The acute odontogenic infection in maritime medicine: clinical and radiological parallels

Relevance. The main thing in the prevention of acute odontogenic infection in sailors during long voyages is the full implementation of the pre-voyage sanitation of the oral cavity, which provides for the elimination of chronic foci of odontogenic infection.The aimof the study was to identify chronic foci of odontogenic infection in sailors after the completion of their prevoyage sanitation of the oral cavity and before going sailing.Material and methods. Dental and X-ray (orthopantomography) examination of 169 men aged 22 to 52 years after completion of dental treatment (oral cavity sanitation) before a long sea voyage was carried out, followed by analysis of clinical and radiological parallels to identify chronic odontogenic foci of infection, which can be a potential source of microorganisms for the development of acute odontogenic infection during swimming.Results and discussion.It was found that, despite the ongoing treatment and prophylactic work on the rehabilitation of the oral cavity with the sailors in the pre-voyage period, in 30.4-77.2% of cases they retain chronic foci of odontogenic infection during a long sea voyage, which can become the cause of the development of acute odontogenic infection. For the qualitative detection of chronic odontogenic foci of infection, it is necessary to supplement the dental examination of sailors in the pre-voyage period with an X-ray examination, which will allow timely identification and elimination of chronic odontogenic inflammation of the maxillary sinuses, as well as chronic periapical and periodontal foci of odontogenic infection.

Deep neck space infections: an upward trend and changing characteristics

Purpose This study reviews our experience with deep neck space infections (DNIs) requiring surgical intervention, including cervical necrotizing fasciitis. The aim of the study was to identify predisposing and aggravating factors of the disease and recognize the possible factors that can lead to life-threatening complications and slow down the healing process. Methods We compare the results to previous data from 1985 to 2005 to find possible alterations and changing trends. The characteristics of four lethal cases are described. This retrospective analysis includes patient data from 2004 to 2015 in tertiary referral hospital and in total, 277 patients were found. Results Surgical drainage through a neck opening ± intraoral incision was made in 215 (77.6%) patients, an intraoral incision was only made in 62 patients (22.4%). ICU care was needed in 66 (23.8%) cases. Odontogenic etiology (44.8%) was the most common origin. The most common comorbidity was a psychiatric disorder and/or dementia and occurred in 55 (19.9%) patients. Patients with underlying illnesses were more likely to be admitted to the ICU (p = 0.020), required a longer ICU stay (p = 0.004) and repeated surgery (p = 0.009). Gas formation seemed to be predictive of a more severe course of infection. Early extraction of the odontogenic foci was related to a lower length of stay (LOS) (p = 0.039). Conclusion The annual numbers have risen from 14 to 24 cases per year when compared to previous data. DNIs remain a cause of lethal complications; the mortality was 1.4% and overall complications occurred in 61 (22.0%) patients.

Morphofunctional Characteristic of Bone Tissue of Alveolar Processes (Parts) in Conditions of Chronic Odontogenic Infection

Assessment of the condition of the alveolar bone is important for the choice of treatment methods for many types of pathology of the dentoalveolar system. The aim of the study was to identify morphofunctional disorders and changes in the optical density of bone tissue of the alveolar process of the maxilla and the alveolar part of the mandible arising from the effects of chronic odontogenic foci of infection. Material and methods. Histological examination of the edges of the alveoli of the removed teeth was carried out in 40 patients with chronic forms of periodontitis. Bony fragments were removed on medical reasons for the prevention of postextraction pain. Decalcification was carried out in Trilon B solution, microtome tissue sections were stained with hematoxylin-eosin. The density of bone tissue was determined on the intraoral radiovisiograms of the removed teeth and intact teeth in 80 persons of the control group. Results. It is established that with chronic forms of periodontitis under the periosteum of the alveolar processes (parts), osteoclastic resorption occurs either in the plane of the bone or with the formation of gauchepic lacunae. The channels of the osteons and the folkman channels widen, and in their circles there are also foci of resorption. Appear pycnosis of osteocytes and extensive areas with empty and dilated osseous lacunae. In the zones of osteolysis, either connective or coarse-fibrous bone tissue is formed. The optical density of bone tissue in patients is significantly less than in individuals with intact teeth. Conclusions. Toxins from chronic odontogenic foci of infection activate the processes of bone resorption of the alveolar process (part) of the jaws and inhibit reparative osteogenesis. The resulting rarefaction of bone tissue leads to a decrease in its optical density.

Az odontogén góc és a szisztémás betegségek. Irodalmi áttekintés

The aim of the present review is to provide an up-to-date picture of what we know about the connection between odontogenic foci and non-oral diseases. After a brief historical summary, we give an overview on how the odontogenic focus causes disease in distant areas of the body in general, and then we start the discussion of the particular conditions, such as cardiovascular diseases, pneumonia, diabetes mellitus, metabolic syndrome, rheumatoid arthritis and adverse pregnancy outcomes. The review is centered around the two main odontogenic foci: periodontitis and periapical periodontitis, the latter being a widely recognized but rarely discussed oral focus. Finally, we offer a few considerations that the practicing dentist may find useful when dealing with odontogenic foci. Orv Hetil. 2018; 159(11): 415–422.

Sanation of carious and periapical foci in young athletes with impairment of cardiovascular adaptation

The aim of this study was to evaluate the impact of sanation of oral cavity in young athletes on the course of adaptation of the cardiovascular system to the condition of sports activities. According to the research results, it was revealed that the optimal period for sanation of periapical odontogenic foci in athletes with clinical signs of impairment (dysfunction) of cardiovascular system adaptation to exercise stress was a preparatory training period, while carious lesion sanation required preparatory or postcompetition periods.