA1c) level was 7.05% (range, 6.8%–7.3%). The mean Implant Stability Quotient of the dental implants was 74.5 (range, 67–85). Postoperative evolution was favorable: only one implant exhibited inflammation of the prosthetic stump. Conclusions Immediate prosthetic rehabilitation using four maxillary dental implants was an effective treatment modality for patients with T2DM in this study. Larger studies are needed to confirm these findings.
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Affiliation(s)
- Raluca-Iulia Juncar
- Department of Prosthetics, Department of Dental Medicine, Faculty of Medicine and Pharmacy, University of Oradea, Oradea, Romania
| | - Alexandru-Iosif Precup
- Oral and Maxillofacial Surgery, Department of Dental Medicine, Faculty of Medicine and Pharmacy, University of Oradea, Oradea, Romania
| | - Mihai Juncar
- Oral and Maxillofacial Surgery, Department of Dental Medicine, Faculty of Medicine and Pharmacy, University of Oradea, Oradea, Romania
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Weise H, Naros A, Weise C, Reinert S, Hoefert S. Severe odontogenic infections with septic progress - a constant and increasing challenge: a retrospective analysis. BMC Oral Health 2019; 19:173. [PMID: 31375095 PMCID: PMC6679486 DOI: 10.1186/s12903-019-0866-6] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 07/26/2019] [Indexed: 12/01/2022] Open
Abstract
Background More than 90% of all infections in the head and neck region can be traced back to an odontogenic origin. In rare cases they can lead to sepsis, which may pose a vital threat to the patient. The purpose of this study was to analyse characteristics concerning etiology and progress of severe odontogenic infections with a fulminant development. Methods All patients with odontogenic infections requiring hospital admission were included in a retrospective analysis conducted from 02/2012 to 09/2017. Of 483 patients 16 patients (13 male, 3 female) showed severe exacerbation with septic progress. The average age was 52.8 years. All patients underwent at least one surgical procedure that involved an extraoral incision and drainage as well as high volume irrigation intraoperatively. At least one revision was required for four of the patients. Three patients showed an exceedingly severe disease progression with multiorgan dysfunction syndrome (MODS) and circulatory arrest. Antibiotic treatment was adjusted according to the results of an antibiogram and resistogram. Irrigation with saline was done several times a day. Results Sixteen patients showed odontogenic infections that spread over multiple maxillo-facial and cervical regions accompanied by septic laboratory signs. All these patients needed intensive care and a tracheostomy. The hospitalization period was 27.8 days on average. In 16 cases risk factors for the development of odontogenic abscesses like diabetes mellitus, obesity, chronic alcohol and nicotine abuse, rheumatism and poor oral hygiene were present. Intraoperative swabs showed a typical polymicrobial aerobic and anaerobic spectrum of oral bacteria, especially anaerobes and streptococci, mainly Streptocococcus viridans. Conclusion Odontogenic infections with fulminant progression should be treated based on clinical and imaging data with immediate surgical incision and drainage including elimination of odontogenic foci as well as intensified intra- and postoperative irrigation. If needed, repeat imaging followed by further incisions should be performed. Immediate antibiotic treatment adapted to the antibiogram is of utmost importance. A combination of tazobactam and piperacillin has proven to be a good first choice and can be recommended for abscesses that spread over multiple levels with initial signs of severe infections.
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Affiliation(s)
- H Weise
- Department of Oral and Maxillofacial Surgery, University Hospital Tuebingen, Osianderstrasse 2-8, 72076, Tübingen, Germany.
| | - A Naros
- Department of Oral and Maxillofacial Surgery, University Hospital Tuebingen, Osianderstrasse 2-8, 72076, Tübingen, Germany
| | - C Weise
- Department of Orthodontics, University Hospital Tuebingen, Osianderstrasse 2-8, 72076, Tübingen, Germany
| | - S Reinert
- Department of Oral and Maxillofacial Surgery, University Hospital Tuebingen, Osianderstrasse 2-8, 72076, Tübingen, Germany
| | - S Hoefert
- Department of Oral and Maxillofacial Surgery, University Hospital Tuebingen, Osianderstrasse 2-8, 72076, Tübingen, Germany
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Juncar M, Juncar RI, Onisor-Gligor F. Ludwig's angina, a rare complication of mandibular fractures. J Int Med Res 2019; 47:2280-2287. [PMID: 30958072 PMCID: PMC6567769 DOI: 10.1177/0300060519840128] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Accepted: 03/06/2019] [Indexed: 11/25/2022] Open
Abstract
Traumas are a major problem worldwide. A considerable proportion of traumas are located in the cephalic extremity. Neglect of these disorders by patients or those responsible for patient management may result in particularly serious consequences. This paper presents the case of a 58-year-old male patient with an intraorally open mandibular fracture, which left untreated for 3 days, was complicated by Ludwig's angina. Following aggressive surgical treatment during which the mandibular fracture was manually reduced and immobilized with a metal splint fixed with circumdental wires and effective antibiotic therapy, the septic process was terminated and the patient's fracture and infected wound were healed. The correct and rapid treatment of open mandibular fractures is mandatory in order to avoid severe septic complications.
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Affiliation(s)
- Mihai Juncar
- Oral and Maxillofacial Surgery, Department of Dental Medicine, Faculty of Medicine and Pharmacy, University of Oradea, Oradea, Romania
| | - Raluca-Iulia Juncar
- Department of Prosthetics, Department of Dental Medicine, Faculty of Medicine and Pharmacy, University of Oradea, Oradea, Romania
| | - Florin Onisor-Gligor
- Department of Oral and Maxillofacial Surgery, Iuliu Haţieganu University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Cluj, Romania
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12
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Power DJ, Sambrook PJ, Goss AN. The healing of dental extraction sockets in insulin-dependent diabetic patients: a prospective controlled observational study. Aust Dent J 2019; 64:111-116. [PMID: 30525221 DOI: 10.1111/adj.12669] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND The aim of this study was to determine whether there was a difference in delayed healing following dental extractions for insulin-dependent diabetics as compared to non-diabetic patients. METHODS Prospective patients referred to the Adelaide Dental Hospital exodontia clinic for dental extractions were recruited into two groups: Known insulin-dependent diabetics and healthy non-diabetics. All had a random blood glucose level (BGL). Delayed healing cases were identified, and statistical evaluation was performed. RESULTS There were 56 insulin-dependent diabetic patients (BGL 10.03, range 4.9-26) and 49 non-diabetic, age- and sex-matched patients. Seven patients (12.5%) in the study group showed delayed healing following extraction, while only four patients (8.2%) in the control group suffered delayed healing. This difference was not statistically significant. Two of the study group developed postextraction infections, requiring incision, drainage and antibiotics. CONCLUSION The study shows that Type 1 and insulin-dependent Type 2 diabetic patients, if well controlled, tend to heal up well following dental extractions but with a small but not statistically different rate of postextraction complications including infection. This is contrary to what is usually taught. Clinicians should take great care with management of insulin-dependent diabetic patients, as compared to non-insulin dependent diabetics or non-diabetic patients.
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Affiliation(s)
- D J Power
- Oral and Maxillofacial Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - P J Sambrook
- Oral and Maxillofacial Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia
- School of Dentistry, The University of Adelaide, Adelaide, South Australia, Australia
| | - A N Goss
- Oral and Maxillofacial Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia
- School of Dentistry, The University of Adelaide, Adelaide, South Australia, Australia
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Jagadish Chandra H, Sripathi Rao BH, Muhammed Manzoor AP, Arun AB. Characterization and Antibiotic Sensitivity Profile of Bacteria in Orofacial Abscesses of Odontogenic Origin. J Maxillofac Oral Surg 2016; 16:445-452. [PMID: 29038627 DOI: 10.1007/s12663-016-0966-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Accepted: 09/16/2016] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Odontogenic infections range from peripheral abscess to superficial and deep infections leading to severe infections in head and neck region. This study was aimed to assess bacterial isolates responsible for orofacial infection of odontogenic origin and their drug susceptibility patterns so as to provide better perceptive for the management of odontogenic infections. METHODS The study was made in a selected cohort of patients, irrespective of age and gender having moderate and severe orofacial infections of odontogenic origin admitted to Yenepoya University Hospital. Pus samples were collected and identification of bacteria was performed by 16S rRNA gene sequencing. Antimicrobial susceptibility testing was performed by Kirby-Bauer disc diffusion method. RESULT A total of 37 study subjects were included, with bacterial isolation rate of 31 (83.7 %). The mean age presented of all patients was 40.62. Of all, 24 (64.9 %) were males. Staphylococcus aureus, Enterobacter claocae subsp. dissolvens, Klebsiella quasipneumoniae subsp. similipneumoniae, Staphylococcus aureus subsp. anaerobius and Klebsiella pneumoniae subsp. ozaenae were the most prevalent isolates. Result showed that 58.6 % of the isolates were resistant to gentamicin, 52.5 % for ampicillin, 51.3 % for piperacillin; least resistant being 18.9 % for azithromycin. CONCLUSION High prevalence of bacterial isolates was found, Staphylococcus aureus being the dominant. Most of the bacteria were resistant to different classes of antibiotics. Appropriate antibiotics should be given based on the bacterial isolates, culture sensitivity and clinical course of the disease.
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Affiliation(s)
- H Jagadish Chandra
- Department of Oral and Maxillofacial Surgery, Yenepoya Dental College, Yenepoya University, Deralakatte, Mangalore, 575018 India
| | - B H Sripathi Rao
- Department of Oral and Maxillofacial Surgery, Yenepoya Dental College, Yenepoya University, Deralakatte, Mangalore, 575018 India
| | - A P Muhammed Manzoor
- Yenepoya Research Centre, Yenepoya University, Deralakatte, Mangalore, 575018 India
| | - A B Arun
- Yenepoya Research Centre, Yenepoya University, Deralakatte, Mangalore, 575018 India
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Juncar M, OniȘor-Gligor F, Bran S, Juncar RI, BăciuȚ MF, DumitraȘcu DI, BăciuȚ G, Moldovan I. Efficiency of Empirically Administered Antibiotics in Patients with Cervical Infections of Odontogenic Origin. Med Pharm Rep 2015; 88:65-8. [PMID: 26528050 PMCID: PMC4508612 DOI: 10.15386/cjmed-399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2015] [Accepted: 01/19/2015] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND AND AIMS Odontogenic infections are among the main types of disorders located in the cephalic extremity. The aim of this study was to determine the efficiency of empirically administered antibiotics on the bacterial strains identified at the infection sites. PATIENTS AND METHOD The study included 10 randomly selected patients with odontogenic cervical soft tissue infections, who received antibiotic treatment prescribed by the family doctor or the dentist. The bacterial flora involved in the development of the septic process, the type of antibiotic administered to the patient and the sensitivity of the identified bacterial flora to the administered antibiotic were determined. RESULTS In the 10 selected patients, 14 bacterial strains were detected; 7 patients had a single bacterial strain, and 3 patients had two or three types of bacteria. Of the administered antibiotics, amoxicillin was the most widely used (33.3% of the cases), followed by amoxicillin with beta-lactamase inhibitors (25% of the cases). In half of the patients, there was no sensitivity of the bacteria detected in the septic focus to the empirically administered antibiotic, and in 10% of the cases, partial sensitivity was evidenced. CONCLUSIONS Empirical administration of antibiotics without the association of surgery did not prove to be effective in the treatment of cervical infections of odontogenic origin.
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Affiliation(s)
- Mihai Juncar
- Department of Oral and Maxillofacial Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Florin OniȘor-Gligor
- Department of Oral and Maxillofacial Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Simion Bran
- Department of Maxillofacial Implantology and Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Raluca-Iulia Juncar
- Department of Prosthetics, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Mihaela-Felicia BăciuȚ
- Department of Maxillofacial Implantology and Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Dinu-Iuliu DumitraȘcu
- Department of Anatomy and Embryology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Grigore BăciuȚ
- Department of Oral and Maxillofacial Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Iuliu Moldovan
- Department of Oral and Maxillofacial Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
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Opitz D, Camerer C, Camerer DM, Raguse JD, Menneking H, Hoffmeister B, Adolphs N. Incidence and management of severe odontogenic infections-a retrospective analysis from 2004 to 2011. J Craniomaxillofac Surg 2014; 43:285-9. [PMID: 25555896 DOI: 10.1016/j.jcms.2014.12.002] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Revised: 11/13/2014] [Accepted: 12/01/2014] [Indexed: 10/24/2022] Open
Abstract
The management of odontogenic infections is a typical part of the spectrum of maxillofacial surgery. Normally these infections can be managed in a straight forward way however under certain conditions severe and complicated courses can arise which require interdisciplinary treatment including intensive care. A retrospective analysis of all patients affected by an odontogenic infection that received surgical therapy from 2004 to 2011 under stationary conditions was performed. Surgical treatment consisted in incision and drainage of the abscess supported by additional i.v. antibiotic medication in all patients. Detailed analysis of all patients that required postoperative intensive medical care was additionally performed with respect to special risk factors. During 8 years 814 patients affected by odontogenic infections received surgical treatment under stationary conditions representing 4% of all patients that have been treated during that period (n = 18981). In 14 patients (1.7%) intensive medical therapy after surgery was required, one lethal outcome was documented (0.12%). In all of these 14 patients a history of typical risk factors was present. According to these results two patients per week affected by an odontogenic infection required stationary surgical treatment, about two patients per year were likely to require additional intensive medical care. If well-known risk factors are present in patients affected by odontogenic infection appropriate interdisciplinary management should be considered as early as possible.
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Affiliation(s)
- Daniel Opitz
- Department of Craniomaxillofacial Surgery (Head: Prof. Dr. med. Dr. med. dent. Bodo Hoffmeister), Clinical Navigation, University Hospital Charité, Campus Virchow-Klinikum, Augustenburger Platz 1, D-13353 Berlin, Germany.
| | - Christian Camerer
- Department of Craniomaxillofacial Surgery (Head: Prof. Dr. med. Dr. med. dent. Bodo Hoffmeister), Clinical Navigation, University Hospital Charité, Campus Virchow-Klinikum, Augustenburger Platz 1, D-13353 Berlin, Germany
| | - Doris-Maria Camerer
- Department of Craniomaxillofacial Surgery (Head: Prof. Dr. med. Dr. med. dent. Bodo Hoffmeister), Clinical Navigation, University Hospital Charité, Campus Virchow-Klinikum, Augustenburger Platz 1, D-13353 Berlin, Germany
| | - Jan-Dirk Raguse
- Department of Craniomaxillofacial Surgery (Head: Prof. Dr. med. Dr. med. dent. Bodo Hoffmeister), Clinical Navigation, University Hospital Charité, Campus Virchow-Klinikum, Augustenburger Platz 1, D-13353 Berlin, Germany
| | - Horst Menneking
- Department of Craniomaxillofacial Surgery (Head: Prof. Dr. med. Dr. med. dent. Bodo Hoffmeister), Clinical Navigation, University Hospital Charité, Campus Virchow-Klinikum, Augustenburger Platz 1, D-13353 Berlin, Germany
| | - Bodo Hoffmeister
- Department of Craniomaxillofacial Surgery (Head: Prof. Dr. med. Dr. med. dent. Bodo Hoffmeister), Clinical Navigation, University Hospital Charité, Campus Virchow-Klinikum, Augustenburger Platz 1, D-13353 Berlin, Germany
| | - Nicolai Adolphs
- Department of Craniomaxillofacial Surgery (Head: Prof. Dr. med. Dr. med. dent. Bodo Hoffmeister), Clinical Navigation, University Hospital Charité, Campus Virchow-Klinikum, Augustenburger Platz 1, D-13353 Berlin, Germany
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The value of early intraoral incisions in patients with perimandibular odontogenic maxillofacial abscesses. J Craniomaxillofac Surg 2014; 43:220-3. [PMID: 25523398 DOI: 10.1016/j.jcms.2014.11.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Revised: 11/12/2014] [Accepted: 11/12/2014] [Indexed: 11/21/2022] Open
Abstract
Perimandibular abscesses require drainage and removal of the underlying cause of infection. Traditionally drainage was established extraorally, but this can be associated with delay to treatment, because this is done under general anaesthesia. Between July 2008 and June 2013, 205 patients were initially either treated by immediate intraoral incision under local anaesthesia or extraoral incisions under general anaesthesia and prospectively evaluated. Predictors of treatment outcomes and complications were analysed. Fewer secondary procedures were needed for patients with primary treatment under general anaesthesia (p < 0.0001), but the overall stay in hospital was shorter after initial treatment under local anaesthesia (p < 0.0001, Odds Ratio (OR) 0.72, 95% CI 0.62-0.85). Postoperative complications occurred significantly more often under general anaesthesia (p < 0.0001, OR = 16.63, 95% CI 5.59-49.5). Significant prognostic variable was the administration of amoxicillin combined with clavulanic acid (p = 0.016, OR = 1.24, 95% CI 1.09-1.41) and adverse prognostic factors were infections with Human Immunodeficiency Virus (HIV) (p = 0.048, OR 17.45, 95% CI 1.02-298) or diabetes mellitus (p = 0.003, OR 10.39, 95% CI 2.23-48.41). Amoxicillin combined with clavulanic acid showed a significant impact on the treatment course of patients with perimandibular abscesses.
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