Assessment of Pro Re Nata Inpatient Opioid Consumption Following Surgical Treatment of Severe Odontogenic Infections

Objectives: In patients hospitalized due to deep neck infections (DNIs), to investigate the association between demographic parameters, etiology, and localization of abscesses and/or phlegmons, complications, comorbidities, treatment, and bacterial cultures. Methods: We analyzed data of 263 patients that were hospitalized from January 1, 2012, to December 31, 2015, due to deep neck space phlegmons and/or abscesses. We performed statistical analysis with the SPSS 22.0 software; statistical significance was set p<0.05. Results: Among the analyzed patients, dental infections were the most frequent, followed by acute phlegmonous pharyngitis. Submandibular space abscesses or phlegmons of the neck were the most frequent complications of these infections. Re-operation was performed in 19.8% of cases, and complications developed in 11% (mostly airway obstruction). DNI complications were less common in smokers than in non-smokers (OR=0.038, p=0.025). Discussion: In our study, dental infections accounted for 70.6% of DNI cases. Thus, our study explains why odontogenic DNIs are the most common DNI type studied in the literature. Poor oral health and odontogenic infections should not be underestimated because they can lead to uncommon but lethal diseases such as descending necrotizing mediastinitis, which requires aggressive surgical treatment and is associated with a mortality rate of 10%-40% despite treatment. The complication developed in 11.4% of cases. In conclusion, oral health and hygiene contribute to DNI development.

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Empirical antimicrobial therapy of acute dentoalveolar abscess

Vojnosanitetski pregled ◽

10.2298/vsp0907544m ◽

2009 ◽

Vol 66 (7) ◽

pp. 544-550 ◽

Cited By ~ 10

Author(s):

Stevo Matijevic ◽

Zoran Lazic ◽

Nada Kuljic-Kapulica ◽

Zorka Nonkovic

Keyword(s):

Surgical Treatment ◽

Antibiotic Susceptibility ◽

Clinical Symptoms ◽

Diffusion Method ◽

Oral Streptococci ◽

Bacterial Strains ◽

Viridans Streptococci ◽

Disk Diffusion Method ◽

Odontogenic Infections ◽

Odontogenic Abscess

Background/Aim. The most common cause of acute dental infections are oral streptococci and anaerobe bacteria. Acute dentoalveolar infections are usually treated surgically in combination with antibiotics. Empirical therapy in such infections usually requires the use of penicillin-based antibiotics. The aim of this study was to investigate the clinical efficiency of amoxicillin and cefalexin in the empirical treatment of acute odontogenic abscess and to assess the antimicrobial susceptibility of the isolated bacteria in early phases of its development. Methods. This study included 90 patients with acute odontogenic abscess who received surgical treatment (extraction of a teeth and/or abscess incision) and were divided into three groups: two surgicalantibiotic groups (amoxicillin, cefalexin) and the surgical group. In order to evaluate the effects of the applied therapy following clinical symptoms were monitored: inflammatory swelling, trismus, regional lymphadentytis and febrility. In all the patients before the beginning of antibiotic treatment suppuration was suched out of the abscess and antibiotic susceptibility of isolated bacteria was tested by using the disk diffusion method. Results. The infection signs and symptoms lasted on the average 4.47 days, 4.67 days, and 6.17 days in the amoxicillin, cefalexin, and surgically only treated group, respectively. A total of 111 bacterial strains were isolated from 90 patients. Mostly, the bacteria were Gram-positive facultative anaerobs (81.1%). The most common bacteria isolated were Viridans streptococci (68/111). Antibiotic susceptibility of isolated bacteria to amoxicillin was 76.6% and cefalexin 89.2%. Conclusion. Empirical, peroral use of amoxicillin or cefalexin after surgical treatment in early phase of development of dentoalveolar abscess significantly reduced the time of clinical symptoms duration in the acute odontogenic infections in comparison to surgical treatment only. Bacterial strains isolated in early stages of dentoalveolar abscess showed high sensitivity to amoxicillin and cefalexin.

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Gangrenous cervicofacial cellulitis from odontogenic infection: two clinical cases

Journal of Oral Medicine and Oral Surgery ◽

10.1051/mbcb/2018032 ◽

2019 ◽

Vol 25 (1) ◽

pp. 4

Author(s):

David Hoarau ◽

Mireille Folia ◽

Narcisse Zwetyenga ◽

Victorin Ahossi

Keyword(s):

Septic Shock ◽

Drug Therapy ◽

Surgical Treatment ◽

Surgical Management ◽

Successful Treatment ◽

Severe Case ◽

Odontogenic Infections ◽

Local Complications ◽

Life Threatening ◽

Dental Infections

Introduction: Cervicofacial cellulitis resulting from common odontogenic infections is rare but serious, with life-threatening complications and potential general or local complications. Observation: Two cases are discussed here. The first observed case concerned a 32-year-old patient, affected by gangrenous cellulitis, following the avulsion of teeth number 38. The second observed case was of a chronic periapical infection being left untreated. The urgency of these two cases required the coordination of medical and surgical specialist teams to ensure a stable and successful treatment, involving surgical treatment, drug therapy, and reanimation. Discussion: The inadequate treatment or chronic dental infections, associated with immunosuppression and some cofactors (tobacco, alcohol, drugs, pregnancy, etc.), can lead to severe case of cellulitis. Medical and surgical management should be carried out as soon as possible to prevent the onset of serious complications such as mediastinitis, septic shock, and thrombophlebitis.

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Human Stapes Crura: Normal Ultrastructure. Scanning Electron Microscopic Findings

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100116267 ◽

1975 ◽

Vol 33 ◽

pp. 528-529

Author(s):

M.D. Graham

Keyword(s):

Electron Microscope ◽

Surgical Treatment ◽

Scanning Electron Microscope ◽

Osmic Acid ◽

Human Cadaver ◽

Electron Microscopic ◽

Scanning Electron Microscopic ◽

Normal Human ◽

Microscopic Findings ◽

Scanning Electron

The recent development of the scanning electron microscope has added great impetus to the study of ultrastructural details of normal human ossicles. A thorough description of the ultrastructure of the human ossicles is required in order to determine changes associated with disease processes following medical or surgical treatment.Human stapes crura were obtained at the time of surgery for clinical otosclerosis and from human cadaver material. The specimens to be examined by the scanning electron microscope were fixed immediately in the operating room in a cold phosphate buffered 2% gluteraldehyde solution, washed with Ringers, post fixed in cold 1% osmic acid and dehydrated in graded alcohol. Specimens were transferred from alcohol to a series of increasing concentrations of ethyl alcohol and amyl acetate. The tissue was then critical point dried, secured to aluminum stubs and coated with gold, approximately 150A thick on a rotating stage in a vacuum evaporator. The specimens were then studied with the Kent-Cambridge S4-10 Scanning Electron Microscope at an accelerating voltage of 20KV.

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