Surgical drainage vs conservative treatment of odontogenic cellulitis in pediatric patients: A systematic review

André Hergesel De Oliva,Ellen Cristina Gaetti Jardim,Cleidiel Aparecido Araújo Lemos,Joel Ferreira Santiago-Júnior,Jaqueline Suemi Hassumi,Eduardo Piza Pellizzer,Ciro Borges Duailibe De Deus,Danilo Chizzolini Masocatto

doi:10.33448/rsd-v10i9.18244

Abstract

The aim of this study was to compare the efficacy of two different treatment of odontogenic cellulitis in pediatric patients: conservative treatment (just intravenous antibiotic administration and tooth root treatment or tooth extraction) and surgical treatment (intravenous antibiotic administration, incision, drainage and tooth root treatment or tooth extraction). The search strategy was conducted based on the model of systematic review adopted by PRISMA guidelines. The search strategy included: Pubmed/MEDLINE, Web of Science, Scopus and Cochrane Library databases seeking clinical trials with, unless, ten pediatric patients, in English and available on-line. The key-words used in the screening were “Infection Control, Dental and Cellulitis OR odontogenic infection and cellulitis”. A total of 404 studies were obtained and the selection of manuscripts was performed based on the defined inclusion and exclusion criteria and four manuscripts were according with review. It was verified that the surgeons of these studies commonly choose the conservative treatment, varying the adherence rate between 75% and 95.2% and no complications were associated with this treatment. Likewise, 75% of the author support the conservative treatment. The conservative treatment of cellulitis in pediatric patients, presents efficacy without having to submit the patient to surgical drainage.

Highlights

Odontogenic cellulitis is an infection arising from the dentition and its adjacent supporting periodontal structure and if treatment is delayed or administered improperly, it can spread to the face, neck, brain, orbital structures, mediastinum or systemically leading to sepsis
Registry Protocol The search strategy was conducted based on the model of systematic review adopted by PRISMA guidelines (Moher et al, 2009)
The PICO question adopted was: “Is the conservative treatment as effective as surgical treatment to odontogenic cellulitis in pediatric patients?”. It was used the Population, Interventional, Control and Outcomes (PICO) format to define an issue in comparative clinical studies involving pediatric patients with facial odontogenic cellulitis (P) undergoing to drainage (I) or not (C) and compare the efficacy of these treatments in this kind of patient (O)

Summary

Introduction

Odontogenic cellulitis is an infection arising from the dentition and its adjacent supporting periodontal structure and if treatment is delayed or administered improperly, it can spread to the face, neck, brain, orbital structures, mediastinum or systemically leading to sepsis. And correct diagnosis of the true source of infection and definitive treatment of odontogenic cellulitis as soon as possible after admission may reduce the morbidity (Unkel et al, 1997). Cellulitis is a stage of infection what overpass the periosteum and permeate to soft tissues spaces. It is a diffuse, acute, rapidly and progressive condition without defined limits which tends not to form pus and presenting mainly aerobic bacteria. Cellulitis will evolve to an abscess or still spreading to the soft tissues and may evolve to a Ludwig’s angina, cerebral abscess or sepsis

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