Management Of Odontogenic Infections Research Articles

Odontogenic Infection of the Infratemporal Fossa: A Diagnostic Challenge

The infratemporal fossa (IF) is an important anatomical space that carries vital neurovascular structures within it. The formation of an abscess in the IF, particularly of odontogenic aetiology, is rare. It can pose a diagnostic challenge due its uncommon presentation and can be life-threatening with delayed treatment. We present an unusual case of an IF abscess in an otherwise healthy female patient. Due to the rising difficulty accessing emergency NHS dental services, the untimely diagnosis and management of odontogenic infections may lead to similar scenarios. CPD/Clinical Relevance: It is important that clinicians have good knowledge of the anatomy of fascial spaces and be aware of signs and symptoms of spreading infections.

NOVEL BIOMATERIAL ASSISTED DRUG DELIVERY SYSTEMS FOR THE MANAGEMENT OF ORAL DISEASES–FUTURE THERAPEUTIC APPROACHES

Oral health is integral to maintaining systemic health as the mouth and oral cavity connect our digestive system with the external environment. The incidence of oro-dental disorders has been emerging as a serious threat to the healthcare sector owing to the increasing complexity of oral microbiome. Conventional treatment modalities are often limited by drug resistance and unwanted inflammatory responses. Recently, therapeutic strategies that can reinstate microbial homeostasis in the oral microenvironment have been implicated in the management of odontogenic infections. Biomaterial-based drug delivery systems, including nanocarriers, dendrimers, hydrogels, oral thin films, oral patches, and other stimuli-responsive polymeric systems, facilitate targeted administration of antimicrobials and anti-inflammatory agents to the site of infection. Bio adhesivity of the polymeric carriers facilitates faster disintegration and accurate dosing of the pharmacological agent to the target site. Moreover, restorative dentistry has been revolutionized by the advent of bio-functional templates that offer improved osseointegration and long-term stability of implants. A comprehensive review of the potential applications of biomaterial-mediated therapeutic strategies in the management of caries, peri-implantitis, periodontitis, and other oro-dental infections is explored here.

Antimicrobial therapy in the management of odontogenic infections: the penicillin-allergic patient

This retrospective analysis was performed to investigate whether clindamycin remains the preferred antibiotic for penicillin-allergic patients with odontogenic infections. The medical records of 311 patients admitted to the study department with odontogenic infections between 2018 and 2022 and treated with either intravenous amoxicillin–clavulanic acid (Augmentin) or intravenous clindamycin were analyzed. The Augmentin-treated group included 268 patients (86.2%) and the clindamycin-treated group included 43 patients (13.8%). Severity parameters did not differ significantly between the two groups, except for a higher prevalence of abscesses in the clindamycin-treated group (58.1% vs 41.0% in the Augmentin-treated group; P = 0.035). The clindamycin-treated group required a longer duration of intravenous antibiotics (P = 0.001) and had a higher rate of treatment failure (14.0% vs 2.2%; P = 0.002) when compared to the Augmentin-treated group, with a seven-fold increased risk of treatment failure. Moreover, significantly more isolated organisms in the clindamycin-treated group were resistant to clindamycin (P = 0.015); these were all Streptococcus anginosus group. Given the higher risk of treatment failure with clindamycin, it is necessary to choose the antibiotic treatment for penicillin-allergic patients carefully. A detailed history and allergy testing followed by combination therapy is recommended, especially in severe cases.

A global science mapping analysis on odontogenic infections

ObjectivesOdontogenic infections are common and a topic of core interest for dentists, and maxillofacial surgeons. The aim of this study was to conduct a bibliometric analysis of the global literature on odontogenic infection and explore the top 100 most cited papers to identify the common causes, sequelae and management trends. MethodsFollowing a comprehensive literature search, a list of top 100 most cited papers was created. The VOSviewer software (Leiden University, The Netherlands) was used to create a graphical representation of the data, and statistical analyses were performed to analyze the characteristics of the top 100 most cited papers. ResultsA total of 1,661 articles were retrieved with the first article published in 1947. There is an exponential upward trend on the number of publications (R2 = 0.919) and a majority of papers are in English language (n = 1,577, 94.94%). A total of 22,041 citations were found with a mean of 13.27 per article. The highest number of publications were recorded from developed countries. There was a male predilection in the reported cases and the most common sites included the submandibular and parapharyngeal spaces. Diabetes mellitus was identified as the commonest co-morbidity. Surgical drainage was ascertained to be the preferred method of management. ConclusionsOdontogenic infections remain prevalent and have a global distribution. Although prevention of odontogenic infection through meticulous dental care is ideal, early diagnosis and prompt management of established odontogenic infections is important to avoid morbidities and mortality. Surgical drainage is the most effective management strategy. There is lack of consensus regarding the role of antibiotics in the management of odontogenic infections.

Presepsin assessment in maxillo-facial infections: a new early biomarker of sepsis?

Odontogenic infections can cause serious inflammatory problems of the soft and hard tissues in the maxillofacial area up to, albeit in quite remote circumstances, involvement of the brain tissues. In recent years, therefore, a holistic diagnostic-therapeutic approach has been developed in the management of odontogenic infections by carrying out a careful systemic history of the patient who has an infectious condition in the oral cavity. The early detection of systemic sepsis conditions was facilitated using serum biomarkers such as PCR, Procalcitonin (PCT) and Presepsin (PSEP) in hospital emergency rooms. However, even if used in combination, their diagnostic accuracy is such as to suggest the importance of researching new, more specific, and sensitive biomarkers. A total of 9 articles was analyzed to investigate the use of the PSEP as biomarker in the maxillo-facial region infections and including only English-language articles and the electronic search of publications from 1 January 2017 to 31 December 2021. This study aimed to determine the diagnostic value of presepsin in condition of sepsis derived from an odontogenic infection and to evaluate its use in the prognostic evaluation phase of surgical interventions performed in the maxillofacial area.

MANAGEMENT OF ODONTOGENIC INFECTION OF PRIMARY TEETH IN CHILD THAT EXTENDS TO THE SUBMANDIBULAR AND SUBMENTAL SPACES

Odontogenic infections are infections originating from the teeth or the supporting tissues of the teeth. This infection can spread to the alveolar processes, the deeper tissues of the face, oral cavity, head, and neck. Infections that spread to a child's facial area can progress rapidly, producing significant systemic symptoms, such as fever, malaise, dehydration, dysphagia, and respiratory distress. The purpose of this case report is to describe the management of odontogenic infection of primary teeth in child that extends to the submandibular and submental spaces. Case Report:A 5-year-old boy patient came to the Emergency Department of Hasan Sadikin Hospital Bandung with complaints of swelling in the right submental and submandibular for seven days. The patient complained of toothache, fever, and trismus. The diagnosis of this case was submandibular abscess extending to the submental area due to dental infection 85.. Patient care includes administering Ceftraxone inj 325 mg IV, Metronidazole inf 170 mg IV, Paracetamol inf 195 mg IV, tooth extraction 85, drainage incision through and through the right mandibular to submental, and installation of a Penrose drain. Conclusion:Odontogenic infections in children can originate from primary teeth and can extend to the maxillofacial space. Prompt and appropriate treatment of severe odontogenic infections in children needs to be done to prevent further complications

Management of odontogenic infections and sepsis: an update

The management of odontogenic infections has improved over recent decades, but further improvements are still required. The ongoing education of GDPs and their dental teams on this issue continues to be important, especially during the current COVID-19 pandemic, where remote triage poses additional difficulties and challenges.

An audit on the use of steroids in the management of odontogenic infections

Introduction: The role of corticosteroid administration in the management of odontogenic infections is variable between clinicians with no consensus usage guidelines available. However, corticosteroid use in mild infections that do not require prolonged hospital admission or general anaesthetic for surgical management is generally considered to be unnecessary. An audit was carried out to assess if corticosteroids were being appropriately used in the management of adults presenting with odontogenic infections.

Effect of Outside Provider Interventions on Severity and Management of Odontogenic Infections in a Hospital Setting

Effect of Outside Provider Interventions on Severity and Management of Odontogenic Infections in a Hospital Setting

Management of odontogenic infections and sepsis: an update.

The management of odontogenic infections has improved over recent decades, but further improvements are still required. The ongoing education of GDPs and their dental teams on this issue continues to be important, especially during the current COVID-19 pandemic, where remote triage poses additional difficulties and challenges.Odontogenic infections can lead to sepsis, a potentially life-threatening condition caused by the body's immune system responding in an abnormal way. This can lead to tissue damage, organ failure and death. A patient with non-odontogenic-related infection could also present with sepsis at a dental practice. Early recognition and prompt management of sepsis improves outcomes. GDPs and their dental teams should be trained in the recognition and management of sepsis. Age-specific sepsis decision support tools have been developed by the UK Sepsis Trust to help dental staff recognise and manage patients with suspected sepsis.The aim of this article is to provide an update on the management of odontogenic infections and sepsis.

Antibioticoterapia em Odontopediatria: Atualização para Odontologia

Objetivo: O presente estudo tem como objetivo descrever os principais fatores envolvidos na antibioticoterapia como manejo das infecções odontogênicas em odontopediatria. Materiais e Métodos: revisão de literatura em livros e artigos publicados em inglês e português disponíveis na base de dados PubMed, Biblioteca Virtual em Saúde, Scielo e Google Acadêmico, publicados entre os anos de 2009 a 2019. Resultados: Diante da importância de uma prescrição medicamentosa baseada em critérios que garantam a eficácia do tratamento e a segurança do paciente, entende-se como obrigatoriedade de todos os cirurgiões-dentistas o entendimento dos parâmetros que regem essa prática. Nesse contexto, as penicilinas compõem o grupo dos antibióticos mais utilizados atualmente na Odontologia e, não diferente, na Odontopediatria. Trata-se de medicamentos seguros, com ação altamente eficaz e capacidade de debelar os principais microrganismos envolvidos nas infecções odontogênicas. Para infecções bucais na fase inicial sendo leves ou de moderada intensidade indica-se a amoxicilina e nos casos de maior gravidade, a associação medicamentosa de penicilina e metronidazol. Em caso de alergia, prescreve-se Clindamicina, Claritromicina ou Azitromicina. Conclusão: a antibioticoterapia em odontopediatria exige conhecimento do cirurgião-dentista sobre os medicamentos prescritos, assim como sobre as individualidades de cada paciente, considerando as condições de desenvolvimento ainda incompleto da criança

Management of Odontogenic Buccal Space Infection in Patient with Severe Hemophilia A - Case Report

In the contemporary surgical scenario, there is no consensus amongst practitioners regarding management of Odontogenic infection in Hemophilia patients and proper treatment is not administered often in fear of bleeding. We report successful management of a case of Severe Hemophilia A with buccal space infection based on protocol designed by Ansari MK, et al. for managing space infection in Hemophilia patient.

Evidence-Based Clinical Criteria for Computed Tomography Imaging in Odontogenic Infections

Odontogenic infections are a common problem in emergency departments and impose a burden on hospital budgets and provider time. Compounding this is the lack of evidence guiding the patient's initial evaluation. The purpose of this study was to derive evidence-based guidelines for the use of computed tomographic (CT) imaging in the management of odontogenic infections. A prospective cohort study was designed. Patients with an odontogenic infection presenting to the emergency department from November 1, 2016 to November 30, 2017 were eligible for inclusion. The outcome variable was need for CT imaging, which was based on the location of the abscess. The potential predictor variables were demographics, history items, examination findings, and laboratory values. The association between the outcome and predictor variables was determined using classification and regression tree analysis and standard logistic regression analysis. There were 129 patients who met the inclusion criteria and consented to participation. The patients were 53.5% men and the mean age was 42.5years. The most common fascial spaces involved were vestibular (58.2%), submandibular (18.6%), pterygomandibular (6.2%), buccal (5.4%), and lateral pharyngeal (5.4%). The classification and regression tree analysis identified mandibular inferior border blunting at the body as the best predictor for necessitating a CT scan and identified a mouth opening smaller than 25mm as the second best predictor. These 2 predictors had an accuracy of 96.9% for needing a CT scan. The logistic regression analysis identified these 2 variables and odynophagia, floor of mouth induration, and white blood cell count as relevant predictors for needing CT imaging. The 2 physical examination findings of mandibular inferior border blunting at the body and restricted mouth opening were found to be strongly associated with the need for CT imaging. Further studies should be directed at validating these criteria in larger multicenter studies.

Evidence-Based Clinical Criteria for Computed Tomography Imaging in Odontogenic Infections

Odontogenic infections are a common problem in emergency departments across the country. These patients present with acute pain and swelling that can lead to airway compromise. Additionally, they often represent a burden on hospital budgets and provider time. Compounding this is the lack of evidence guiding the initial evaluation of these patients. Current recommendations widely vary and are based on anecdotal experience, rather than evidence. The purpose of this study is to derive evidence-based guidelines for the use of computed tomography imaging in the management of odontogenic infections.

Increasing Use of Intensive Care Unit for Odontogenic Infection Over One Decade: Incidence and Predictors

To determine whether intensive care unit (ICU) admissions for odontogenic infections have increased during the past decade and whether certain clinical features are associated with a greater rate of ICU admission. The data from patients undergoing surgery for odontogenic infections at the Royal Brisbane and Women's Hospital in the 24month from January 2003 to December 2004 were compared with those from patients treated from January 2013 to December 2014. A χ2 analysis was used to compare the demographic, admission, and clinical patient data in each cohort. A multiple logistic regression model was used to determine which clinical features were associated with greater rates of ICU admission. The rate of ICU admission increased significantly from 7 to 24% during the decade (χ2=12.74; P=.000), although the clinical presentation of patients admitted to the ICU was similar in both cohorts. The mean number of days spent in the ICU increased significantly from 1.7±0.5 to 3.24±2.5days (t=-3.63; P=.001), and the overall length of stay increased from 1.7±0.5 to 3.5±4.1days (t=2.99; P=.004). The use of preoperative computed tomography (CT) increased significantly from 42.9 to 93.3% (χ2=13.25; P=.000). The most significant predictors of ICU admission were lower third molar involvement (P=.026), dysphagia (P=.020), and C-reactive protein (CRP) levels exceeding 150mg/L (P=.039). The use of the ICU in the management of odontogenic infection has increased significantly at the Royal Brisbane and Women's Hospital over 1decade. The demographic data and clinical presentation of the patients admitted to the ICU did not change significantly. However, the length of ICU stay and the total length of stay have both increased. A significant increase in CT usage for odontogenic infections also occurred. Third molar infections, dysphagia, and elevated CRP might be relevant clinical predictors of a more complicated course of care requiring ICU admission. More judicious use of CT scanning, combined with prompt surgical consultation and intervention, might reduce the rate of ICU admissions for odontogenic infections.

Management of odontogenic infection at a district general hospital.

Management of odontogenic infection at a district general hospital.

C-reactive protein concentration as a prognostic factor for inflammation in the management of odontogenic infections

Our aim was to find out if it is possible to correlate the duration of stay in hospital, the severity of infection, involvement of particular anatomical spaces, white cell count, efficacy of surgical treatment, and fever with C-reactive protein (CRP) concentrations on admission. One hundred patients met our inclusion criteria. After their notes had been examined they were subdivided according to whether the infection of the main facial space involved was less severe, moderately severe, or very severe. The relations between degree of severity and CRP concentration on admission (<100mg/L compared with 100+), age (years), sex, and duration of hospital stay (days) were examined using Poisson regression (because the distribution of characteristics, and particularly the duration of stay, were skewed). The overall model was significant (p=0.003). Pearson and deviance chi square tests did not indicate overdispersion (p=0.97 in both cases), which suggested that the assumptions about the Poisson distribution were valid. Log-rank chi square tests indicated that only severity had a significant effect (p=0.0001), and C-reactive protein concentration was not significantly associated with group on admission, age, or sex. The moderately and very severe groups had longer median (range) durations of stay than the less severe group (5 (2-8) compared with 3 (1-8) days, respectively). CRP concentration was not a prognostic factor for the extent of odontogenic infections or presumed duration of stay, but severity scoring was a significant factor in the prediction of duration of stay in hospital.

Comparación de la Politerapia vs Monoterapia antibiótica en la aplicación empírica en contra de las infecciones odontogénicas

El presente estudio se realizó con el objetivo de conocer la eficacia de las distintas terapéuticas de tratamiento contra las infecciones odontogénicas que se aplican a los pacientes ingresados con severidad moderada en el hospital Roberto Calderón los resultados obtenidos mostraron una similitud en la aplicación de la politerapia y la cobertura de manejo de la monoterapia. Por otro lado existe una diferencia significativa para este estudio ya que la politerapia presenta factores de evaluación desfavorable para esta terapia. Así mismo el manejo con monoterapia facilitó factores favorables en beneficio de este tratamiento ante las infecciones odontogénicas. A partir de los resultados descritos, esta investigación concluye que el manejo de las infecciones odontogénicas puede llevarse a cabo adecuadamente a nivel hospitalario por los pacientes afectados con severidad moderada por estas infecciones con la monoterapia de Clindamicina. Dando respuesta a la problemática planteada. Por tanto con este estudio se recomienda al servicio de cirugía oral y maxilofacial del Hospital escuela Roberto Calderón G. la creación de un protocolo para infecciones odontogénicas donde contenga en sus indicaciones el uso de la Monoterapia para pacientes con esta patología

A survey to assess knowledge, practice, and attitude of dentists in the Western region of Saudi Arabia.

Objectives:To assess knowledge regarding the management of odontogenic infections by dentists in Jeddah, Kingdom of Saudi Arabia.Methods:In this cross-sectional study, 150 practitioners responded to a 26-item paper-based questionnaire between August and December 2014. The questionnaire evaluated knowledge and current clinical practices in managing odontogenic infections, as well as the attitude towards antibiotic use and resistance in the community. Basic medical knowledge (BMK) and critical knowledge (CK) scores were calculated from the dentists’ response to these questions and were compared according to educational level (bachelor and postgraduate degree holders).Results:The mean BMK score was 1.98 ± 0.4 and CK score was 1.89 ± 0.3. Dentists with bachelor’s degrees had higher BMK scores than those with a postgraduate degree (p=0.005), but CK was not significantly different (p=0.400). Most dentists (77%) would prescribe antibiotics after a routine dental extraction, and would undertake definitive surgical treatment (49.2%) only after a localized space infection developed. Although 82.2% agreed that routine prescription of antibiotics increases bacterial resistance in the community, 71% believe that prescribing an antibiotic after routine oral surgical procedures prevents odontogenic infections.Conclusion:Dentists in Jeddah require further education through lectures and workshops to stay up to date on current concepts in odontogenic infection management.

Negative pressure wound therapy: is there an application for use in post-surgical management of odontogenic infections?

Negative pressure wound therapy: is there an application for use in post-surgical management of odontogenic infections?