Treatment Of Odontogenic Infections Research Articles

THE CONCEPT OF COMPLEX TREATMENT OF ODONTOGENEOUS PHLEGMONS OF MAXILLOFACIAL AREA

Odontogenic phlegmons of maxillofacial localization are a common problem of modern medicine. According to the literature data, it was established that odontogenic phlegmons of maxillofacial localization make up from 2.7% to 3.4% of all visits to the dentist. Unfortunately, these pathological processes do not have a tendency to decrease their prevalence among the population, which is due to the general low level of dental rehabilitation of patients, as well as reluctance to seek medical help and hope for the effectiveness of selftreatment. The aim of this work. The analysis of methods of treatment of odontogenic phlegmons of maxillofacial localization, substantiation of factors affecting the effectiveness of treatment of purulent-inflammatory diseases have been carried out. Materials and methods: The analysis of literary sources of Ukrainian and foreign authors regarding the course, treatment and complications of maxillofacial localization over the past 10 years has been conducted. Research results and their discussion. Although the treatment of odontogenic infections has been improved over the past decades, further improvements are needed in this area. The main factors that contributed to the development of odontogenic phlegmons of maxillofacial localization are unsatisfactory oral hygiene (76%), smoking (41%) and alcohol consumption (19%). To optimize the treatment of patients with purulent odontogenic processes of maxillofacial localization, it is necessary to perform a thorough history and clinical examination, which are important for determining the severity of any infection. The concept of "physiological reserve" is a significant driver of outcomes in patients fighting infection. Age is a significant factor that is inversely proportional to physiological reserve; that is, a decrease in respiratory, cardiovascular and metabolic reserve. Early and adequate intervention is essential to prevent avoidable deterioration of the condition with invasion of corrected anatomic spaces and symptoms of sepsis. Conclusions. According to the results of the study, it was established that the treatment of patients with odontogenic phlegmon of maxillofacial localization should have a comprehensive approach, failure to comply with which can lead to the development of severe complications of both local and general nature.

Determinant of antibacterial failure in patients with head and neck infections with odontogenic source.

<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.

Antibiotic prescription after tooth extraction in adults: a retrospective cohort study in Austria

BackgroundBroad spectrum antibiotics are often used for the prophylaxis of infectious endocarditis and treatment of odontogenic infections, but there are limited data related to antibiotic use and adherence to prescription guidelines. MethodsData from patients with tooth extraction between 2014 and 2018 were selected from a database of a regional health insurance fund. We created three data sets, one based on all tooth extractions, one on multiple teeth extractions, and one including only single tooth extraction. After data collection, descriptive analysis was carried out. The differences in prescription pattern of antibiotic medicine were tested by χ2 test, Student´s t-test or ANOVA.ResultsFrom 43,863 patients with tooth extraction, 53% were female, and 3,983 patients (9.1%) filled a prescription for antibiotic medicine. From 43,863 patients, 157 patients (0.4%) had endocarditis risk, but only 8 patients of these (5.1%) filled an antibiotic prescription. In total, 9,234 patients had multiple and 34,437 patients had only one tooth extraction. Patients with more than one tooth extraction received more often antibiotic treatment (10.7%) compared to those with single tooth extractions (χ2 = 36; p < 0,001). Patients with more than one tooth extraction were older, however, younger patients received antibiotics more frequently (t = 28,774, p = 0.001). There was no relationship with endocarditis risk status. Clindamycin and amoxicillin/clavulanic acid were the most frequently prescribed antibiotic medicines.ConclusionsIn this retrospective cohort study, dentists did not discriminate prophylactic antibiotic prescription with regard to endocarditis risk status. A factor influencing prescribing behaviour of antibiotic medicines was the number of extracted teeth.

Current approaches to the diagnosis and management of odontogenic abscesses

A wide scale of medical professionals including general practitioners, dentists, maxillofacial surgeons, otolaryngologists or even emergency physicians frequently encounter patients suffering from abscesses of odontogenic origin. These dental infections spreading along the fascial planes into the adjacent anatomical spaces or by the lymphatic vessels and veins may result in life-threatening situations. It is essential to prevent and - in the case of an evolved disease pattern - to treat them properly, since improper or delayed treatment may entail avoidable burdens on the healthcare system. Our aim was to review the current literature regarding the development, diagnostics and treatment of odontogenic infections. A review of the English and Hungarian literature was performed. Considerations regarding the surgical management of dental abscesses have well-tried, traditional routes. Prompt intervention is considered mandatory with surgical decompression of the swelling by performing incision and drainage. A rapid improvement of radiology has provided the possibility to realize and avoid fatal consequences of this disorder. The administration route, necessity and duration of empiric antibiotic therapy are still debated, protocols vary across studies. Based on inconsistency in findings among the studies and lack of high-quality prospective studies, future research should evaluate evidence-based and effective management of dental abscesses.

Importance of early identification of a deep neck abscess

Treatment of odontogenic infections, such as drainage of submucosal abscesses, should be carried out by the dental practitioner. However, when an odontogenic infection deteriorates into a deep neck abscess, treatment should be carried out by the oral maxillofacial surgeon. Based on two cases, this article describes the clinical presentation, course, and necessary treatment of a deep neck abscess. It also points out that timely recognition of the disease is key in treatment. In any case of delay, there is a possibility for fast deterioration by complications, such as airway obstruction, development of descending necrotizing mediastinitis, or sepsis. Oral health practitioners play an important role in early identification of a deep neck abscess. This article proposes recommendations for dentists when to suspect a deep neck infection, which could be useful in quick and adequate referral to an OMF surgeon.

Odontogenic Infection. Review of the Pathogenesis, Diagnosis, Complications and Treatment

Odontogenic infections are frequently seen in the dental practice, being dental caries its main etiology; therefore, dentists should be familiarized with its presentation and management as it can spread rapidly and have serious consequences. The purpose of this article is to provide essential knowledge on the pathogenesis, diagnosis, possible complications and treatment of odontogenic infections.

Odontological Drugs and Their Action on Some Biological Organisms

Odontology is the study of teeth, of theirs diseases and treatment of these. Many odontological drugs are commonly used in dental practice. Antibiotics are indicated for the treatment of odontogenic infections, oral non-odontogenic infections, as prophylaxis against focal infection, and as prophylaxis against local infection and spread to neighboring tissues and organs. In addition to antibiotic, antifungals (drugs for classes azoles, imidazoles and polyenes), antiviral such as antimicrobial mouthwashes and nucleases inhibitors are also indicated for the treatment. These drugs prescription is almost invariably associated with the prescription of Nonsteroidal Antiinflammatory Drugs (NSAIDs), topical corticoids, local anaesthesic for odontological pain and/or Sodium Fluoride for dental caries. Odontalogical drugs act on several levels of metabolism either of microorganisms’ constitutive material (e.g. wall, membrane, cytoplasm and nuclear materials for antibiotics, antivirals, antifungals and oxidizing substances) to destroys them or of humans system cells (receptors, enzymes, hormones for painful, inflammation, local anaesthesic and dental building drugs) to inhibit or stimulate them for the best functioning.

Antibiotic prescribing at a periodontal residency practice in Connecticut.

Antibiotics are important in the treatment of odontogenic infections and the prevention of infection following dental procedures in high-risk situations. Little is known about antibiotic prescribing in periodontal practice. This study describes prescribing practices by periodontal faculty and residents in an academic setting in order to identify opportunities to optimize prescribing behaviors. This cross-sectional study analyzed all antibiotic prescriptions from residents or faculty in an academic periodontal clinic from 2014-2017. Information was manually extracted from the electronic health record. Antibiotic prescriptions were stratified into three indication categories: pre-procedural prophylaxis, post-procedural prophylaxis, and treatment. Out of 275 prescriptions analyzed, 266 met inclusion criteria. The most frequent antibiotic indication was post-procedural prophylaxis (n=130, 48.87%). Amoxicillin was the most frequently prescribed antibiotic across all groups (n=236, 88.72%), followed by clindamycin (n=22, 8.27%). Most patients presented in a non-emergent setting (n=200, 75.19%), without pain (n=210, 78.95%), and had restorative/endodontic-related clinical findings (n=55, 20.68%). Among the 35 patients receiving antibiotics for infection treatment, 8 (22.86%) underwent a surgical intervention on the date of antibiotic prescription. Of the 130 patients receiving post-procedural prophylaxis, 121 (93.08%) received surgical interventions on the day of antibiotic prescription. Antibiotics are prescribed in various situations in periodontal practice, most frequently as post-procedural prophylaxis, an indication for which data is limited. There is an urgent need to study the role of post-procedural prophylactic antibiotics and understand antibiotic prescribing in the management of periodontal disease in order to optimize prescribing practices.

Clinical, CT scan, and laboratory changes of abscess patients with odontogenic origin admitted to Shiraz acute surgical care center, Iran.

Introduction:Rapid diagnosis of maxillofacial abscess with the odontogenic origin is effective in the treatment of patients. This study aimed to check the clinical evaluation, head, and neck computed tomography (CT) scan, and microbial sensitivity of hospitalized patients diagnosed with maxillofacial abscess admitted to the Maxillofacial Surgery Ward Shaheed Rajaie Surgical Acute Care Center of Shiraz, Iran from 2019-2021.Method:A cross-sectional study was conducted. The sample included patients diagnosed with the abscess of odontogenic origin. Data collection tools included personal profile registration form, chief complainant and clinical evaluation, laboratory test results, pus culture, antibiogram results, and head and neck CT scan changes form. Data was reported with descriptive statistics by SPSS-16 software.Results:The majority of patients were male; infection duration was 10 days; maximum mouth opening size was less than 20 mm in more than half of patients. The scan revealed 41.8% abscess, 36.4% cellulite, and 21.8% mixed abscess and cellulitis. There was 29.1% involvement of salivary glands. The majority of abscesses were unifocal involved in the submandibular space, and the least involvement was in peri mandibular space and carotid sheath. The most common organism causing was staphylococcal abscess coagulase-negative.Conclusion:In patients with maxillofacial abscess requiring hospitalization, the most common clinical features were trismus, toxic appearance, and dysphagia, and the most common source of abscess in scanning patients with mandibular molars was the most involved submandibular space and pterygomandibular space. Vancomycin, cotrimoxazole, and cefazolin had the greatest effect in the treatment of odontogenic infections in terms of antibiogram results and microbial culture.

Does Having State-Funded Insurance Predispose Patients to Delaying Treatment of Odontogenic Infections until They Are Severe?

Does Having State-Funded Insurance Predispose Patients to Delaying Treatment of Odontogenic Infections until They Are Severe?

Immediate Versus Delayed Treatment of Odontogenic Infections

Immediate Versus Delayed Treatment of Odontogenic Infections

Case Report: Resolution of chronic urticaria following treatment of odontogenic infection

Background: Chronic spontaneous urticaria (CSU) is a condition characterised by the presence of hives with/without angioedema, that affects individuals on more days than not for 6 weeks or more. The role of infection as a potential trigger for CSU is well described, but the current clinical guidelines do not recommend routine screening for underlying infections. Main observations: We report a case of severe prolonged chronic spontaneous urticaria in a 19-year-old, that went into rapid remission following the treatment of dental infection. Conclusions: Clinicians should recognise the potential role that infection can have in causing chronic urticaria. There should be a low threshold to treat infection in such circumstances.

Knowledge of Senior Dental Students on Odontogenic Infections

Odontogenic infections are the most common infections that require early diagnosis and proper treatment. Given the sensitivity of the issue, the dental community needs to have correct information about the current status. Therefore, this study aimed to assess the knowledge of students in Tabriz University of Medical Sciences about the treatment of odontogenic infections in 2017. In this descriptive‒analytical study, all the senior students of Tabriz Faculty of Dentistry were evaluated. Data were collected using a questionnaire consisting of 20 questions related to students’ awareness about the treatment of odontogenic infection. Data were analyzed with descriptive statistics and chi-squared test. The results indicated that the mean knowledge score of the students was 8.64±2.6. Knowledge of 77.4 % of students was low, 20.8 % had moderate knowledge and 1.8 % had a high level of knowledge. There were no significant differences in knowledge between male and female students. Knowledge of senior dental students in Tabriz University of Medical Sciences was poor, with no difference between male and female students.

Following in the footsteps of Hippocrates-interrelation between the incidence of odontogenic abscess and meteorological parameters.

Although many physicians in daily practice assume a connection between odontogenic infections and meteorological parameters, this has not yet been scientifically proven. Therefore, the aim of the present study was to evaluate the incidence of odontogenic abscess (OA) in relation to outdoor temperature and atmospheric pressure. An analysis of patients with an odontogenic abscess who presented at the emergency department within a period of 24months was performed. Only patients who had not received surgical or antibiotic treatment prior to presentation and who lived in Berlin/Brandenburg were included. The OA incidence was correlated with the mean/maximum outdoor temperature and atmospheric pressure starting from 14days before presentation. The statistical analysis was carried out using Poisson regression models with OA incidence as dependent and meteorological parameters as independent variables. A total of 535 patients (mean age 39.4years; range 1 to 95years) with 538 cases were included. Of these, 227 were hospitalized. The most frequent diagnosis was a canine fossa abscess. A significant association between mean (p = 0.0153) and maximum temperature (p = 0.008) on the day of the presentation and abscess incidence was observed. Furthermore, a significant correlation between OA incidence and maximum temperature 2days before presentation was found (p = 0.034). The deviation of the mean temperature on the day of the presentation from the monthly mean temperature had a significant influence (p = 0.021) on the incidence of OA. In contrast to temperature, atmospheric pressure had no significant influence on the incidence of OA. This study supports a relationship between the incidence of odontogenic abscess and outdoor temperature, but not atmospheric pressure. A significantly higher frequency of patients with an OA presented at our emergency department on days with (comparably) low and high outdoor temperatures. Furthermore, a significant correlation between incidence and maximum temperature 2days before presentation was found. The treatment of odontogenic infections has become a significant economic burden to public health care facilities. The results of this study may help to adapt the numbers of doctors/dentists on duty in relation to different weather conditions. In any case, it is an impetus to think outside the box.

The rational use of antibiotics by dentists for odontogenic infection treatment in kupang, East Nusa Tenggara

Background: Many odontogenic infection cases do not need antibiotic prescriptions. The excessive use of antibiotics can lead to microbial resistance. Objective: This study aims to acknowledge the rationale and varieties of antibiotic prescriptions in odontogenic infection treatment by dentists. Methods: Data were collected from 513 patients' medical records from the provincial public hospital and district public health center (PHC), Kupang City, from January to June 2016. The variables of this study were odontogenic infections treated with antibiotic therapy and the span of that antibiotic therapy. Results: Antibiotic use was not required in odontogenic infection cases: periapical abscess (27%), nonsurgery tooth extraction (20.7%), apical periodontitis (17.3%), and pulpitis (15%). Amoxicillin (76%) and clindamycin (12%) are widely used in odontogenic infection treatment. Based on the duration of therapy, it was found that the use of amoxicillin was 44% and clindamycin was 34%. Conclusion: Excessive antibiotic use is done by general dental practitioners in the treatment of odontogenic infection. Strict rules for antibiotic prescription are needed to prevent antibiotic resistance.

Case Report: Resolution of chronic urticaria following treatment of odontogenic infection

Background: Chronic spontaneous urticaria (CSU) is a condition characterised by the presence of hives with/without angioedema, that affects individuals on more days than not for 6 weeks or more. The role of infection as a potential trigger for CSU is well described, but the current clinical guidelines do not recommend routine screening for underlying infections. Main observations: We report a case of severe prolonged chronic spontaneous urticaria in a 19-year-old, that went into rapid remission following the treatment of dental infection. Conclusions: Clinicians should recognise the potential role that infection can have in causing chronic urticaria. There should be a low threshold to treat infection in such circumstances.

Treatment of odontogenic infections: An analysis of two antibiotic regimens

PurposeRetrospective analysis of the efficacy for two commonly used antibiotic regimens in the management of severe odontogenic infections. Patients and MethodsEvaluation of records of patients admitted to the Oral and Maxillofacial Surgery service at Boston University Medical Center from 2009 to 2014 with severe infections of odontogenic origin (SOI). Patients were divided into two groups based on the administered intravenous antibiotic: 1) Group I: Clindamycin only and 2) Group II: Penicillin and Metronidazole. Variables evaluated included demographic characteristics, ASA status, and anatomic site of infection risk, length of hospital stay, antibiotic failure, and pharmaceutical treatment cost. Results78 patients (46 males and 32 females) were included in the study. There were 57 patients in group I (average age 32.6 years) and 21 in Group II (average age 32.8 years). The average white cell count at time of admission count was higher in Group I (19.3) versus Group II (17.4). Antibiotic failure rate was 3.5% in Group I and 4.7% for group 2 patients. ConclusionClindamycin alone and combination of Penicillin with Metronidazole are both effective pharmaceutical regimens for SOI. Clindamycin therapy resulted in shorter hospital stay and lower net treatment costs with a slightly higher success rate.

Controversies in the Management of Oral and Maxillofacial Infections.

The management and treatment of odontogenic infection, and its frequent extension into the head and neck, remains an important section of oral and maxillofacial surgical practice. This area of maxillofacial expertise is widely recognized by the medical community and an essential component to the hospital referral system. Although the general principles of infection management have not changed, there have been modifications in the timing of treatment sequences and treatment techniques. These modifications are influenced by the development of diagnostic methods and advances in bacterial genetics and antibiotic usage. This article reviews treatment considerations and controversies surrounding this subject.

Epidemiology of odontogenic infections in a secondary healthcare centre in Southern Nigeria

Association of odontogenic infections with several systemic diseases is of public health importance in Nigeria. This study aimed at determining the epidemiological and microbiological profiles of odontogenic infections and it aetiologic agents in dental patients in Benin City metropolis. Surface and deep socket swabs were collected from each patient before and after tooth extraction and processed for aerobic bacteria. Antimicrobial susceptibility test was carried out on each isolate using standard microbiological methods. Demographics of patients were collected with standard data recording format. Patients aged 20-29 years were more predisposed to odontogenic infections, predominantly peridontitis (51.5%) followed by caries (18.6%) and irreversible pulpitis (9.3%). Teeth in the right lower quadrant of the mouth were most frequently excised in both sexes. Predominant isolates were: β-haemolytic Streptococci (34%), Enterococci (20.6%), Corynebacteria (11.9%), Staphylococci (9.3%), γ-haemolytic Streptococci (5.2%), Neisseria (1.5%), Bacillus (1%), and α-haemolytic Streptococci (0.5%). There was low level of susceptibility of isolates to amoxicillin 30% and high level of susceptibility to perfloxacin (80%). A total of 19.1% of isolates were resistant to the five classes of antibiotics, indicative of multiple drug resistance (MDR) phenomenon. Our study has shown that, treatment of odontogenic infection in the study centre must change and be guided by antimicrobial susceptibility test result to ensure rational use of available antimicrobials.Keywords: Odontogenic infections; Antimicrobial activity; Epidemiological profile; Isolates

Improving antibiotics prescription habits in the treatment of odontogenic infections

Improving antibiotics prescription habits in the treatment of odontogenic infections