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Matsuo T, Matsuo CN, Matsuo N, Mori A, Murakami M, Ito H. Pericardial Effusion in Association With Periodontitis: Case Report and Review of 8 Patients in Literature. J Investig Med High Impact Case Rep 2024; 12:23247096241239559. [PMID: 38504421 PMCID: PMC10953104 DOI: 10.1177/23247096241239559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 02/27/2024] [Indexed: 03/21/2024] Open
Abstract
Periodontal diseases are well-known background for infective endocarditis. Here, we show that pericardial effusion or pericarditis might have origin also in periodontal diseases. An 86-year-old man with well-controlled hypertension and diabetes mellitus developed asymptomatic increase in pericardial effusion. Two weeks previously, he took oral new quinolone antibiotics for a week because he had painful periodontitis along a dental bridge in the mandibular teeth on the right side and presented cheek swelling. The sputum was positive for Streptococcus species. He was healthy and had a small volume of pericardial effusion for the previous 5 years after drug-eluting coronary stents were inserted at the left anterior descending branch 10 years previously. The differential diagnoses listed for pericardial effusion were infection including tuberculosis, autoimmune diseases, and metastatic malignancy. Thoracic to pelvic computed tomographic scan demonstrated no mass lesions, except for pericardial effusion and a small volume of pleural effusion on the left side. Fluorodeoxyglucose positron emission tomography disclosed many spotty uptakes in the pericardial effusion. The patient denied pericardiocentesis, based on his evaluation of the risk of the procedure. He was thus discharged in several days and followed at outpatient clinic. He underwent dental treatment and pericardial effusion resolved completely in a month. He was healthy in 6 years until the last follow-up at the age of 92 years. We also reviewed 8 patients with pericarditis in association with periodontal diseases in the literature to reveal that periodontal diseases would be the background for developing infective pericarditis and also mediastinitis on some occasions.
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Affiliation(s)
| | | | | | | | | | - Hiroshi Ito
- Okayama University, Japan
- Kawasaki Medical School, Okayama, Japan
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Devakumar H, Tailor B, Law S, Ioannidis D. Deep neck space infection extending to the mediastinum that was treated conservatively. BMJ Case Rep 2022; 15:e250881. [PMID: 36223139 PMCID: PMC9472164 DOI: 10.1136/bcr-2022-250881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Deep neck space infections (DNSIs) are challenging to diagnose and manage. A female ex-smoker presented with difficulty breathing and chest pain. She was initially treated for exacerbation of emphysema with intravenous antibiotics. The ear, nose and throat team were later asked to review the patient for left submandibular swelling and odynophagia. CT of the neck was performed 10 days later, due to limited availability during COVID-19. It showed an extensive retropharyngeal collection from the level of the vallecula to just above the carina. Normally, a DNSI extending to the mediastinum would require prompt surgical management. However, the patient was clinically well once imaged, so the abscess was managed conservatively with intravenous antibiotics.
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Affiliation(s)
| | | | - Sarah Law
- ENT, Colchester General Hospital, Colchester, UK
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McGoldrick DM, Edwards J, Praveen P, Parmar S. Admission patterns and outcomes of patients admitted to critical care in the UK with surgically treated facial infecion: an analysis of the Intensive Care National Audit and Research Centre Case Mix Programme database. Br J Oral Maxillofac Surg 2022; 60:1074-1079. [DOI: 10.1016/j.bjoms.2022.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 03/09/2022] [Accepted: 03/28/2022] [Indexed: 11/25/2022]
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Ajeigbe T, Ria B, Wates E, Mattine S. Severe parapharyngeal abscess that developed significant complications: management during the COVID-19 pandemic. BMJ Case Rep 2020; 13:e236449. [PMID: 33370968 PMCID: PMC10577725 DOI: 10.1136/bcr-2020-236449] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2020] [Indexed: 11/15/2022] Open
Abstract
A 50-year-old Caucasian man presented to the emergency department during the early stages of the COVID-19 pandemic with a rapidly progressive facial swelling, fever, malaise and myalgia. The patient had recently travelled to a COVID-19-prevalent European country and was therefore treated as COVID-19 suspect. The day before, the patient sustained a burn to his left forearm after falling unconscious next to a radiator. A CT neck and thorax showed a parapharyngeal abscess, which was surgically drained, and the patient was discharged following an intensive care admission. He then developed mediastinitis 3 weeks post-discharge which required readmission and transfer to a cardiothoracic unit for surgical drainage. This report discusses the evolution of a deep neck space infection into a mediastinitis, a rare and life-threatening complication, despite early surgical drainage. This report also highlights the difficulties faced with managing patients during the COVID-19 pandemic.
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Affiliation(s)
- Teslimat Ajeigbe
- Oral and Maxillofacial Unit, Worcestershire Royal Hospital, Worcester, Worcestershire, UK
| | - Basmal Ria
- Department of Oral Surgery, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Emma Wates
- University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Samuel Mattine
- Oral and Maxillofacial Unit, Worcestershire Royal Hospital, Worcester, Worcestershire, UK
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Heim N, Jürgensen B, Kramer FJ, Wiedemeyer V. Mapping the microbiological diversity of odontogenic abscess: are we using the right drugs? Clin Oral Investig 2020; 25:187-193. [PMID: 32472254 DOI: 10.1007/s00784-020-03350-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 05/15/2020] [Indexed: 12/15/2022]
Abstract
OBJECTIVES The aim of this study was categorizing the microbial flora and susceptibility to antibiotics and to clarify to which degree the empiric administered antibiotics are suitable for therapy. MATERIALS AND METHODS A 3.5-year retrospective study evaluated hospital records of 206 patients who suffered from head and neck infections of odontogenic origin. All patients underwent surgical incision and drainage and received intravenous antibiotics and inpatient treatment. The specimens were obtained by performing a swab. RESULTS Two hundred six patients were included with 251 strains isolated (1.22 per patient). One hundred eight strains showed antibiotic resistance. Eighty-seven patients showed at least one bacterial strain that showed antibiotic resistance (42.2%). The most frequent isolated bacteria were Streptococcus spp. (n = 116), with a high rate of antibiotic resistance (50.8%). We investigated 205 cases of antibiotic resistance in 87 subjects. Nine bacterial strains showed no susceptibility to unacid (4.3%) and 36 strains to clindamycin (17.5%). CONCLUSION Antibiotic resistance against clindamycin was rather high. The distribution of the afflicted spaces and isolated bacteria was alike recent findings. It is mandatory to understand that immediate surgical treatment in terms of incision and drainage is the basis in abscess treatment. Antibiotic treatment is adjunct therapy. CLINICAL RELEVANCE Streptococcus species were the most frequently identified bacteria presenting antibiotic resistance in more than 50%. Increased resistant rates for clindamycin require reconsiderations regarding an empiric antibiotic treatment.
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Affiliation(s)
- Nils Heim
- Department of Oral & Maxillofacial Plastic Surgery, University Hospital Bonn, Venusberg Campus 1, Haus 11, 2. OG, D-53127, Bonn, Germany.
| | - Benedict Jürgensen
- Department of Oral & Maxillofacial Plastic Surgery, University Hospital Bonn, Venusberg Campus 1, Haus 11, 2. OG, D-53127, Bonn, Germany
| | - Franz-Josef Kramer
- Department of Oral & Maxillofacial Plastic Surgery, University Hospital Bonn, Venusberg Campus 1, Haus 11, 2. OG, D-53127, Bonn, Germany
| | - Valentin Wiedemeyer
- Department of Oral & Maxillofacial Plastic Surgery, University Hospital Bonn, Venusberg Campus 1, Haus 11, 2. OG, D-53127, Bonn, Germany
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Ye WH, Yeghiasarian L, Cutler CW, Bergeron BE, Sidow S, Xu HHK, Niu LN, Ma JZ, Tay FR. Comparison of the use of d-enantiomeric and l-enantiomeric antimicrobial peptides incorporated in a calcium-chelating irrigant against Enterococcus faecalis root canal wall biofilms. J Dent 2019; 91:103231. [PMID: 31712128 DOI: 10.1016/j.jdent.2019.103231] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 11/06/2019] [Accepted: 11/07/2019] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES To compare the anti-biofilm efficacy of two antimicrobial peptides (AMPs), 1018 and DJK-5, in disrupting canal wall biofilms in the isthmus, canal and dentinal tubules of single-rooted maxillary premolars. METHODS Enterococcus faecalis single-species biofilms were formed in-situ in the root canal system of the premolars (n = 91). Confocal laser scanning microscopy, bacterial sampling, colony-forming unit counting, XTT assay, lactate dehydrogenase assay and phenol-sulphuric acid method were used to identify the anti-biofilm efficacy of both AMPs and their influence on bacterial metabolic activity. RESULTS Both AMPs disrupted in-situ E. faecalis biofilms and altered their metabolic activity. At 20 μg/mL, the d-enantiomeric AMP DJK-5 killed 55.5 %, 57.3 % and 55.8 % of biofilm bacteria in the isthmus, canal and dentinal tubules, respectively, in 1 min. In contrast, the l-enantiomeric AMP 1018 only eradicated 25.6 %, 25.5 % and 27.5 % of biofilm bacteria in the isthmus, canal and dentinal tubules, respectively, within the same time. Anti-biofilm efficacy of the root canal irrigants tested were in the order: 6 % NaOCl > 20 μg/mL DJK-5 > 10 μg/mL DJK-5 > 20 μg/mL 1018 > 10 μg/mL 1018 > 0.9 % NaCl. CONCLUSIONS The present results are confirmatory of previous studies, in that d-enantiomeric AMPs exhibit more potent antibacterial properties than l-enantiomeric AMPs against E. faecalis biofilms within the canal space. Nevertheless, the potency of both AMPs are concentration-dependent. Incorporation of these agents into EDTA, a non-antibacterial calcium-chelating irrigant for removal of the inorganic component of the canal space debris, does not reduce the efficacy of either AMP. CLINICAL SIGNIFICANCE The present study provides the proof of concept that incorporation of an antimicrobial peptide into a calcium-chelating root canal irrigant enhances the disinfection of intratubular single-species biofilms during smear layer and smear plug removal.
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Affiliation(s)
- Wei-Hu Ye
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | | | | | - Brian E Bergeron
- The Dental College of Georgia, Augusta University, Augusta, GA, USA
| | - Stephanie Sidow
- The Dental College of Georgia, Augusta University, Augusta, GA, USA
| | - Hockin H K Xu
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD, USA
| | - Li-Na Niu
- The Dental College of Georgia, Augusta University, Augusta, GA, USA; State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, China; The Third Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan, China.
| | - Jing-Zhi Ma
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Franklin R Tay
- The Dental College of Georgia, Augusta University, Augusta, GA, USA.
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The role of immediate versus secondary removal of the odontogenic focus in treatment of deep head and neck space infections. A retrospective analysis of 248 patients. Clin Oral Investig 2019; 23:2921-2927. [PMID: 30623306 DOI: 10.1007/s00784-018-02796-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 12/20/2018] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Aim of this study was to investigate conditions and predisposing factors for head and neck infection progress regarding the length of stay (LOS) in hospital, with special emphasis on the time of removal of the odontogenic infection focus. MATERIAL AND METHODS A 3-year retrospective study reviewed hospital records of 248 subjects who were treated under inpatient conditions with severe odontogenic infections who received surgical incisions, drainage, and intravenous (IV) antibiotics. Outcomes measured included age, gender, involved fascial spaces, LOS, number of infected spaces, antibiotics administered, and comorbidities. We precisely recorded the time between abscess incision and focus extraction. RESULTS Removal of infection focus (tooth) in the same stay (1 stay, n = 106; group 1; mean 6.5 days ± 3) showed significantly higher (p = 0.042) LOS than extraction in a second stay (2 stays, n = 46; group 2; 5.3 ± 3.1). Group 3 patients showed infection after removal of teeth in outpatient management (1 stay ex-op, n = 96) and presented significantly lower LOS (5.6 ± 2.5) compared to group 1 (p = 0.0216). LOS of group 3 to group 2 patients showed no significance (p = 0.668). Infection expansion and diabetes showed a significant increase of LOS. CONCLUSION Simultaneous removal of infection focus and abscess incision leads to the lowest LOS. If tooth extraction is performed after incision, subsequent focus extraction performed in a second stay shows lower overall-LOS than extraction at the same stay at later stage. CLINICAL RELEVANCE Multiple factors tend to increase the LOS of patients with severe head and neck infections of odontogenic origin. Our data reveals the role of removal of odontogenic focus and additionally ranks further parameters that influence the LOS. Based on our findings, decisions regarding the surgical treatment can be recommended.
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Burczynska A, Dziewit L, Decewicz P, Struzycka I, Wroblewska M. Application of Metagenomic Analyses in Dentistry as a Novel Strategy Enabling Complex Insight into Microbial Diversity of the Oral Cavity. Pol J Microbiol 2018; 66:9-15. [PMID: 29359689 DOI: 10.5604/17331331.1234988] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The composition of the oral microbiome in healthy individuals is complex and dynamic, and depends on many factors, such as anatomical location in the oral cavity, diet, oral hygiene habits or host immune responses. It is estimated at present that worldwide about 2 billion people suffer from diseases of the oral cavity, mainly periodontal disease and dental caries. Importantly, the oral microflora involved in local infections may spread and cause systemic, even life-threatening infections. In search for etiological agents of infections in dentistry, traditional approaches are not sufficient, as about 50% of oral bacteria are not cultivable. Instead, metagenomic analyses are particularly useful for studies of the complex oral microbiome - both in healthy individuals, and in patients with oral and dental diseases. In this paper we review the current and future applications of metagenomic studies in evaluation of both the composition of the oral microbiome as well as its potential pathogenic role in infections in dentistry.
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Affiliation(s)
| | - Lukasz Dziewit
- Department of Bacterial Genetics, Institute of Microbiology, Faculty of Biology, University of Warsaw, Poland
| | - Przemysław Decewicz
- Department of Bacterial Genetics, Institute of Microbiology, Faculty of Biology, University of Warsaw, Poland; Research and Development for Life Sciences Ltd., Poland
| | - Izabela Struzycka
- Department of Comprehensive Dental Care, Medical University of Warsaw, Poland
| | - Marta Wroblewska
- Department of Dental Microbiology, Medical University of Warsaw, Poland; Department of Microbiology, Central Clinical Hospital in Warsaw, Poland
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Ricucci D, Loghin S, Siqueira JF. Complicated untreated apical periodontitis causing paraesthesia: A case report. AUST ENDOD J 2017; 44:281-285. [DOI: 10.1111/aej.12220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2017] [Indexed: 01/05/2023]
Affiliation(s)
| | | | - José F. Siqueira
- Department of Endodontics; Faculty of Dentistry; Estácio de Sá University; Rio de Janeiro RJ Brazil
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Cobb M, Little M, Liggins S. Mediastinal abscess and empyema complicating an odontogenic infratemporal fossa abscess. Br J Oral Maxillofac Surg 2016; 55:339-340. [PMID: 27591166 DOI: 10.1016/j.bjoms.2016.08.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Accepted: 08/16/2016] [Indexed: 11/17/2022]
Affiliation(s)
- Mark Cobb
- Newcastle University Medical School, Framlington Place, Newcastle Upon Tyne, NE2 4HH.
| | - Mhairi Little
- ST5, Oral and Maxillofacial Surgery, Royal Victoria Infirmary, Queen Victoria Road, Newcastle Upon Tyne, NE1 4LP.
| | - Steve Liggins
- Locum Consultant, Oral and Maxillofacial Surgery, Broomfield Hospital, Essex, CM1 7ET.
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Agbara R, Obiadazie AC, Ediagbini S, Ernest I. A fatal case of empyema thoracis: the price for underestimating odontogenic infections. ORAL AND MAXILLOFACIAL SURGERY CASES 2016. [DOI: 10.1016/j.omsc.2015.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Abstract
Acute apical abscess is the most common form of dental abscess and is caused by infection of the root canal of the tooth. It is usually localized intraorally, but in some cases the apical abscess may spread and result in severe complications or even mortality. The reasons why dental root canal infections can become symptomatic and evolve to severe spreading and sometimes life-threatening abscesses remain elusive. Studies using culture and advanced molecular microbiology methods for microbial identification in apical abscesses have demonstrated a multispecies community conspicuously dominated by anaerobic bacteria. Species/phylotypes commonly found in these infections belong to the genera Fusobacterium, Parvimonas, Prevotella, Porphyromonas, Dialister, Streptococcus, and Treponema. Advances in DNA sequencing technologies and computational biology have substantially enhanced the knowledge of the microbiota associated with acute apical abscesses and shed some light on the etiopathogeny of this disease. Species richness and abundance and the resulting network of interactions among community members may affect the collective pathogenicity and contribute to the development of acute infections. Disease modifiers, including transient or permanent host-related factors, may also influence the development and severity of acute abscesses. This review focuses on the current evidence about the etiology and treatment of acute apical abscesses and how the process is influenced by host-related factors and proposes future directions in research, diagnosis, and therapeutic approaches to deal with this disease.
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de Queiroz SBF, Curioso PAB, Carvalho FSR, de Lima VN. Submandibular-space abscess from loss of a bonded molar tube during orthognathic surgery. Am J Orthod Dentofacial Orthop 2013; 143:735-7. [PMID: 23631975 DOI: 10.1016/j.ajodo.2012.03.036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2010] [Revised: 03/01/2012] [Accepted: 03/01/2012] [Indexed: 10/26/2022]
Abstract
The use of bonded orthodontic molar tubes is becoming more prevalent in orthodontics because they have some advantages over conventional bonding. However, a bonded apparatus can become detached, leading to complications. This article presents the case of a submandibular-space abscess associated with a molar tube that detached during orthognathic surgery and became embedded in the soft tissues. The site became infected, and antibiotics were prescribed. Eventually, the molar tube migrated and could be removed under local anesthesia.
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Jundt JS, Gutta R. Characteristics and cost impact of severe odontogenic infections. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 114:558-66. [PMID: 22819453 DOI: 10.1016/j.oooo.2011.10.044] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2011] [Revised: 10/16/2011] [Accepted: 10/23/2011] [Indexed: 10/28/2022]
Abstract
OBJECTIVE The objective of this study was to retrospectively analyze the clinical presentation, surgical management, and cost implications of inpatients treated for odontogenic infections at a public tertiary care hospital. STUDY DESIGN Specific analysis from 3 years of chart review included length of stay, cost of hospitalization, site of infection, number of infected spaces, microbiology profile, antibiotics administered, intensive care unit (ICU) stay, number of days intubated, comorbidities, number of operating room visits, imaging studies, and whether the patients received preadmission treatment. RESULTS Multiple fascial spaces were involved in most of the infections. The average length of stay was 4.57 days and average time in the ICU was 3.1 days. Ninety percent of the patients had a coexisting medical comorbidity. The overall hospital costs totaled $749,382 averaging $17,842 per person. CONCLUSIONS This study reveals a staggering cost burden on a public health care facility as a result of odontogenic infections.
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Affiliation(s)
- Jonathon S Jundt
- Department of Oral & Maxillofacial Surgery, University of Texas, Dental Branch at Houston, Houston, Texas, USA
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15
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Occurrence of Odontogenic Infections in Patients Treated in a Postgraduation Program on Maxillofacial Surgery and Traumatology. J Craniofac Surg 2011; 22:1689-94. [DOI: 10.1097/scs.0b013e31822e5c8d] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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16
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Descending Necrotizing Mediastinitis and Facial Palsy as Serial Complications in Orthognathic Surgery. J Craniofac Surg 2011; 22:559-61. [DOI: 10.1097/scs.0b013e318207b51f] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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17
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Kim JH, Ryu DM, Jee YJ, Lee JW, Lee DW. Mediastinitis: a case report. J Korean Assoc Oral Maxillofac Surg 2010. [DOI: 10.5125/jkaoms.2010.36.6.538] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Affiliation(s)
- Jae Hwan Kim
- Department of Oral and Maxillofacial Surgery, Kyung Hee University Dental Hospital at Gangdong, Seoul, Korea
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University, Seoul, Korea
| | - Dong-Mok Ryu
- Department of Oral and Maxillofacial Surgery, Kyung Hee University Dental Hospital at Gangdong, Seoul, Korea
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University, Seoul, Korea
| | - Yu-Jin Jee
- Department of Oral and Maxillofacial Surgery, Kyung Hee University Dental Hospital at Gangdong, Seoul, Korea
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University, Seoul, Korea
| | - Jung-Woo Lee
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University, Seoul, Korea
| | - Deok-Won Lee
- Department of Oral and Maxillofacial Surgery, Kyung Hee University Dental Hospital at Gangdong, Seoul, Korea
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University, Seoul, Korea
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Sato FRL, Hajala FAC, Freire Filho FWV, Moreira RWF, de Moraes M. Eight-year retrospective study of odontogenic origin infections in a postgraduation program on oral and maxillofacial surgery. J Oral Maxillofac Surg 2009; 67:1092-7. [PMID: 19375023 DOI: 10.1016/j.joms.2008.09.008] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2008] [Revised: 08/13/2008] [Accepted: 09/08/2008] [Indexed: 10/20/2022]
Abstract
PURPOSE Infections are one of the most commonly found conditions in oral and maxillofacial surgery practice. They always represent a risk to patients regardless of whether they are of odontogenic origin or not, and if not treated at an early stage they may rapidly evolve and spread to adjacent anatomical structures, leading to serious complications and, occasionally, to death. For this reason, the objective of this study was to retrospectively analyze data from patients with infections attended by the Department of Oral and Maxillofacial Surgery of the Piracicaba Dental School at the State University of Campinas-Unicamp. PATIENTS AND METHODS In accordance with date and inclusion criteria, sampling comprised 210 patient reports from January 1999 to March 2007. Patients' demographic data reviewed were gender, age, signs and symptoms, facial spaces affected, and therapy adopted. RESULTS The mean age of patients was 30 years old (SD = 16.6), and the main origin of infections was odontogenic (79.31%); principal signs and symptoms were trismus (43.33%), fever (28.10%), and dysphagia (25.24%). The main facial spaces affected were the buccal mandibular space (50.00%), submandibular space (31.90%), and buccal maxillary space (19.05%). Surgical drainage was carried out in 46.67% of cases, and 10.95% of these interventions were performed under general anesthetic. Only 3 of all patients developed complications. CONCLUSIONS Infection patients were basically young adults; no predisposition concerning gender or race was detected. The therapeutic protocol adopted presented very positive results, with a small number of complications.
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Affiliation(s)
- Fábio Ricardo Loureiro Sato
- Oral and Maxillofacial Surgery, Piracicaba Dental School, Campinas State University-Unicamp, São Paulo, Brazil.
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Bell G. An audit of 600 referrals to a primary care based oral surgery service. Br Dent J 2007; 203:E6; discussion 146-7. [PMID: 17571090 DOI: 10.1038/bdj.2007.571] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2006] [Indexed: 11/09/2022]
Abstract
AIM To identify potential problems in the quality of care when oral surgery is provided in the primary health care setting. METHOD Retrospective analysis of referral patterns, waiting times, treatment with clinical and histological diagnosis, including complications of 600 patients referred to a practice-based oral surgical referral service. RESULTS Fifty-three patients were not treated. Seventy-nine percent of patients were treated within four weeks of referral. The most common procedure performed was surgical removal of impacted third molar teeth. The most frequently observed complications were dry socket (n = 31/703), pain and inflammation associated with resorbable sutures (n = 11/453), and post-operative infection (n = 9/547). One patient with post-operative infection required care in the acute hospital setting. CONCLUSION Acknowledging the small sample, it was safe and effective to diagnose and treat a broad spectrum of patients and oral surgical problems in the primary health care setting.
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Affiliation(s)
- G Bell
- Oakdale Cottage, Hawksdale, Dalston, Carlisle, Cumbria, UK.
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