Complication Of Odontogenic Infection Research Articles

Ludwig’s angina to retrosternal abscess: a complication of odontogenic infection

Ludwig's angina (LA) is a rapidly spreading cellulitis involving sublingual and submaxillary spaces. It arises most frequently from periapical and periodontal infection of the mandibular molars. Two major complications of LA are life-threatening upper airway obstruction and infectious seeding of the mediastinum, which are responsible for a high mortality rate. Other complications of LA include thrombophlebitis of the internal jugular vein, rupture of the carotid artery, metastatic abscesses and necrosis of the tongue. We have encountered two such cases, with a rapid spread of the inflammation resulting in various local and systemic complications. Awareness of such complications and early clinical as well as radiological diagnosis can lead to prompt surgical drainage, proper antibiotic therapy, and better survival chance. Recognised less often today, this rapidly progressive submaxillary cellulitis may still be fatal.

Management of canine fossa abscess due to Odontogenic Infection : A Case Report

ABSTRACT Introduction: Canina fossa abscesses are rarely reported in the literature. Tooth infection is often derived from bacteria associated with the abscess. Canina fossa abscesses can lead to the development of secondary abscesses, infection of incisors and canines in the upper jaw and, maxillary sinusitis infection. Odontogenic infections can easily spread throughout the muscles and the face, which can cause abscesses vestibular or accumulation of pus in the eyelid and face. This paper aimed to expose the guideline treatment of Canina fossa abscesses as a complication of odontogenic infection. Case report: A 36-Year-old Patient experienced a history of pain and fever. Physical examination showed enlargement and swelling of the right cheek and panoramic radiographs appear radiolucent on the apex of tooth tip 12. Treatment included an intraoral drainage incision at the apex of tooth 12 and continued administration of antibiotic therapy. Conclusion: Successful treatments require early recognition, determination of etiological factors, appropriate medical and surgical management, and also proper wound healing. Keywords /: Canina fossa Abscess, Odontogenic Infection, Modern dressing, drainage incision

Assessment of Prognosis in Odontogenic Descending Necrotizing Mediastinitis: A Longitudinal Retrospective Study.

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.

Orbital cellulitis as a complication of odontogenic infection

Orbital cellulitis is uncommon sequelae of the spread of odontogenic infection to adjacent maxillary sinuses or to distant sites such as the orbits. Once it happened, the spread of such infection can be of serious complication such as complete blindness or even more serious and life threatening situations as cavernous sinus thrombosis, intra-cranial abscess, or even death. This paper aimed to expose the guideline treatment of orbital cellulitis as a complication of odontogenic infection. It reported one case of orbital cellulitis in the emergency unit of Hasan Sadikin hospital Bandung, with complaints of pain, swelling at cheek and periorbital region, and the history of toothache. The treatment include incision drainage, extraction of tooth, and parenteral administration of antibiotic and analgesic. Odontogenic infections are derived from dental infection and can potentially spread rapidly to be ascending infection like orbital cellulitis. Odontogenic infection and orbital cellulitis should be adequately treated with incision drainage, extraction of tooth and parenteral administration of antibiotic, steroid and analgesic. Without immediate treatment, odontogenic infection can lead to ascending infection. Orbital cellulitis due to spreading of odontogenic infection is a rare case. In this case report, the patient had a significantimprovement due to immediate and proper treatment.

Correlates of illness behaviour related to orofacial infections of odontogenic origin among adults in a semi urban community in Nigeria.

Infections of facial spaces in the maxillofacial region occur in most cases as a complication of odontogenic infections. It often results in substantial morbidity, with serious and potentially life threatening outcomes if allowed to progress without prompt medical attention. To identify factors that determine illness behaviour related to maxillofacial space infections. This was a descriptive cross-sectional study of adult residents of pakoto community, Ifo local government area, Ogun state. The study was conducted using an interviewer administered questionnaire which included key information about respondents' awareness of predisposing factors of maxillofacial space infections; common actions taken with regards to treatment, and the factors that influenced their utilization of the available oral health care service. A total of 187 individuals were sampled, mean age was 30.5(SD 11.7) years with majority being females (59.4%) The proportion of the total respondents who reported a history suggestive of orofacial space infection was 20.3% (n=38). Visiting a patent medicine dealer (26.3%) along with visiting a dentist (31.6%) were the illness behaviours most frequently engaged in by respondents who have had an orofacial swelling following a toothache, with majority (73.7%) indicating the action they took was based on what was most convenient. This study has revealed that engagement in unorthodox practises by individuals in a semi-urban community studied is prevalent, and influenced by factors such as age, gender, level of education and occupation. None.

Mediastinitis as complication of odontogenic infection: A case report

Odontogenic infections are one of the most common dental problems, which affect 80%-90% of the population. Untreated odontogenic infections can cause life-threatening complications such as necrotizing fasciitis, descending necrotizing mediastinitis, internal jugular vein thrombosis, cavernous sinus thrombosis, carotid artery pseudoaneurysm or rupture, and systemic inflammatory response syndrome. This report aims to present a mediastinitis case, in a 22-year-old healthy male patient, which originated from an odontogenic infection. The patient was hospitalized because of worsening general health status, despite the antibiotherapy. Computed tomography (CT) scan revealed that periapical abscess was spreading to the mediastinum through retropharyngeal space. The patient was successfully treated by IV antibiotherapy, transcervical drainage, and extraction of tooth.

Temporoparietal and Infratemporal fossa abscess as a complication of dental extraction – a rare and potentially lethal condition

Abscesses of the infratemporal fossa are rare in clinical practice. Usually it occurs as a complication of odontogenic infections, dental extraction, sinusitis and trauma. The initial signs & symptoms of this condition may be very non-specific in nature. If treatment is delayed, the abscess may extend superiorly to involve the temporoparietal region and only then it can be appreciated clinically. A middle aged male patient presented to us with the complaint of restricted mouth opening along with extensive swelling of the temporoparietal region. There was past history of tooth extraction. MRI scan confirmed it to be a case of temporoparietal & infratemporal fossa abscess with features of osteomyelitis of the ramus and adjacent body of the mandible on the right side. The patient was started on parenteral antibiotics and subsequently the abscess was drained by combined external and intraoral approach. The patient had an uneventful recovery. A thorough review of the literature has been done in relation to this condition and its management. A delay in diagnosis of this condition can lead to a number of potentially lethal complications. CT scan and MRI scan are the best modalities for confirming the diagnosis in suspected cases. Prompt drainage of the abscesses under antibiotic cover is the cornerstone of management. Isolated abscess of the infratemporal fossa may be drained intraorally or endoscopically by trans-maxillary approach. However if the temporoparietal region is also involved, a combined approach with a separate incision over the temporal region is indicated.Asian Journal of Medical Sciences Vol.9(4) 2018 57-60

Cutaneous Basal Cell Carcinoma Arising in Odontogenic Cutaneous Fistula.

An odontogenic cutaneous fistula is a pathological communication between the outer skin surface of the face and the oral cavity. Facial cutaneous fistula is a complication of odontogenic infection that is often misdiagnosed with skin infection. We report a rare case, which was diagnosed as basal cell carcinoma based on the biopsy of skin lesions in the patient who had been diagnosed with odontogenic cutaneous fistula. A 64-year-old male patient presented with a cutaneous odontogenic fistula. The patient had undergone surgical extraction of fistula tract and loose tooth before dermatology or plastic surgery consultation. With the biopsy and computed tomography, it was confirmed that fistula and basal cell carcinoma. However, the connection between the fistula and skin cancer was not clear. Positron emission tomography-computed tomography scan was performed and was not detected as other local or distant metastasis. After that, wide excision of the skin lesion was performed. Although skin cancer is not commonly observed, it is necessary to rule out this disease entity by performing biopsy of skin lesions.

Rehabilitation of a complete maxillectomy patient: A case report of osteomyelitis of maxilla

Osteomyelitis of the jaws is osteomyelitis (which is inflammation of the bone marrow, sometimes abbreviated to OM) which occurs in the bones of the jaws (i.e. maxilla or the mandible). Historically, osteomyelitis of the jaws was a common complication of odontogenic infection (infections of the teeth). Before the antibiotic era, it was frequently a fatal condition. Today osteomyelitis of facial bones is a rare condition. Maxillary osteomyelitis is rare compared to mandible osteomyelitis because extensive blood supply & strut like bone of the maxilla make it less prone to chronic infection. We report a rare case of Osteomyelitis involving whole of the Maxilla in a 63 year old male patient, diabetic and hypertensive for the past 2 years. He presented to us with anpalatally exposed bone with offensive odour from the nose. Examination revealed a necrotic maxilla involving whole hard palate. A computerized tomography scan confirmed Osteomyelitis of whole Maxilla. Patient underwent complete surgical excision with prosthesis reconstruction. Prosthetic rehabilitation of patients with acquired defects of the maxilla present a challenging task because of inadequate retention and stability of prosthesis and these goals are even more challenging in a complete maxillectomy case. This case report describes the fabrication of prosthesis utilizing soft tissue undercuts for retention using soft liners as one technique and fabrication of a two piece prosthesis utilizing magnets to meet the goals.

Descending necrotizing mediastinitis as a complication of odontogenic infection

Descending necrotizing mediastinitis (DNM) is a serious, life threatening complication that can occur from a common odontogenic infection. Even with advancements in antibiotics, diagnostic imaging, and surgical management, the mortality rate remains between 20 and 40%. It is imperative that the practitioner taking care of patients with odontogenic infections be sensitized to this potentially fatal complication. We report the successful management of a case of mediastinitis complicating an odontogenic infection in a 39-year-old male.

下顎の歯性感染症から継発した脳膿瘍の１例

We report a rare case of brain abscess secondary to mandibular odontogenic infection. A 50-year-oldman developed an abscess of the infratemporal fossa, masticatory myositis, and temporal myositis caused bylower first molar marginal periodontitis. Incision and drainage were performed by an intraoral approach, andantibiotics were administered intravenously. On the 8th disease day, vomiting occurred, but responded to anantiemetic drug. On the 9th disease day, extraction of lower first molar and adrasion was performed, resulting inthe alleviation of local symptoms. However, a persistent headache occurred, CT and MRI scans revealed a brainabscess and subdural abscess in the temporal lobe, immediately above the skull internal base. The patient wasgiven a diagnosis of brain abscess caused by odontogenic infection. The abscess almost disappeared after conservativetherapy administered at the department of brain surgery, and no sequelae were noted. The abscess apparentlyexpanded directly and continuously from the skull base through the foramen ovale and foramen spinosum.This case emphasizes the need to diagnose brain abscess and subdural abscess as complications of odontogenicinfection.

Mediastinitis occurring as a complication of odontogenic infections

Mediastinitis occurring from a descending odontogenic infection occurs rarely. The diagnosis is sometimes difficult to make and is often delayed until the patient is in extremis. The physical examination is often nondiagnostic, but may include brawny edema of the neck and chest. CT scanning provides the most accurate diagnostic information. The treatment is always surgical, in combination with appropriate antibiotics. Five patients with mediastinitis secondary to odontogenic infections are presented, and the technique of transcervical drainage of the anterior and posterior mediastinum is reviewed.