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Lozano CP, Faustova MO, Loban GA. Editorial: Odontogenic infection as a complication of dental caries: microbiological and molecular aspects. Front Oral Health 2024; 5:1385026. [PMID: 38450103 PMCID: PMC10915183 DOI: 10.3389/froh.2024.1385026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Accepted: 02/13/2024] [Indexed: 03/08/2024] Open
Affiliation(s)
- Carla P. Lozano
- Institute for Research in Dental Sciences, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - Mariia O. Faustova
- Department of Microbiology, Virology and Immunology, Poltava State Medical University, Poltava, Ukraine
| | - Galina A. Loban
- Department of Microbiology, Virology and Immunology, Poltava State Medical University, Poltava, Ukraine
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Lokes K, Kiptilyi A, Skikevych M, Steblovskyi D, Lychman V, Bilokon S, Avetikov D. Microbiological substantiation of the effectiveness of quercitin and its combination with ethylmethylhydroxypyridine succinate in the complex treatment of odontogenic phlegmon and maxillofacial abscesses. Front Oral Health 2024; 5:1338258. [PMID: 38314105 PMCID: PMC10834767 DOI: 10.3389/froh.2024.1338258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 01/09/2024] [Indexed: 02/06/2024] Open
Abstract
Odontogenic infections can become life-threatening. The aim of the study was to determine the effectiveness of quercitin and its combination with ethylmethylhydroxypyridine succinate in the complex treatment of odontogenic infections by assessing the microbial population of the infection site. Materials and methods The cross-sectional study included 75 patients. Purulent exudate was collected from the infection site. The number of colony-forming units was counted using the standard plate method. Results The microbiological examination of purulent exudate obtained from the patients revealed the general prevalence of Gram-positive cocci. On the seventh day of treatment, the total number of microorganisms in the purulent exudate of patients in group I, whose treatment included a combination of the standard protocol with quercitin, significantly decreased compared to the first day of the same group. The results of treatment of patients in group II, which included the standard protocol in combination with quercitin and 2-ethyl-6-methyl-3-hydroxypyridine succinate, demonstrate a significant decrease in the total number of bacteria in the infection focus on the fifth day of treatment compared to this indicator of the group at the beginning of the study. Conclusions When quercitin was used as part of complex treatment, the total treatment period was reduced by 1.4 days. However, the combined use of quercitin and ethylmethylhydroxypyridine succinate against the background of standard treatment of patients with odontogenic infection contributed to a reduction in hospital stay by 2 days.
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Affiliation(s)
- Kateryna Lokes
- Department of Oral and Maxillofacial Surgery, Poltava State Medical University, Poltava, Ukraine
| | - Anatolii Kiptilyi
- Department of Oral and Maxillofacial Surgery, Poltava State Medical University, Poltava, Ukraine
| | - Margaryta Skikevych
- Department of Oral and Maxillofacial Surgery, Poltava State Medical University, Poltava, Ukraine
| | - Dmytro Steblovskyi
- Department of Oral and Maxillofacial Surgery, Poltava State Medical University, Poltava, Ukraine
| | - Vitaliy Lychman
- Department of Oral and Maxillofacial Surgery, Poltava State Medical University, Poltava, Ukraine
| | - Serhii Bilokon
- Department of Pediatric Oral Surgery, Poltava State Medical University, Poltava, Ukraine
| | - David Avetikov
- Department of Oral and Maxillofacial Surgery, Poltava State Medical University, Poltava, Ukraine
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Palafox-Sánchez CA, Cruz A, Salazar-Camarena DC, Gascón LG, Cintra LTA, Muñoz-Valle JF, García-Arellano S, Estrela C, Menchaca-Tapia PA. Evaluation of Serum Levels of Cytokines in Acute Apical Abscess: A Longitudinal Observational Study. J Endod 2023; 49:1090-1098. [PMID: 37423583 DOI: 10.1016/j.joen.2023.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 06/23/2023] [Accepted: 07/02/2023] [Indexed: 07/11/2023]
Abstract
INTRODUCTION Cytokine levels are related to the aethiopathogenia of acute apical abscesses (AAA); however, the specific cytokine profiles in these cases are unclear. This study aimed to investigate the changes in systemic cytokine levels in patients with AAA and trismus onset, postantibiotic treatment, and postroot canal disinfection. METHODS In total, 46 AAA patients with trismus and 32 control subjects were included. After seven days of antibiotic therapy, root canal disinfection was performed in the AAA patients. The serum levels of cytokines were evaluated at basal, seven, and 14 days after endodontic treatment. Quantification of cytokines from T helper (Th) 1, Th2, Th17, and regulatory T cells profiles was determined using the BioPlex MagPix system, and the obtained data were analyzed using SPSS statistical software (P < .05). RESULTS AAA patients showed higher tumor necrosis factor-alpha (TNF-α), interleukin (IL) -6, and IL-10 levels than control subjects, at basal measurement (P < .05); there were similar levels of interferon gamma, IL-1β, IL-4, and IL-17 between groups (P > .05). IL-6 and IL-10 levels decreased after antibiotic treatment (P < .05), which was also associated with clinical improvement in patients with AAA and trismus. Patients with AAA had a positive correlation with higher serum levels of IL-6 and IL-10. In addition, TNF-α levels decreased only after antibiotic and endodontic treatment. CONCLUSIONS In conclusion, patients with AAA had increased systemic serum levels of TNF-α, IL-6, and IL-10. Moreover, increased levels of IL-6 and IL-10 are associated with acute inflammatory symptoms. However, IL-6 and IL-10 levels decreased after antibiotic treatment, while TNF-α levels decreased after antibiotic and endodontic treatment.
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Affiliation(s)
- Claudia Azucena Palafox-Sánchez
- Instituto de Investigación en Ciencias Biomédicas (IICB), Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico; Grupo de Inmunología Molecular, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
| | - Alvaro Cruz
- Instituto de Investigación en Ciencias Biomédicas (IICB), Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico; Posgrado de Endodoncia, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico.
| | - Diana Celeste Salazar-Camarena
- Grupo de Inmunología Molecular, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico; Posgrado de Endodoncia, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
| | - Luis Gerardo Gascón
- Posgrado de Endodoncia, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
| | - Luciano Tavares Angelo Cintra
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), and School of Dentistry, Dental Assistance Center for Disabled Persons (CAOE) of the São Paulo State University (UNESP), Araçatuba, SP, Brazil
| | - José Francisco Muñoz-Valle
- Instituto de Investigación en Ciencias Biomédicas (IICB), Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
| | - Samuel García-Arellano
- Instituto de Investigación en Ciencias Biomédicas (IICB), Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
| | - Carlos Estrela
- Department of Stomatologic Sciences, School of Dentistry, Federal University of Goiás (UFG), Goiânia, GO, Brazil
| | - Paula Annahi Menchaca-Tapia
- Doctorado en Ciencias Biomédicas, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
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Ba-Shammakh SA, Alrayes BM, Abu-Obead HM, Ba-Shammakh MA, Al-Mohd FM, Ramzoun EH, Abu-Nowar L. Vacuum-Assisted Closure Therapy: A Lifesaver in a Case of Neck Necrotizing Fasciitis. Cureus 2023; 15:e44291. [PMID: 37779734 PMCID: PMC10535721 DOI: 10.7759/cureus.44291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2023] [Indexed: 10/03/2023] Open
Abstract
Necrotizing fasciitis (NF) is a severe and rare soft tissue infection with a high potential for mortality, particularly in cases related to odontogenic infections in immunocompromised patients. The conventional treatment for NF includes broad-spectrum antibiotics and aggressive surgical debridement. This report presents a unique case of a 34-year-old healthy male who developed NF following a lower left wisdom tooth extraction. The infection extended into the superior mediastinum, requiring emergency surgical intervention. The therapeutic management included vacuum-assisted closure (VAC), a treatment modality showing promise in managing complex soft tissue infections, in combination with other adjunct treatments. The patient showed a satisfactory healing process and no signs of recurrence during the six-month follow-up period. This case underlines the importance of early diagnosis and the potential benefit of VAC therapy in managing advanced NF, emphasizing the need for further research and clinical application.
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Affiliation(s)
| | | | | | | | - Fahmi M Al-Mohd
- Department of General Surgery, The Islamic Hospital, Amman, JOR
| | - Ebrahim H Ramzoun
- Department of Oral and Maxillofacial Surgery, The Islamic Hospital, Amman, JOR
| | - Laith Abu-Nowar
- Department of General Surgery, The Islamic Hospital, Amman, JOR
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Roi CI, Roi A, Nicoară A, Nica D, Rusu LC, Soancă A, Motofelea AC, Riviș M. Impact of Treatment on Systemic Immune-Inflammatory Index and Other Inflammatory Markers in Odontogenic Cervicofacial Phlegmon Cases: A Retrospective Study. Biomedicines 2023; 11:1710. [PMID: 37371805 DOI: 10.3390/biomedicines11061710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/07/2023] [Accepted: 06/13/2023] [Indexed: 06/29/2023] Open
Abstract
Cervicofacial odontogenic infections can have an aggressive evolution with life-threatening complications. Management in many cases can be a challenge for clinicians, implying an extra focus on individual inflammatory parameters. The aim of this study is to evaluate the evolution of inflammatory markers for the included diagnosed odontogenic cervicofacial phlegmon cases at the moment of hospitalization and after receiving surgical and pharmaceutical treatment. MATERIALS AND METHODS A total of 39 patients diagnosed with odontogenic cervicofacial phlegmons that were admitted to the Maxillofacial Surgery Department of the Emergency Hospital from Timisoara were included in the study. The main focus was the parameters represented by the systemic immune-inflammatory index (SII) based on neutrophil, platelet, and lymphocytes count; the neutrophil-lymphocyte ratio (NLR); C-reactive protein level (CRP); and white blood cell count (WBC) before and after the treatment as potential prognosis factors. RESULTS The results of the study after analyzing the included parameters revealed a significant difference between the calculated values of the SII, NLR, CRP, and WBC at admission and at time of discharge, being directly influenced by the treatment. CONCLUSIONS SII, NLR, CRP, and WBC dynamic changes in severe cervicofacial odontogenic infections can be influenced by receiving accurate surgical and pharmacological treatment, with the potential to become future severity prognosis indexes.
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Affiliation(s)
- Ciprian Ioan Roi
- Department of Anesthesiology and Oral Surgery, "Victor Babeș" University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 30041 Timișoara, Romania
- Multidisciplinary Center for Research, Evaluation, Diagnosis and Therapies in Oral Medicine, "Victor Babeș" University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 30041 Timișoara, Romania
| | - Alexandra Roi
- Multidisciplinary Center for Research, Evaluation, Diagnosis and Therapies in Oral Medicine, "Victor Babeș" University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 30041 Timișoara, Romania
- Department of Oral Pathology, "Victor Babeș" University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 30041 Timișoara, Romania
| | - Adrian Nicoară
- Department of Anesthesiology and Oral Surgery, "Victor Babeș" University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 30041 Timișoara, Romania
| | - Diana Nica
- Department of Anesthesiology and Oral Surgery, "Victor Babeș" University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 30041 Timișoara, Romania
| | - Laura Cristina Rusu
- Multidisciplinary Center for Research, Evaluation, Diagnosis and Therapies in Oral Medicine, "Victor Babeș" University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 30041 Timișoara, Romania
- Department of Oral Pathology, "Victor Babeș" University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 30041 Timișoara, Romania
| | - Andrada Soancă
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Hațieganu University of Medicine and Pharmacy, Victor Babes Street, No. 15, 40012 Cluj-Napoca, Romania
| | - Alexandru Cătălin Motofelea
- Department of Internal Medicine, Faculty of Medicine, "Victor Babeș" University of Medicine and Pharmacy, 30041 Timișoara, Romania
| | - Mircea Riviș
- Department of Anesthesiology and Oral Surgery, "Victor Babeș" University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 30041 Timișoara, Romania
- Multidisciplinary Center for Research, Evaluation, Diagnosis and Therapies in Oral Medicine, "Victor Babeș" University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 30041 Timișoara, Romania
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Mahran H, Hassanein AG, Rizq M. Trends and Outcome of Aggressive Fascial Space Infections. Surg Infect (Larchmt) 2023; 24:475-481. [PMID: 37279453 DOI: 10.1089/sur.2023.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023] Open
Abstract
Background: Odontogenic infections are common and self-limiting in most cases; however, they can lead to severe consequences, considerable morbidity and can even be fatal despite modern medical therapy. Patients and Methods: This retrospective study included patients with severe deep fascial space infections treated in the Maxillofacial Surgery Unit, General Surgery Department, Faculty of Medicine, Sohag University, Sohag Governorate, Egypt, and the Department of Oral and Maxillofacial Surgery, King Fahd Specialist Hospital (tertiary referral center), Burayda City, Qassim Province, Saudi Arabia, from June 2017 to June 2022. Results: This study included 296 patients, 161 (54.4%) males, 135 (45.6%) females. The fifth decade of life was the most common vulnerable age group. Forty-three percent of patients had diabetes mellitus, 26.6% were hypertensive, and 13.3% were on long-term steroid therapy. In 83% of patients, the offending tooth was identified but in 17% of patients no dental cause was identified. The lower third molar tooth was most commonly involved. Sixty-nine (23.3%) patients had submandibular space infections. Fifty-three (17.9%) patients had canine space infections. Thirty (10.1%) patients had submasseteric space infection. Twenty-eight (9.5%) patients had submental space infections. Twenty-three (7.8%) patients had combined infection of the submasseteric, submandibular, and pterygomandibular spaces, whereas 19 (6.4%) patients presented with Ludwig's angina. Conclusions: Odontogenic infections are common. The submandibular space is the most commonly affected single space. These infections could lead to lethal complications in immunocompromised patients, especially patients with diabetes mellitus. These infections require urgent surgical intervention to decrease hospital stays and avoid potentially lethal complications.
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Affiliation(s)
- Hamada Mahran
- Maxillofacial Surgery Unit, General Surgery Department, Faculty of Medicine, Assiut University, Asyut, Egypt
- King Fahd Specialist Hospital, Burayda, Qassim Province, Saudi Arabia
| | - Ahmed Gaber Hassanein
- Maxillofacial Surgery Unit, General Surgery Department, Faculty of Medicine, Sohag University, Akhmim, Sohag Governorate, Egypt
| | - Moataz Rizq
- Oral and Maxillofacial Surgeon, Alexandria, Egypt
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Pachar Flores MR, Andrade-Alegre R, Santiago E, Sierra L. Descending Necrotizing Mediastinitis by Streptococcus anginosus and Prevotella buccae in an Intensive Care Unit Patient: A Case Report. Cureus 2023; 15:e39703. [PMID: 37398802 PMCID: PMC10309078 DOI: 10.7759/cureus.39703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2023] [Indexed: 07/04/2023] Open
Abstract
Necrotizing infections of deep neck spaces are a group of life-threatening infectious diseases acquired through trauma or as a descending infection from an odontogenic source. The isolation of pathogens is unusual because of the anaerobic nature of the infection; however, one way to achieve this is through the use of automated microbiological methods like matrix-assisted laser desorption/ionization and time-of-flight (MALDI-TOF) following standard microbiology protocols for analyzing samples from potential anaerobic infections. We present a case of a patient without risk factors for descending necrotizing mediastinitis with isolation of Streptococcus anginosus and Prevotella buccae managed at the intensive care unit with a multidisciplinary team. We present our approach and how we successfully treat this complicated infection.
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Affiliation(s)
- Monica R Pachar Flores
- Infectious Diseases, Hospital Santo Tomas, Panama, PAN
- Infectious Diseases, Instituto Oncologico Nacional, Panama, PAN
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Al-Sebaei M, Sindi MA. A Knowledge and Practice Survey Among Dentists in Saudi Arabia Analysing Myths and Misconceptions in Dentistry and Oral Surgery: What Do Dentists Believe? Cureus 2023; 15:e36625. [PMID: 37155434 PMCID: PMC10122836 DOI: 10.7759/cureus.36625] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2023] [Indexed: 05/10/2023] Open
Abstract
Introduction To ensure safe and effective practice, dental practitioners must stay up-to-date with all scientific updates involving their profession. In this regard, many outdated myths and misconceptions may be persistently believed and practiced. This study aimed to examine dental misconceptions circulating among dentists in Saudi Arabia. Methods An electronic survey was administered to Saudi Arabian dental practitioners classified and registered with the Saudi Commission of Health Specialties. It collected their demographics, career and experience details, and responses to 16 questions that targeted different myths. Logistic regression was used to analyze factors associated with their knowledge. Results A total of 519 dentists answered the survey, of which 54% were male with a mean age of 32 ± 9 years and a mean practice of 7 ± 8 years. More than half (57%) practiced general dentistry. In most (69%) of the questions, 40% of the respondents answered incorrectly. The proportion of incorrect answers to some questions reached 62%. Years of teaching, years in practice, and doctor rank had no association with the knowledge score. Conversely, the type of practice and specialty had multiple statistically significant associations (p < 0.05). Conclusion This study shows that many myths, despite being debunked for more than 20 years, are still circulating among Saudi Arabian dentists, including many young dentists. Academic institutions must urgently address these concepts and the science that disproves them; dentists must implement up-to-date, evidence-based knowledge in their practice.
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Affiliation(s)
- Maisa Al-Sebaei
- Oral and Maxillofacial Surgery, King Abdulaziz University (KAU), Jeddah, SAU
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Pucci R, Cassoni A, Di Carlo D, Bartolucci P, Della Monaca M, Barbera G, Di Cosola M, Polimeni A, Valentini V. Odontogenic-Related Head and Neck Infections: From Abscess to Mediastinitis: Our Experience, Limits, and Perspectives-A 5-Year Survey. Int J Environ Res Public Health 2023; 20:3469. [PMID: 36834169 PMCID: PMC9965740 DOI: 10.3390/ijerph20043469] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 02/08/2023] [Accepted: 02/10/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Head and neck infections are commonly caused by affections with an odontogenic origin. Untreated or non-responsive to treatment odontogenic infections can cause severe consequences such as localized abscesses, deep neck infections (DNI), and mediastinitis, conditions where emergency procedures such as tracheostomy or cervicotomy could be needed. METHODS An epidemiological retrospective observational study was performed, and the objective of the investigation was to present a single-center 5-years retrospective analysis of all patients admitted to the emergency department of the hospital Policlinico Umberto I "Sapienza" with a diagnosis of odontogenic related head and neck infection, observing the epidemiological patterns, the management and the type of surgical procedure adopted to treat the affections. RESULTS Over a 5-year period, 376,940 patients entered the emergency room of Policlinico Umberto I, "Sapienza" University of Rome, for a total of 63,632 hospitalizations. A total of 6607 patients were registered with a diagnosis of odontogenic abscess (10.38%), 151 of the patients were hospitalized, 116 of them were surgically treated (76.8%), and 6 of them (3.9%) manifested critical conditions such as sepsis and mediastinitis. CONCLUSIONS Even today, despite the improvement of dental health education, dental affections can certainly lead to acute conditions, necessitating immediate surgical intervention.
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Affiliation(s)
- Resi Pucci
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy
| | - Andrea Cassoni
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy
- Oncological and Reconstructive Maxillo-Facial Surgery Unit, Policlinico Umberto I, Viale del Policlinico 155, 00161 Rome, Italy
| | - Daniele Di Carlo
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy
- Oncological and Reconstructive Maxillo-Facial Surgery Unit, Policlinico Umberto I, Viale del Policlinico 155, 00161 Rome, Italy
| | - Piero Bartolucci
- Surgical Sciences and Emergency Department, AOU Policlinico Umberto I Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy
| | - Marco Della Monaca
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy
- Oncological and Reconstructive Maxillo-Facial Surgery Unit, Policlinico Umberto I, Viale del Policlinico 155, 00161 Rome, Italy
| | - Giorgio Barbera
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy
| | - Michele Di Cosola
- Department of Clinical and Experimental Medicine, Università Degli Studi di Foggia, 71122 Foggia, Italy
| | - Antonella Polimeni
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy
| | - Valentino Valentini
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy
- Oncological and Reconstructive Maxillo-Facial Surgery Unit, Policlinico Umberto I, Viale del Policlinico 155, 00161 Rome, Italy
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Gheibollahi H, Mousavi S, Daneste H, Taheri MM, Peyravi A, Babaei A. Determinant of antibacterial failure in patients with head and neck infections with odontogenic source. Otolaryngol Pol 2023; 77:1-6. [PMID: 37772323 DOI: 10.5604/01.3001.0016.2344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/30/2023]
Abstract
<b>Introduction:</b> Odontogenic infections are polymicrobial in origin and can be life-threatening. Antibacterial failure is an important issue in the treatment of odontogenic infections. Aim: This study aimed to determine the factors associated with antibacterial failure in patients with head and neck infections of odontogenic origin.</br></br> <b>Material and method:</b> This retrospective epidemiological study was performed using data collected from 229 patients with head and neck infections of odontogenic origin who were operated on in Shahid Rajaee hospital from March 2014 to December 2019.</br></br> <b>Results:</b> 123 (53.7%) patients were female and there were 106 (46.3%) males. The mean age SD was 33.01 13.37 years (range 7 to 80). The most common offending teeth were lower molars (81.7%) and lower premolars (5.7%). The most common site of infection was the submandibular area (36.4%) followed by the buccal (20.4%) and pterygomandibular (17.1%) regions. The most common pathogen was Streptococcus haemolyticus. The length of hospitalization was higher (4.66 days) in patients with failure of treatment compared to those without it (6.00 days) (P = 0.002). A combination of penicillin G and metronidazole was prescribed for all patients with failure of treatment compared to 57.6% in patients without failure of treatment (P = 0.002). There was no statistically significant difference between the two groups regarding age, duration of illness before hospitalization, WBC, gender, history of chemotherapy, hypertension, smoking, pregnancy, alcohol consumption, diabetes mellitus, the rate of fever, trismus, dysphagia, malaise, antibiotic before hospitalization, or surgical approach.</br></br> <b>Conclusion:</b> Possible determinants in this study were not associated with antibacterial failure. Further studies should be conducted to investigate this relationship.
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Affiliation(s)
- Hamed Gheibollahi
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Sona Mousavi
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Rajaei Acute Care Surgical Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hossein Daneste
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Rajaei Acute Care Surgical Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Mehdi Taheri
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Rajaei Acute Care Surgical Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Peyravi
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amirhossein Babaei
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran, Otolaryngology Research Center, Department of Otolaryngology, Shiraz University of Medical Sciences, Shiraz, Iran
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Gheibollahi H, Mousavi S, Daneste H, Taheri MM, Peyravi A, Babaei A. Determinant of antibacterial failure in patients with head and neck infections with odontogenic source. Otolaryngol Pol 2023; 77:1-5. [PMID: 36718574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
INTRODUCTION Odontogenic infections are polymicrobial in origin and can be life-threatening. Antibacterial failure is an important issue in the treatment of odontogenic infections. This study aimed to determine the factors associated with antibacterial failure in patients with head and neck infections with odontogenic sources. MATERIAL AND METHOD This retrospective epidemiological study was performed using data collected from 229 patients with head and neck infections with an odontogenic source who had been operated on in Shahid Rajaee hospital from March 2014 to December 2019. RESULTS 123 (53.7%) patients were female and there were106 (46.3%) males. The mean age ± SD was 33.01±13.37 years (range 7 to 80). The most common offending teeth were lower molars (81.7%) and lower premolars (5.7%). The most common site of infection was the submandibular area (36.4%) followed by the buccal (20.4%) and pterygomandibular (17.1%) regions. The most common pathogen was Streptococcus haemolyticus. The length of hospitalization was higher (4.66 days) in patients with failure of treatment compared to those without it (6.00 days) (p=0.002). A combination of penicillin G and metronidazole was prescribed for all patients with failure of treatment compared with 57.6% in patients without failure of treatment (p=0.002). There was no statistically significant difference between the two groups regarding age, duration of illness before hospitalization, WBC, gender and history of chemotherapy, hypertension, smoking, pregnancy, alcohol usage, diabetes mellitus, the rate of fever, trismus, dysphagia, malaise, antibiotic before hospitalization, and surgical approach. CONCLUSION Possible determinants in this study were not associated with antibacterial failure. Further studies should be conducted to investigate this relationship.
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Affiliation(s)
- Hamed Gheibollahi
- 1. Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Sona Mousavi
- 2. Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Rajaei Acute Care Surgical Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hossein Daneste
- 2. Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Rajaei Acute Care Surgical Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Mehdi Taheri
- 2. Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Rajaei Acute Care Surgical Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Peyravi
- 3. Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amirhossein Babaei
- 4. Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran. 5. Otolaryngology Research Center, Department of Otolaryngology, Shiraz University of Medical Sciences, Shiraz, Iran
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12
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Rosca O, Bumbu BA, Ancusa O, Talpos S, Urechescu H, Ursoniu S, Bloanca V, Pricop M. The Role of C-Reactive Protein and Neutrophil to Lymphocyte Ratio in Predicting the Severity of Odontogenic Infections in Adult Patients. Medicina (Kaunas) 2022; 59:medicina59010020. [PMID: 36676644 PMCID: PMC9866968 DOI: 10.3390/medicina59010020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/11/2022] [Accepted: 12/20/2022] [Indexed: 12/24/2022]
Abstract
Background and Objectives: Odontogenic infections (OI) represent a frequent cause of dental and maxillo-facial interventions, mostly due to late presentations or misdiagnosed complications. It is believed that the intensity of the immunoinflammatory response in OI is the main prognostic factor. Therefore, in this research, it was pursued to determine if the combination of C-reactive protein (CRP) and Neutrophil to Lymphocyte Ratio (NLR) (CRP-NLR) may serve as potential severity predictors in patients with odontogenic infections. Materials and Methods: A retrospective analysis on 108 patients hospitalized for odontogenic infections was conducted at the Department of Maxillofacial Surgery. Depending on the symptom severity scale, patients hospitalized with OI were divided into two equal groups based on infection severity (SS). Results: Patients with severe OI from Group B were associated more frequently with diabetes mellitus and smoking more often than those with a lower severity from Group A. In Group A, abscesses of odontogenic origin accounted for 70.4% of hospitalizations, while in Group B, abscesses and cellulitis were associated in 55.6% of cases (p-value < 0.001). The disease outcomes were more severe in Group B patients, where 22.2% of them developed sepsis, compared to 7.4% of Group A patients (p-value = 0.030). However, there was no significant difference in mortality rates. The SS and systemic immune inflammation index (SII) scores of Group B patients were substantially higher than Group A patients (13.6 vs. 6.1 for the SS score, p-value < 0.001), respectively, 2312.4 vs. 696.3 for the SII score (p-value < 0.001). All biomarker scores, including the CRP-NLR relationship, were considerably higher in Group B patients, with a median score of 341.4 vs. 79.0 in Group B (p-value < 0.001). The CRP-NLR association determined a 7.28-fold increased risk of severe OI. The receiver operating curve (ROC) analysis of CRP-NLR yielded an area under curve (AUC) value of 0.889, with high sensitivity (79.6%) and high specificity (85.1%), for predicting a severe odontogenic infection using biomarkers measured at hospital admission (p-value < 0.001). Conclusions: Therefore, it can be concluded that CRP-NLR is a reliable and affordable biomarker for determining the severity of odontogenic infections that may be included in other prognostic models for dental infections.
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Affiliation(s)
- Ovidiu Rosca
- Department XIII, Discipline of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Bogdan Andrei Bumbu
- Department of Dental Medicine, Faculty of Medicine and Pharmacy, University of Oradea, University Street 1, 410087 Oradea, Romania
- Correspondence:
| | - Oana Ancusa
- Department V, Discipline of Medical Semiology I, Faculty of General Medicine, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Serban Talpos
- Discipline of Oral and Maxillo-Facial Surgery, Faculty of Dental Medicine, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Horatiu Urechescu
- Discipline of Oral and Maxillo-Facial Surgery, Faculty of Dental Medicine, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Sorin Ursoniu
- Department of Functional Sciences, Center for Translational Research and Systems Medicine, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Vlad Bloanca
- Department of Plastic Surgery, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Marius Pricop
- Discipline of Oral and Maxillo-Facial Surgery, Faculty of Dental Medicine, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
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13
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Cuevas-Gonzalez MV, Mungarro-Cornejo GA, Espinosa-Cristóbal LF, Donohue-Cornejo A, Tovar Carrillo KL, Saucedo Acuña RA, García Calderón AG, Guzmán Gastelum DA, Zambrano-Galván G, Cuevas-Gonzalez JC. Antimicrobial resistance in odontogenic infections: A protocol for systematic review. Medicine (Baltimore) 2022; 101:e31345. [PMID: 36550913 PMCID: PMC9771230 DOI: 10.1097/md.0000000000031345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND It is estimated that up to 90% of head and neck infections have an odontogenic origin, which are considered among the most common in the oral cavity and maxillofacial region. Bacterial resistance has been 1 of the main problems related to the treatment of this type of infection in recent years. The frequency of this resistance is increasing, which is mainly due to patient self-medication and the mutations that bacteria present. Therefore, the objective of this study is to analyze the antimicrobial resistance of antibiotics commonly administered for the treatment of odontogenic infections. METHOD To carry out the study, PubMed, ScienceDirect, and Scopus databases were reviewed using the keywords "odontogenic infection", "pharmacological treatment", and "microbial resistance. Studies whose main objective was the pharmacological treatment of odontogenic infections were selected. Exclusions were review-type studies, systematic reviews, or in vitro or animal model studies. For the analysis of risk of bias, the Checklist for Analytical Cross-Sectional Studies of the Joanna Briggs Institute was used. The search and analysis of the studies was carried out by 2 researchers independently. RESULTS A total of 13 studies were included in this review. The mean age was 39.6 years; the location of the infection in the study subjects was in the submandibular and vestibular spaces; there were periodontal, periapical, and dentoalveolar lesions; the main microorganisms identified were Streptococcus, Staphylococcus, Prevotella, Peptostreptococcus, Clostridium, and Klebsiella; and finally, the main microorganisms identified for bacterial resistance were penicillin, clindamycin and amoxicillin. CONCLUSION The health professional is obliged to update their knowledge to avoid such antibiotic resistance and thus provide better patient care.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Juan Carlos Cuevas-Gonzalez
- Juarez City, Chihuahua, Mexico
- * Correspondence: Juan Carlos Cuevas-Gonzalez, Institute of Biomedical Sciences, Autonomous University of Ciudad Juarez, Av. Benjamín Franklin no. 4650, Zona Pronaf Condominio LA Plata, 32310 Cd Juárez, Chihuahua, Mexico (e-mail: )
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14
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Pricop M, Ancusa O, Talpos S, Urechescu H, Bumbu BA. The Predictive Value of Systemic Immune-Inflammation Index and Symptom Severity Score for Sepsis and Systemic Inflammatory Response Syndrome in Odontogenic Infections. J Pers Med 2022; 12:jpm12122026. [PMID: 36556246 PMCID: PMC9782876 DOI: 10.3390/jpm12122026] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 12/01/2022] [Accepted: 12/06/2022] [Indexed: 12/12/2022] Open
Abstract
Acute Odontogenic Infections (OI) are the leading cause of emergency visits and hospitalizations to the maxillofacial department, and may induce systemic inflammatory complications. Increasing numbers of OI patients need extended hospitalizations, various treatments, and intensive care. The Symptom Severity score (SS) helps doctors assess the likelihood of infection and admission complications. Systemic Immune-inflammation Index (SII) is a biomarker-based inflammatory prognosis score. It was hypothesized that greater SII and SS values might suggest a higher risk for sepsis and systemic inflammatory response syndrome (SIRS). Therefore, this research aims to discover whether SII and SS scores can reliably predict odontogenic infection severity and prognosis, and if they can be used to predict the development of SIRS and sepsis in OI using admission features. The study was designed as a retrospective cohort, with patients' data being retrieved from medical records between January 2017 to April 2022. A total of 108 OI patients were matched 1:1 as low-severity and high-severity groups. Most individuals with severe infections had diabetes and smoking as comorbidities. Severe patients had longer hospital stays (12.0 days vs. 4.1 days), although mortality rates did not significantly differ. A total of 11.1% lower-severity patients (Group A) had SIRS during hospitalization, compared to Group B with 25.9%. Group A had 7.4% of patients that developed sepsis compared to Group B's rate of 22.2%. The correlation between OI's SS and SII index values was positive and statistically significant (r = 0.6314). The total SII index mean was 1303, whereas the mean values by severity were 696.3 in Group A and 2312.4 in Group B. Group A's mean SS score was 6.1, while Group B's was 13.6. According to the calculated AUC plots, SII and SS scores were accurate predictors of sepsis and SIRS development using OI admission parameters. The adjusted odds ratio for SIRS in OI patients was 2.09, and 2.27 for sepsis. Medical professionals and dentistry teams should be encouraged to use the SII and SS scores to diagnose and anticipate sepsis and SIRS, hence improving disease management decisions.
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Affiliation(s)
- Marius Pricop
- Discipline of Oral and Maxillo-Facial Surgery, Faculty of Dental Medicine, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Oana Ancusa
- Department V, Discipline of Medical Semiology I, Faculty of General Medicine, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
- Correspondence:
| | - Serban Talpos
- Discipline of Oral and Maxillo-Facial Surgery, Faculty of Dental Medicine, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Horatiu Urechescu
- Discipline of Oral and Maxillo-Facial Surgery, Faculty of Dental Medicine, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Bogdan Andrei Bumbu
- Department of Dental Medicine, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
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15
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Cracchiolo AN, Palma DM, Palmeri M, Tantillo D, Lo Bue R, Braconi A, Caramanna C, Solazzo L, Genco F, Mirto P. Hyperbaric oxygen therapy as adjuvant therapy for odontogenic necrotizing myositis: A case report. Clin Case Rep 2021; 9:e04726. [PMID: 34484762 PMCID: PMC8405431 DOI: 10.1002/ccr3.4726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 07/26/2021] [Accepted: 08/02/2021] [Indexed: 11/24/2022] Open
Abstract
In a young man affected by skin soft tissue infections complicated with myositis, the use of hyperbaric oxygen treatment as an adjuvant therapy to surgical debridement and antibiotic therapy could improve management and prognosis.
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Affiliation(s)
- Andrea N. Cracchiolo
- UOC Emergenza Urgenza 118 Servizio di Medicina IperbaricaARNAS Ospedale Civico Di Cristina BenfratelliPalermoItaly
| | - Daniela Maria Palma
- UOS Terapia Intensiva e Trauma Center ARNAS Ospedale Civico Di Cristina BenfratelliPalermoItaly
| | - Marco Palmeri
- UOC Emergenza Urgenza 118 Servizio di Medicina IperbaricaARNAS Ospedale Civico Di Cristina BenfratelliPalermoItaly
| | - Diego Tantillo
- UOC Emergenza Urgenza 118 Servizio di Medicina IperbaricaARNAS Ospedale Civico Di Cristina BenfratelliPalermoItaly
| | - Rosalia Lo Bue
- UOC Emergenza Urgenza 118 Servizio di Medicina IperbaricaARNAS Ospedale Civico Di Cristina BenfratelliPalermoItaly
| | - Andrea Braconi
- UOC Chirurgia Maxillo‐Faciale ARNAS Ospedale Civico Di Cristina BenfratelliPalermoItaly
| | - Claudio Caramanna
- UOC Chirurgia Maxillo‐Faciale ARNAS Ospedale Civico Di Cristina BenfratelliPalermoItaly
| | - Luigi Solazzo
- UOC Chirurgia Maxillo‐Faciale ARNAS Ospedale Civico Di Cristina BenfratelliPalermoItaly
| | - Fabio Genco
- UOC Emergenza Urgenza 118 Servizio di Medicina IperbaricaARNAS Ospedale Civico Di Cristina BenfratelliPalermoItaly
| | - Paola Mirto
- Basingstoke and North Hampshire HospitalHampshireUK
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16
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Kuligowski P, Jaroń A, Preuss O, Gabrysz-Trybek E, Bladowska J, Trybek G. Association between Odontogenic and Maxillary Sinus Conditions: A Retrospective Cone-Beam Computed Tomographic Study. J Clin Med 2021; 10:jcm10132849. [PMID: 34199113 PMCID: PMC8268029 DOI: 10.3390/jcm10132849] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 06/22/2021] [Accepted: 06/25/2021] [Indexed: 12/16/2022] Open
Abstract
Odontogenic infections can directly trigger maxillary sinusitis. CBCT is an excellent choice for precise examination of maxillary sinuses and hard tissues within the oral cavity. The objective of this retrospective and the cross-sectional study was to analyze the influence of odontogenic conditions on the presence and intensity of maxillary sinus mucous membrane thickening using CBCT imaging. Moreover, periodontal bone loss and anatomic relationship between adjacent teeth and maxillary sinuses were assessed to evaluate its possible impact on creating maxillary thickening. The study sample consisted of 200 maxillary sinuses of 100 patients visible on CBCT examination with a field of view of 13 × 15 cm. The presented study revealed a significant influence of periapical lesions, inappropriate endodontic treatment, severe caries, and extracted teeth on the presence of increased thickening of maxillary sinus mucous membrane. In addition, an increase in the distance between root apices and maxillary sinus floor triggered a significant reduction of maxillary sinus mucous membrane thickening. The presence of periodontal bone loss significantly increases maxillary sinus mucous membrane thickening.
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Affiliation(s)
- Piotr Kuligowski
- Department of Oral Surgery, Pomeranian Medical University in Szczecin, Al. Powstańców Wlkp. 72, 70-111 Szczecin, Poland; (P.K.); (A.J.); (O.P.)
| | - Aleksandra Jaroń
- Department of Oral Surgery, Pomeranian Medical University in Szczecin, Al. Powstańców Wlkp. 72, 70-111 Szczecin, Poland; (P.K.); (A.J.); (O.P.)
| | - Olga Preuss
- Department of Oral Surgery, Pomeranian Medical University in Szczecin, Al. Powstańców Wlkp. 72, 70-111 Szczecin, Poland; (P.K.); (A.J.); (O.P.)
| | - Ewa Gabrysz-Trybek
- Department of Diagnostic Imaging and Interventional Radiology, Pomeranian Medical University, Unii Lubelskiej 1 St., 71-242 Szczecin, Poland;
| | - Joanna Bladowska
- Department of General and Interventional Radiology and Neuroradiology, Wroclaw Medical University, Borowska 213 St., 50-556 Wroclaw, Poland;
| | - Grzegorz Trybek
- Department of Oral Surgery, Pomeranian Medical University in Szczecin, Al. Powstańców Wlkp. 72, 70-111 Szczecin, Poland; (P.K.); (A.J.); (O.P.)
- Correspondence:
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17
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Meinen A, Reuss A, Willrich N, Feig M, Noll I, Eckmanns T, Al-Nawas B, Markwart R. Antimicrobial Resistance and the Spectrum of Pathogens in Dental and Oral-Maxillofacial Infections in Hospitals and Dental Practices in Germany. Front Microbiol 2021; 12:676108. [PMID: 34149666 PMCID: PMC8206268 DOI: 10.3389/fmicb.2021.676108] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 05/10/2021] [Indexed: 11/13/2022] Open
Abstract
Data on microbiological profiles in odontogenic infections are scarce. This study aimed to analyze the spectrum of pathogens and antimicrobial resistance in clinical isolates from dental and oral-maxillofacial clinical settings in Germany. We analyzed 20,645 clinical isolates (dental practices: n = 5,733; hospitals: n = 14,912) from patients with odontogenic infections using data (2012-2019) from the German Antimicrobial-Resistance-Surveillance (ARS) system. A total of 224 different species from 73 genera were found in clinical isolates from dental practices, and 329 different species from 97 genera were identified in isolates from hospital patients. In both hospitals and dental practices Streptococcus spp. (33 and 36%, respectively) and Staphylococcus spp. (21 and 12%, respectively) were the most frequently isolated microorganisms. In Streptococcus spp. isolates from hospitals, penicillin and aminopenicillin resistance proportions were 8.0% (95%CI 4.7-14.9%) and 6.9% (95%CI 4.7-9.9%), respectively. Substantially lower resistance proportions of penicillin and aminopenicillin were observed in dental practices [2.6% (95%CI 1.4-4.7%) and 2.1% (95%CI 1.1-4.0%), respectively]. Among Staphylococcus aureus isolates from hospital patients methicillin resistance proportions were 12.0% (95%CI 9.7-14.8%), which was higher than in isolates from dental practices (5.8% (95%CI 4.1-8.1%)]. High clindamycin and macrolide resistance proportions (>17%) were observed in Streptococcus spp. and Staphylococcus aureus isolates. In Klebsiella spp. isolates carbapenem resistance proportions were <1%. In sum, substantial antibiotic resistance was observed in isolates from odontogenic infections, which calls for strengthened efforts in antibiotic stewardship and infection prevention and control measures in both hospitals and dental practices.
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Affiliation(s)
- Annika Meinen
- Robert Koch Institute, Unit 37: Nosocomial Infections, Surveillance of Antimicrobial Resistance and Consumption, Berlin, Germany
| | - Annicka Reuss
- Robert Koch Institute, Unit 37: Nosocomial Infections, Surveillance of Antimicrobial Resistance and Consumption, Berlin, Germany
| | - Niklas Willrich
- Robert Koch Institute, Unit 37: Nosocomial Infections, Surveillance of Antimicrobial Resistance and Consumption, Berlin, Germany
| | - Marcel Feig
- Robert Koch Institute, Unit 37: Nosocomial Infections, Surveillance of Antimicrobial Resistance and Consumption, Berlin, Germany
| | - Ines Noll
- Robert Koch Institute, Unit 37: Nosocomial Infections, Surveillance of Antimicrobial Resistance and Consumption, Berlin, Germany
| | - Tim Eckmanns
- Robert Koch Institute, Unit 37: Nosocomial Infections, Surveillance of Antimicrobial Resistance and Consumption, Berlin, Germany
| | - Bilal Al-Nawas
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Robby Markwart
- Robert Koch Institute, Unit 37: Nosocomial Infections, Surveillance of Antimicrobial Resistance and Consumption, Berlin, Germany.,Institute of General Practice and Family Medicine, Jena University Hospital, Jena, Germany
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18
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Singh J, O'Donnell K, Nieves DJ, Adler-Shohet FC, Arrieta AC, Ashouri N, Ahuja G, Cheung M, Holmes WN, Huoh K, Tran L, Tran MT, Pham N, Zahn M. Invasive Mycobacterium abscessus Outbreak at a Pediatric Dental Clinic. Open Forum Infect Dis 2021; 8:ofab165. [PMID: 34113683 PMCID: PMC8186244 DOI: 10.1093/ofid/ofab165] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 03/26/2021] [Indexed: 11/25/2022] Open
Abstract
Background Mycobacterium species, specifically M. abscessus and M. chelonae (MABs), are known to contaminate water systems and are uncommon causes of health care–associated infection, but morbidity can be significant and treatment complex. Methods Odontogenic MAB infections occurred in patients following pulpotomy procedures at dental clinic A from 1 January to 6 September 2016. We identified confirmed and probable cases using culture data, imaging, pathology results, and surgical findings. Epidemiologic and clinical data including demographics, symptoms, laboratory findings, treatment regimens, and outcomes were extracted. Results Of 1082 at-risk patients, 71 case patients (22 confirmed; 49 probable) were identified. Median age was 6 years. Median symptom onset was 85 days postpulpotomy. Pain and/or swelling on admission occurred in 79%. On imaging, 49 of 70 had abnormalities of the mandible or maxilla, 13 of 70 had lymphadenopathy, and 19 of 68 had pulmonary nodules. Seventy were hospitalized (average of 8.5 days). Intravenous antibiotics were administered to 32 cases for a median length of 137 days. Clofazimine was administered to 29 patients as part of their multidrug regimen. Antibiotic treatment was associated with many adverse effects. Treated children showed evidence of jaw healing with resolved/improving pulmonary nodules at 1-year follow-up. Conclusions This is the largest outbreak of invasive MAB infections associated with a pediatric dental practice. While infections were indolent, patients suffered medical and surgical consequences of treatment, including permanent tooth loss. Identification of this outbreak led to a change in water standards for pediatric dental procedures in California. Enhanced national dental water quality standards are needed to prevent future outbreaks.
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Affiliation(s)
- Jasjit Singh
- Department of Pediatric Infectious Diseases, Children's Hospital of Orange County, Orange, California, USA
| | - Kathleen O'Donnell
- Disease Control and Epidemiology, Orange County Health Care Agency, Santa Ana, California, USA
| | - Delma J Nieves
- Department of Pediatric Infectious Diseases, Children's Hospital of Orange County, Orange, California, USA
| | - Felice C Adler-Shohet
- Department of Pediatric Infectious Diseases, Children's Hospital of Orange County, Orange, California, USA
| | - Antonio C Arrieta
- Department of Pediatric Infectious Diseases, Children's Hospital of Orange County, Orange, California, USA
| | - Negar Ashouri
- Department of Pediatric Infectious Diseases, Children's Hospital of Orange County, Orange, California, USA
| | - Gurpreet Ahuja
- Department of Pediatric Otolaryngology, Children's Hospital of Orange County, Orange, California, USA.,University of California, Irvine School of Medicine, Irvine, California, USA
| | - Michele Cheung
- Disease Control and Epidemiology, Orange County Health Care Agency, Santa Ana, California, USA
| | - W Nathan Holmes
- Department of Pediatric Radiology, Children's Hospital of Orange County, Orange, California, USA
| | - Kevin Huoh
- Department of Pediatric Otolaryngology, Children's Hospital of Orange County, Orange, California, USA.,University of California, Irvine School of Medicine, Irvine, California, USA
| | - Lisa Tran
- Department of Surgery, Children's Hospital of Orange County, Orange, California, USA
| | - M Tuan Tran
- Department of Pediatric Infectious Diseases, Children's Hospital of Orange County, Orange, California, USA
| | - Nguyen Pham
- Department of Pediatric Otolaryngology, Children's Hospital of Orange County, Orange, California, USA.,University of California, Irvine School of Medicine, Irvine, California, USA
| | - Matthew Zahn
- Disease Control and Epidemiology, Orange County Health Care Agency, Santa Ana, California, USA
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Matsumoto Y, Yokoi H, Ikeda T, Kawada M, Saito K. The Prevalence of Odontogenic Pathology in Patients With Bilateral Rhinosinusitis. Allergy Rhinol (Providence) 2021; 12:1177_2152656721989287. [PMID: 33598334 PMCID: PMC7863140 DOI: 10.1177/2152656721989287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
OBJECTIVE We investigated cases with opacification on maxillary sinus computed tomography (CT) among patients with rhinosinusitis with opacification in both paranasal sinuses (bilateral rhinosinusitis) to confirm the involvement of odontogenic infections. METHODS This study included 75 patients who were diagnosed with bilateral rhinosinusitis based on clinical examination and evident opacification on at least one side on maxillary sinus imaging with computed tomography CT. The definition of odontogenic sinusitis was determined by examining EPT and oral findings, in addition to the CT and orthopantomography (OP), by one oral surgeon and two otolaryngologists. RESULTS We found that 45.3% of patients had odontogenic infections, which were associated with multiple infected teeth in some cases. Odontogenic infection was observed in both sinuses in some patients. Sinusitis with polyps was frequently associated with dental infection, and some cases were also associated with mycosis. Almost no oral symptoms were observed. CONCLUSIONS The results suggest that clinicians should consider odontogenic infection in patients with bilateral rhinosinusitis with opacification, on at least one side on maxillary sinus imaging. This means that accurate diagnosis may be challenging for otolaryngologist or dentists alone, suggesting that a collaboration between the two would be suitable for this task.
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Affiliation(s)
- Yuma Matsumoto
- Department of Otolaryngology—Head and Neck Surgery, Kyorin University School of Medicine, Tokyo, Japan
| | - Hidenori Yokoi
- Department of Otolaryngology—Head and Neck Surgery, Kyorin University School of Medicine, Tokyo, Japan
| | - Tetsuya Ikeda
- Department of Oral Surgery, Kyorin University School of Medicine, Tokyo, Japan
| | - Michitsugu Kawada
- Department of Otolaryngology—Head and Neck Surgery, Kyorin University School of Medicine, Tokyo, Japan
| | - Koichiro Saito
- Department of Otolaryngology—Head and Neck Surgery, Kyorin University School of Medicine, Tokyo, Japan
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20
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Gaber Hassanein A, Mohamed EEH, Hazem M, El Sayed AESM. Assessment of Prognosis in Odontogenic Descending Necrotizing Mediastinitis: A Longitudinal Retrospective Study. Surg Infect (Larchmt) 2020; 21:709-715. [PMID: 32096688 DOI: 10.1089/sur.2019.302] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background: Descending necrotizing mediastinitis [DNM] is a serious complication of odontogenic infections, being associated with a high mortality rate. The diagnosis, classification, and management depend on computed tomography [CT] findings. Incision, drainage, and debridement represent the principal management. This study aimed to assess the prognosis in odontogenic DNM. Methods: The DNM type I was managed by transcervical mediastinal drainage, while in DNM type II, a right or left posterolateral thoracotomy was used. Data were compared among survivors and deceased to detect the risk factors affecting the prognosis. Results: This study included 63 patients. Transcervical mediastinal drainage was performed in 57 patients with Endo Type I while drainage through a right posterolateral thoracotomy was performed in the other five patients with Endo Type I and one patient with Endo Type IIA. Of patients in the study, 82.5% survived while 17.5% died because of multiple organ failure. Multiple complications and severe sepsis or septic shock as risk factors were statistically significant. Conclusion: A CT scan is the modality of choice for diagnosis and classification of DNM. Incision and drainage of the maxillofacial infection with mediastinal drainage and debridement represent the main management. Multiple complications and severe sepsis or septic shock were associated with poor prognosis.
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Affiliation(s)
- Ahmed Gaber Hassanein
- Maxillofacial Surgery Unit, General Surgery Department, Faculty of Medicine, Sohag University, Sohag, Egypt.,Maxillofacial Surgery Department, Faculty of Dentistry, Al-Baha University, Kingdom of Saudi Arabia
| | | | - Mohammed Hazem
- Surgery Department, Faculty of Medicine, King Faisal University, Kingdom of Saudi Arabia.,Radiology Department, Faculty of Medicine, Sohag University, Sohag, Egypt
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Adamson OO, Adeyemi MO, Gbotolorun OM, Oduyebo OO, Odeniyi O, Adeyemo WL. Comparison of sensitivity of bacteria isolated in odontogenic infections to ceftriaxone and amoxicillin-clavulanate. Afr Health Sci 2019; 19:2414-2420. [PMID: 32127812 PMCID: PMC7040266 DOI: 10.4314/ahs.v19i3.15] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Odontogenic infections is a cause of mortality and morbidity in maxillofacial patients. This is largely due to resistance of organisms to antibiotics prescribed. OBJECTIVES To isolate organisms involved in odontogenic infections and compare the sensitivity of the organisms to Ceftriaxone and Amoxicillin-Clavulanate. METHODS The causative organisms and antibiotic sensitivity were determined by the following steps: Aspiration of pus done with needle, sample of pus or exudate collected using sterile swab if aspiration was unsuccessful and specimen were placed in transport media (thioglycolatebroth) and sent immediately to microbiology laboratory for culture of organisms and antibiotic sensitivity. RESULTS Out of a total 55 samples taken for bacteriology, 42 (76.4%) yielded positive culture for bacteria. A total number of 21 bacteria species were identified from the positive cultures. Overall, 52% of isolated organisms were sensitive to amoxicillin-clavulanate, 70% were sensitive to Ceftriaxone while 24% were resistant to both antibiotics (Table 3). Ceftriaxone was statistically significantly more potent in inhibiting bacteria growth than amoxicillin-clavulanate (P =0.009). [Table: see text].
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Affiliation(s)
- Olawale Olatunbosun Adamson
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, College of Medicine, University of Lagos
| | - Michael Olayinka Adeyemi
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, College of Medicine, University of Lagos
| | - Olalekan Micah Gbotolorun
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, College of Medicine, University of Lagos
| | - Omoniyi Omolola Oduyebo
- Department of Medical Microbiology and Parasitology, Faculty of Basic Medical Sciences, College of Medicine, University of Lagos
| | - Olalekan Odeniyi
- Department of Medical Microbiology and Parasitology, Faculty of Basic Medical Sciences, College of Medicine, University of Lagos
| | - Wasiu Lanre Adeyemo
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, College of Medicine, University of Lagos
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22
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Kanthan RK. The use of superficial cervical plexus block in oral and maxillofacial surgical practice as an alternative to general anesthesia in selective cases. Ann Maxillofac Surg 2016; 6:4-8. [PMID: 27563598 PMCID: PMC4979341 DOI: 10.4103/2231-0746.186120] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Aim: (1) To assess the feasibility, safety, and effectiveness of superficial cervical plexus (SCP) block in oral and maxillofacial surgical (OMFS) practice as an alternative to general anesthesia in selective cases. (2) To assess any associated complication specifically related to the procedure. Subjects and Methods: The total number of patients was 10, out of which 6 were male and 4 were female patients. Six patients had incision and drainage of perimandibular space infections, two patients had Level Ib cervical lymph node biopsies, one patient had enucleation of cyst in the body of mandible, one patient had open reduction and internal fixation isolated angle fracture. Informed written consent was obtained from the patients after they had the procedure explained to them. Exclusion criteria included patient's refusal to undergo the procedure under regional anesthesia, allergy to local anesthetic, excessively anxious, and apprehensive patients, significant upper airway compromise warranting an endotracheal intubation to secure airway. All patients had the procedure done by the same operating surgeon. All patients had their surgical procedures under regional anesthesia (SCP block with supplemental nerve blocks) performed by the same surgeon with satisfactory anesthesia and analgesia without any complication. Results: SCP block with concomitant mandibular nerve and long buccal nerve block has a high success rate, low complication rate, and high patient acceptability as shown in the study. Conclusion: The notable anesthetic effect and adequate working time, summed with the low risk of accidents and complications, make this technique a good alternative for sensitive blockage of part of the cranial and cervical regions and have positive outcomes in selective OMFS cases.
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Abstract
Life-threatening infections of odontogenic or upper airway origin may extend to potential spaces formed by fascial planes of the lower head and upper cervical area. Complications include airway obstruction, mediastinitis, necrotizing fascitis, cavernous sinus thrombosis, sepsis, thoracic empyema, Lemierre's syndrome, cerebral abscess, orbital abscess, and osteomyelitis. The incidence of these “space infections” has been greatly reduced by modern antibiotic therapy. However, serious morbidity and even fatalities continue to occur. This study reviews complications of odontogenic infections. The search done was based on PubMed and Google Scholar, and an extensive published work search was undertaken. Advanced MEDLINE search was performed using the terms “odontogenic infections,” “complications,” and “risk factors.”
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Affiliation(s)
- Rishi Kumar Bali
- Department of Oral and Maxillofacial Surgery, JN Kapoor DAV (C) Dental College and Hospital, Yamunanagar, Haryana, India
| | - Parveen Sharma
- Department of Oral and Maxillofacial Surgery, JN Kapoor DAV (C) Dental College and Hospital, Yamunanagar, Haryana, India
| | - Shivani Gaba
- Department of Oral and Maxillofacial Surgery, JN Kapoor DAV (C) Dental College and Hospital, Yamunanagar, Haryana, India
| | - Avneet Kaur
- Department of Oral and Maxillofacial Surgery, JN Kapoor DAV (C) Dental College and Hospital, Yamunanagar, Haryana, India
| | - Priya Ghanghas
- Department of Oral and Maxillofacial Surgery, JN Kapoor DAV (C) Dental College and Hospital, Yamunanagar, Haryana, India
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Shah A, Ahmed I, Hassan S, Samoon A, Ali B. Evaluation of ultrasonography as a diagnostic tool in the management of head and neck facial space infections: A clinical study. Natl J Maxillofac Surg 2015; 6:55-61. [PMID: 26668454 PMCID: PMC4668734 DOI: 10.4103/0975-5950.168213] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Introduction: Superficial facial space infections represent a significant amount of the dental problems that present to hospital. Determining whether an odontogenic swelling is a cellulitis or abscess is difficult, but important as both may require different treatments. The use of an ultrasound may aid in differentiating cellulitis and abscess. This study was done to compare the accuracy of clinical examination alone versus ultrasonography (USG) in the diagnosis of cellulitis and abscess in symptomatic patients with a diagnosis of superficial facial space infection. Materials and Methods: Twenty patients (1870 years) diagnosed as superficial facial space infections by clinical and radiographic examinations were included in the study and patients with significant medical conditions were excluded. The provisional clinical diagnosis was made after a thorough history was taken and clinical examination was performed to determine if the swelling was a cellulitis or abscess. Swelling was then evaluated using the ultrasonic transducer which was placed over the swelling to aid the diagnosis which was again recorded. An incision and drainage procedure was performed after the administration of local anesthesia. The success of the ultrasound intervention versus clinical examination was based on whether frank exudation was detected during incision and drainage of such swellings. Results: The statistical analysis found that USG is a valuable diagnostic aid for detection of abscess or cellulitis in head and neck facial space infections. Interpretation and Conclusion: The findings of this prospective analysis indicate that there was statistical difference between clinical examination alone and USG in making the correct diagnosis. The sensitivity, specificity, positive predictive, negative predictive, and accuracy were not similar for all methods tested. From the results of this study, ultrasound is recommended as an adjunct to clinical examination in differentiating between cellulitis and abscess.
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Affiliation(s)
- Ajaz Shah
- Department of Oral and Maxillofacial Surgery, Government Dental College, Srinagar, Jammu and Kashmir, India
| | - Irshad Ahmed
- Department of Oral and Maxillofacial Surgery, Government Dental College, Srinagar, Jammu and Kashmir, India
| | - Shahid Hassan
- Department of Oral and Maxillofacial Surgery, Government Dental College, Srinagar, Jammu and Kashmir, India
| | - Amina Samoon
- Department of Oral and Maxillofacial Surgery, Government Dental College, Srinagar, Jammu and Kashmir, India
| | - Babar Ali
- Department of Oral and Maxillofacial Surgery, Government Dental College, Srinagar, Jammu and Kashmir, 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] [What about the content of this article? (0)] [Affiliation(s)] [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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Rastenienė R, Aleksejūnienė J, Pūrienė A. Determinants of length of hospitalization due to acute odontogenic maxillofacial infections: a 2009-2013 retrospective analysis. Med Princ Pract 2015; 24:129-35. [PMID: 25592626 PMCID: PMC5588211 DOI: 10.1159/000370073] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Accepted: 11/24/2014] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES To investigate the determinants of the length of hospitalization (LOH) due to acute odontogenic maxillofacial infections (AOMIs) from 2009 to 2013. MATERIALS AND METHODS Dental records of adult patients with AOMIs and related data were retrieved from the Vilnius University's dental hospital. The LOH was related to several determinants in each of the following domains: outpatient primary care, severity of AOMIs, lifestyle and disease domains. Determinants were also associated with the LOH using multivariate analysis. RESULTS A total of 285 patients were hospitalized with AOMIs, of which 166 (58.2%) were males and 119 (41.8%) were females. The mean LOH was 8.3 ± 4.9 days. The bivariate analysis did not reveal any statistically significant differences in LOH between patients with AOMIs who received urgent outpatient primary care and those who did not receive such care prior to hospitalization. All AOMI severity-related determinants were associated with the LOH. The LOH was related to coexisting systemic conditions but not to the higher severity of dental or periodontal diseases. Both bivariate and multivariate analyses revealed similar trends, where the most significant determinants of a longer LOH were related to the severity of AOMIs. CONCLUSION The most important determinants regarding longer hospitalization were indicators of infection severity such as an extension of the odontogenic infection and the need for an extraoral incision to drain the infection.
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Affiliation(s)
- Rūta Rastenienė
- Institute of Odontology, Faculty of Medicine, University of Vilnius, Vilnius, Lithuania
- * Rūta Rastenienė, Institute of Odontology, Faculty of Medicine, University of Vilnius, Žalgirio 115, LT-08217 Vilnius (Lithuania), E-Mail
| | - Jolanta Aleksejūnienė
- Division of Preventive and Community Dentistry, Faculty of Dentistry, University of British Columbia, Vancouver, B.C., Canada
| | - Alina Pūrienė
- Institute of Odontology, Faculty of Medicine, University of Vilnius, Vilnius, Lithuania
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Kumar Verma D, Rajan R. A Case of Thrombocytopenia due to Odontogenic Infection. J Dent Res Dent Clin Dent Prospects 2011; 5:144-7. [PMID: 22991625 PMCID: PMC3442439 DOI: 10.5681/joddd.2011.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2011] [Accepted: 08/20/2011] [Indexed: 01/15/2023] Open
Abstract
Thrombocytopenia in surgical patients is a potentially serious condition,faced by surgeons. A close relationship between sepsis and thrombocytopenia has been suggested. Thrombocytopenia has even been suggested to be indicative of an acute infection. Platelet count in a septicemic patient may also serve as a prognostic tool. There are many reports of thrombocy-topenia due to septicemia in the literature but the occurrence of thrombocytopenia in maxillofacial infections is rare. Thrombocytopenia in a patient with odontogenic infection presents unique diagnostic and management challenges. A case report of an adult male patient with odontogenic infection, who developed life-threatening thrombocytopenia, is presented.
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Affiliation(s)
- Dinesh Kumar Verma
- Reader, Department of Oral and Maxillofacial Surgery, Sharad Pawar Dental College and Hospital, Sawangi, Wardha, Maharashtra, India
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