scholarly journals Knowledge and Practice towards Management of Space Infections among Dental Practitioners

2020 ◽  
Vol 11 (SPL3) ◽  
pp. 967-971
Author(s):  
Ahmed Hilal Sheriff ◽  
Dhanraj Ganapathy ◽  
Subhashree Rohinikumar
Keyword(s):  
Odontogenic Infection ◽  
Incision And Drainage ◽  
Odontogenic Infections ◽  
Space Infection ◽  
Periodontal Infection ◽  
First Choice ◽  
Dental Practitioners ◽  
Knowledge And Practice ◽  
Essential Knowledge ◽  
Supporting Structures

An odontogenic infection is an alveolar, jaw, or facial infection that is caused by a tooth or its supporting structures and is one of the most common infections. Dental caries, heavy restorations or unsuccessful endodontic treatment, pericoronitis and periodontal infection are by far the most likely reasons for odontogenic infections. Infections are typically clustered around teeth and may stay concentrated to the region where it began, and may propagate to neighbouring or distant locations. The questionnaire included questions regarding essential knowledge and understanding of the Management of odontogenic space infections. Responses were obtained, and the data were analyzed. 72% of the respondents have said streptococcus viridans is the most common microorganisms in odontogenic infection, 57% said they would give antibiotics, incision and drainage for canine space infection, 63% said they would give antibiotics, incision and drainage for submandibular infection space infection, 57% said their first choice of antibiotic in managing space infection is Amoxicillin, and 53% said clindamycin is the choice of antibiotics in patients allergic to Amoxicillin. Most of the dental practitioners in this study did not have complete knowledge regarding the new generations of cephalosporins rather; they were aware of the 3rd and 4th generation cephalosporins. More education and understanding will improve the effectiveness of use and solve the difficulties faced in dentistry.

scholarly journals Severe odontogenic infections with septic progress - a constant and increasing challenge: a retrospective analysis

2019 ◽  
Author(s):  
Hannes Weise ◽  
Andreas Naros ◽  
Christina Weise ◽  
Siegmar Reinert ◽  
Sebastian Hoefert
Keyword(s):  
Retrospective Analysis ◽  
Antibiotic Treatment ◽  
Circulatory Arrest ◽  
Severe Disease ◽  
Oral Bacteria ◽  
Severe Exacerbation ◽  
Incision And Drainage ◽  
Odontogenic Infections ◽  
First Choice ◽  
Hospitalization Period

Abstract ABSTRACT Background More than 90% of all infections in the head and neck region can be traced back to an odontogenic origin. In rare cases they can lead to sepsis, which may pose a vital threat to the patient. The purpose of this study was to analyse characteristics concerning etiology and progress of severe odontogenic infections with a fulminant development. Methods All patients with odontogenic infections requiring hospital admission were included in a retrospective analysis conducted from 02/2012 to 09/2017. Of 483 patients 16 patients (13 male, 3 female) showed severe exacerbation with septic progress. The average age was 52.8 years. All patients underwent at least one surgical procedure that involved an extraoral incision and drainage as well as high volume irrigation intraoperatively. At least one revision was required for four of the patients. Three patients showed an exceedingly severe disease progression with multiorgan dysfunction syndrome (MODS) and circulatory arrest. Antibiotic treatment was adjusted according to the results of an antibiogram and resistogram. Irrigation with saline was done several times a day. Results Sixteen patients showed odontogenic infections that spread over multiple maxillo-facial and cervical regions accompanied by septic laboratory signs. All these patients needed intensive care and a tracheostomy. The hospitalization period was 27.8 days on average. In 16 cases risk factors for the development of odontogenic abscesses like diabetes mellitus, obesity, chronic alcohol and nicotine abuse, rheumatism and poor oral hygiene were present. Intraoperative swabs showed a typical polymicrobial aerobic and anaerobic spectrum of oral bacteria, especially anaerobes and streptococci, mainly Streptocococcus viridans. Conclusion Odontogenic infections with fulminant progression should be treated based on clinical and imaging data with immediate surgical incision and drainage including elimination of odontogenic foci as well as intensified intra- and postoperative irrigation. If needed, repeat imaging followed by further incisions should be performed. Immediate antibiotic treatment adapted to the antibiogram is of utmost importance. A combination of tazobactam and piperacillin has proven to be a good first choice and can be recommended for abscesses that spread over multiple levels with initial signs of severe infections.

scholarly journals Severe odontogenic infections with septic progress - a constant and increasing challenge

2019 ◽  
Author(s):  
Hannes Weise ◽  
Andreas Naros ◽  
Christina Weise ◽  
Siegmar Reinert ◽  
Sebastian Hoefert
Keyword(s):  
Antibiotic Treatment ◽  
Circulatory Arrest ◽  
Severe Disease ◽  
Neck Region ◽  
Severe Exacerbation ◽  
Imaging Data ◽  
Incision And Drainage ◽  
Odontogenic Infections ◽  
First Choice ◽  
Hospitalization Period

Abstract Objective More than 90% of all infections of the head and neck region can be traced back to an odontogenic origin. In rare cases they can lead to sepsis, which may pose a vital threat to the patient. The purpose of this study was to analyse characteristics concerning etiology and progress of severe odontogenic infections with a fulminant development. Patients and Methods In a retrospective analysis from 02/2012 to 09/2017 all patients with odontogenic infections requiring hospital admission were included. Among 483 patients 16 patients (13 male, 3 female) showed severe exacerbation with septic progress. The average age was 52.8 years. All patients underwent at least one surgical procedure that involved an extraoral incision and drainage as well as high volume irrigation intraoperatively. At least one revision was required for 4 of the patients. 3 patients showed an exceedingly severe disease progression with multiorgan dysfunction syndrome (MODS) and circulatory arrest. Antibiotic treatment was adjusted according to the results of an antibiogram and resistogram. Irrigation with saline was done multiple times daily. Results 16 patients showed odontogenic infections that spread over multiple maxillo-facial and cervical regions accompanied by septic laboratory signs. All these patients needed intensive care and a tracheostomy. The hospitalization period on the average was 27.8 days. In 16 cases risk factors e.g. for the development of odontogenic abscesses were present. Intraoperative swabs showed a typical polymicrobial aerobic and anaerobic spectrum of oral bacterias, especially anaerobes and streptococci, mainly Streptocococcus viridans. Conclusion Odontogenic infections with fulminant progression should be treated according to clinical and imaging data with immediate surgical incision and drainage including elimination of odontogenic focus and intensified intra- and postoperative irrigation. If needed, repeated imaging followed by further incisions must be performed. Immediate antibiotic treatment adapted to the antibiogram is of most importance. Clinical relevance For abscesses that spread over multiple levels with initial signs of severe infections a combination of tazobactam and piperacillin has proven to be a good first choice and can be recommended as such.

scholarly journals Fatal Ludwig's Angina: Cases of Lethal Spread of Odontogenic Infection

2018 ◽  
Vol 8 (1) ◽  
pp. 150-169 ◽  
Author(s):  
Catherine R. Miller ◽  
Kendall Von Crowns ◽  
Vickie Willoughby
Keyword(s):  
Pleural Empyema ◽  
Odontogenic Infection ◽  
Odontogenic Infections ◽  
Space Infection ◽  
Dental Abscess ◽  
Submandibular Space ◽  
History Of ◽  
Ludwig’S Angina ◽  
Submandibular Space Infections ◽  
Ludwig's Angina

We report two cases of deaths resulting from complications of odontogenic infections/submandibular space infections. In one case, the decedent had a history of toothache as well as facial and tongue swelling; autopsy revealed inflammation involving the tongue and larynx. In the second case, the decedent had a history of toothache, and at autopsy there was spread of infection to the mediastinum. Ludwig's angina is a form of submandibular space infection, which often is a result of odontogenic infection. The infection can spread into the deep spaces of the neck, producing complications including edema of the tongue and pharynx (causing airway obstruction), descending mediastinitis, pericarditis, necrotizing fasciitis, pleural empyema, and pneumonia. Gross findings at autopsy might reveal a dental abscess or other forms of infection of the head and neck, necrosis of the neck muscles and larynx, and infrequently, infection extending to the chest cavity. Microscopically, there is acute inflammation with necrosis and/or granulation tissue predominantly within the fascia. Without treatment, submandibular space infections can be life threatening and progression to death can be swift. These cases demonstrate the lethal effects of odontogenic infections. Without a clinical history of toothache or dental abscess, one can be alerted to a possible submandibular space infection by identifying isolated necrosis of the neck musculature.

scholarly journals Conservative Management of Submandibular Space Infection in a 5-Year-Old Child: A Case Report

2021 ◽  
Vol 2 (1) ◽  
pp. 36-40
Author(s):  
Sanchita Khadka ◽  
Bandana Koirala ◽  
Mehul Rajesh Jaisani ◽  
Siddhartha Rai
Keyword(s):  
Mouth Opening ◽  
Salvage Treatment ◽  
Progressive Decrease ◽  
Submandibular Region ◽  
Incision And Drainage ◽  
Odontogenic Infections ◽  
Space Infection ◽  
Submandibular Space ◽  
Appropriate Treatment ◽  
The Face

 Submandibular space infection is a potentially fatal infection that could arise as a result of odontogenic or non-odontogenic infections. The management should be prompt as the infection can spread rapidly leading to airway obstruction. A 5-year-old child reported with a complaint of swelling on the left side of the face for four days. On examination, patient had a diffuse swelling involving the left submandibular region with decreased mouth opening secondary to carious 75. The patient was administered intravenous (i.v) fluids, antibiotics and analgesics. Incision and drainage of the abscess was done extraorally under i.v sedation using midazolam with local anaesthesia followed by rubber drain placement. Patient responded to the treatment with progressive decrease in the swelling. Pulpectomy of 75 was performed followed by stainless-steel crown placement. This case highlights the importance of prompt appropriate treatment supplemented by salvage treatment to overcome the associated morbidity at this very young age.  

scholarly journals Severe odontogenic infections with septic progress - a constant and increasing challenge: a retrospective analysis

2019 ◽  
Author(s):  
Hannes Weise ◽  
Andreas Naros ◽  
Christina Weise ◽  
Siegmar Reinert ◽  
Sebastian Hoefert
Keyword(s):  
Retrospective Analysis ◽  
Antibiotic Treatment ◽  
Circulatory Arrest ◽  
Severe Disease ◽  
Oral Bacteria ◽  
Severe Exacerbation ◽  
Incision And Drainage ◽  
Odontogenic Infections ◽  
First Choice ◽  
Hospitalization Period

Abstract ABSTRACT Background More than 90% of all infections in the head and neck region can be traced back to an odontogenic origin. In rare cases they can lead to sepsis, which may pose a vital threat to the patient. The purpose of this study was to analyse characteristics concerning etiology and progress of severe odontogenic infections with a fulminant development. Methods All patients with odontogenic infections requiring hospital admission were included in a retrospective analysis conducted from 02/2012 to 09/2017. Of 483 patients 16 patients (13 male, 3 female) showed severe exacerbation with septic progress. The average age was 52.8 years. All patients underwent at least one surgical procedure that involved an extraoral incision and drainage as well as high volume irrigation intraoperatively. At least one revision was required for four of the patients. Three patients showed an exceedingly severe disease progression with multiorgan dysfunction syndrome (MODS) and circulatory arrest. Antibiotic treatment was adjusted according to the results of an antibiogram and resistogram. Irrigation with saline was done several times a day. Results Sixteen patients showed odontogenic infections that spread over multiple maxillo-facial and cervical regions accompanied by septic laboratory signs. All these patients needed intensive care and a tracheostomy. The hospitalization period was 27.8 days on average. In 16 cases risk factors for the development of odontogenic abscesses like diabetes mellitus, obesity, chronic alcohol and nicotine abuse, rheumatism and poor oral hygiene were present. Intraoperative swabs showed a typical polymicrobial aerobic and anaerobic spectrum of oral bacteria, especially anaerobes and streptococci, mainly Streptocococcus viridans. Conclusion Odontogenic infections with fulminant progression should be treated based on clinical and imaging data with immediate surgical incision and drainage including elimination of odontogenic foci as well as intensified intra- and postoperative irrigation. If needed, repeat imaging followed by further incisions should be performed. Immediate antibiotic treatment adapted to the antibiogram is of utmost importance. A combination of tazobactam and piperacillin has proven to be a good first choice and can be recommended for abscesses that spread over multiple levels with initial signs of severe infections.

scholarly journals Temporal space infection secondary to recurrent buccal space infection from mandibular deciduous molar in 7-year-old child: a case report

2019 ◽  
Vol 9 (1) ◽  
pp. 70-73
Author(s):  
Sourav Rout ◽  
Shailesh Gautam ◽  
Arun Kumar Shah
Keyword(s):  
Case Report ◽  
Early Stage ◽  
Maxillofacial Surgery ◽  
Fatal Outcome ◽  
Oral And Maxillofacial Surgery ◽  
Incision And Drainage ◽  
Odontogenic Infections ◽  
Space Infection ◽  
Temporal Space ◽  
Fascial Space

Head and neck space infections are usually secondary to odontogenic infections due to translocation of oral microbes to fascial space via odontogenic route resulting in progression by enzymatic degradation of connective tissue. Various factors like microbiological, host, nutritional and socioeconomic factors are responsible for progression of fascial space infection that might take fatal course if not treated in time. The present case report describes a child with fascial space infection of oral and maxillofacial region who was treated by incision and drainage in department of oral and maxillofacial surgery of this hospital. Fascial space infections are one of the surgical emergencies and need to be addressed in early stage as it has rapid regional and systemic progression leading to fatal outcome. It is multifactorial and all need to be addressed. Incision and drainage with removal of cause with antimicrobial therapy is treatment modality of space infection. Inadequate drainage might lead to recurrence of infection and progression to distant secondary spaces.

scholarly journals Coronavirus Disease 2019 (COVID-19): Emerging and Future Challenges for Dental and Oral Medicine

2020 ◽  
Vol 99 (5) ◽  
pp. 481-487 ◽  
Author(s):  
L. Meng ◽  
F. Hua ◽  
Z. Bian
Keyword(s):  
Public Health ◽  
Infection Control ◽  
Control Measures ◽  
World Health ◽  
Infection Control Measures ◽  
Dental Practitioners ◽  
The World ◽  
Essential Knowledge ◽  
Novel Coronavirus ◽  
Health Organization

The epidemic of coronavirus disease 2019 (COVID-19), originating in Wuhan, China, has become a major public health challenge for not only China but also countries around the world. The World Health Organization announced that the outbreaks of the novel coronavirus have constituted a public health emergency of international concern. As of February 26, 2020, COVID-19 has been recognized in 34 countries, with a total of 80,239 laboratory-confirmed cases and 2,700 deaths. Infection control measures are necessary to prevent the virus from further spreading and to help control the epidemic situation. Due to the characteristics of dental settings, the risk of cross infection can be high between patients and dental practitioners. For dental practices and hospitals in areas that are (potentially) affected with COVID-19, strict and effective infection control protocols are urgently needed. This article, based on our experience and relevant guidelines and research, introduces essential knowledge about COVID-19 and nosocomial infection in dental settings and provides recommended management protocols for dental practitioners and students in (potentially) affected areas.

scholarly journals The Use of Instruments by Iranian Endodontics and General Practioners

2012 ◽  
Vol 6 (1) ◽  
pp. 105-110 ◽  
Author(s):  
Farokh Gisour Elham ◽  
Zarmehi Sedigheh
Keyword(s):  
Contingency Table ◽  
Sampling Method ◽  
File Systems ◽  
Technological Advances ◽  
Dental Practitioners ◽  
Chi Squared ◽  
Males And Females ◽  
Knowledge And Practice ◽  
Simple Sampling ◽  
New Generation

Aim: The current clinical practice of endodontics involves utilization of a variety of new technological advances and materials. Technologies available for use in endodontic offices today include battery or electric motors using NiTi rotary file systems, new generation of electronic apex locators (EALs), improved digital radiographic sensors, surgical microscopes, and ultrasonic units. The aim of this study was to determine the prevalence and use of newer technologies among Iranian dental practitioners. Materials and methods: The population under study included the dental practitioners participating in the 49th and 50th Congress of Dentistry, who were selected with a simple sampling method. Data was collected by questionnaires which were completed by the participants in an anonymous manner. The contingency table and chi-squared test were used for data analysis by SPSS 13.5 software. Results: A total of 700 dental practitioners participated in the study; NiTi rotary systems were used by 50.1%; electronic apex locators were often employed by 46.3%; 21.7% reported that ultrasonic units were often used. Only 1.1% frequently used surgical microscopes. Males and females differed with respect to the use of newer technologies (P<0.05). Conclusion: Based on the results of the present study, it seems necessary for dentists to take part in continuing dental education programs related to the newer technologies to improve their knowledge and practice.

scholarly journals Five Predictors Affecting the Prognosis of Patients with Severe Odontogenic Infections

2020 ◽  
Author(s):  
Nathalie Pham Dang ◽  
Candice Delbet-Dupas ◽  
Aurélien Mulliez ◽  
Laurent Devoize ◽  
Isabelle Barthelemy
Keyword(s):  
Statistical Tests ◽  
Odontogenic Infection ◽  
Conditional Inference ◽  
Penicillin Allergy ◽  
Chi Square ◽  
Surgical Interventions ◽  
Exact Test ◽  
Odontogenic Infections ◽  
Mandibular Molar

Abstract Background: For over ten years, dental cellulitis management is not so longer simple: more and more patients need long-time hospitalization, several surgical interventions and intensive care follow-up. This prospective study seeks to highlight criteria that can split patients with severe odontogenic infection into two main groups: those with simple evolution after treatment of the infection and those for whom complex management is necessary to obtain healing.Methods: All patients with severe odontogenic infection (namely patients which necessitated hospital admission, intravenous antibiotherapy and general anesthesia) were prospectively recorded between January 2004 and December 2014. Statistical tests used were: chi-square test (or Fisher’s exact test when appropriate) for categorical data, and Student t-test (or Mann & Withney test when appropriate) for continuous data; statistics were computed with STATA V12 (Stata Corp, College Station, Texas, USA) and with R (R version 3.0.2; The R Foundation for Statistical Computing, Vienna, Austria; http://www.r-project.org).Results: A total of 653 patients were included in the study, 611 (93.6%) had one surgery, 42 (6.4%) had more than one surgery (range 2 – 15 surgeries) before healing. In multivariate analysis, objectives criteria which emerge are: C-reactive protein (CRP) level (CRP>200 mg/l, p=0.01, OR=4.12 IC95%=[1.33-12.72]), alcohol abuse (p=0.03, OR=2.70 IC95%=[1.09-6.7]), penicillin allergy (p=0.001, OR=5.47 IC95%=[1.99-15-09]), mandibular molar infection (p= 0.02, OR=2.74 IC95%=[1.16-6.48]). A conditional inference tree (CTREE) illustrated the association of prognostic factors and the need of multiple surgery. Conclusion: Four subgroups of patients with severe odontogenic infection have a relative risk range between 25 % and 33% to have several surgical intervention associated with complications as intensive unit care follow-up, tracheotomy or death: 1- patients with CRP>200 mg/l; 2- patients with CRP between 50 and 200 mg/l and penicillin allergy; 3- patients with CRP between 50 and 200 mg/l, without penicillin allergy but with molar mandibular infection and psychiatric disorders; 4- patients with CRP ≤ 50 mg/l or unknown CRP level and immunodepression.IRB number: CE-CIC-GREN-12-08

scholarly journals Bilateral canine space infection secondary to odontogenic origin. A rare case report.

2019 ◽  
Vol 6 (4) ◽  
pp. 129-132
Author(s):  
Mayur Janardan Gawande ◽  
Mithilesh Kumar Gupta ◽  
Manu Goel
Keyword(s):  
Surgical Management ◽  
Early Recognition ◽  
Panoramic Radiograph ◽  
Etiological Factors ◽  
Odontogenic Infections ◽  
Space Infection ◽  
Rare Case Report ◽  
Odontogenic Origin ◽  
Success Of Treatment

Odontogenic infections (OI) are a major reason for consultation in dental practice. They affect people of all ages, and most of them respond well to current medical and surgical treatments. The aim of this paper is to emphasize different and rare etiological factors that can play a role in odontogenic abscesses, which can lead to complications. A 54-year-old man complaints of pain and swelling on the upper front-side of his face. Physical examination of the face showed enlargement and swelling in the upper front region. Panoramic radiograph images showed a radiolucent appearance of the canine region. Based on the results of the clinical and radiographic examinations, the patient was diagnosed with a bilateral canine space infection. The treatment performed was FNAC (Fine neddle aspiration cytology) from canine region followed by intraoral drainage incision at the most prominent part of swelling (Modified Hiltons method), 5 ml of pus was removed, postoperative dressing was applied and regular follow-up was done with continued antibiotic therapy. Bilateral canine space abscess is a rare odontogenic infection that can cause life-threatening complications. The success of treatment requires early recognition, determination of etiological factors, and appropriate medical and surgical management. To perform treatment of odontogenic infections, the Oral & Maxillofacial Surgeon should understand the terminology regarding infectious diseases and pathophysiology. The success of treatment requires early recognition, determination of etiological factors, and appropriate medical and surgical management.

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