Odontogenic infection in immunocompromised patients tends to extend. Pdf one of the most difficult cases to be managed in dentistry is an odontogenic infection. They can range in severity from a mild buccal space infection to a severe lifethreatening multispace infection. A systematic approach to evaluation and treatment of odontogenic infection will be outlined including surgery and pharmacotherapy as well as a discussion of potential complications. The aim of this study was to give a detailed overview of clinical and economic data on children and young people treated and hospitalized due to an odontogenic abscess at a tertiary.
Antibiotic prescription in the treatment of odontogenic. Dentists therefore need to have a thorough understanding of infectious diseases in order to diagnose such infections correctly and to decide whether. As there was no section for odontogenic infections in the document, this section. Mediastinitis from odontogenic or deep cervical origin is extremely rare. A literature search was conducted to identify evidence. Antibiotic introduction odontogenic infections are among the most common infections of the oral cavity. Dental infections, including gingivitis, periodontitis, dental caries and odontogenic infections, result in numerous dental visits each year in canada.
Odontogenic infections, consisting primarily of dental caries and periodontal disease gingivitis and periodontitis, are common and have local eg, tooth loss and, in some cases, systemic implications. Cavernous sinus thrombosis, brain abscess, airway obstruction, and mediastinitis are possible complications of dental infections. The acute dental abscess is usually polymicrobial comprising facultative anaerobes, such as viridans group streptococci and the streptococcus. Results odontogenic infections arising in the mandible first spread upward, into the masseter andor medial pterygoid muscles in the.
Diagnosis and management of odontogenic oral and facial. Odontogenic infection is a complicated dental problem that originates within a tooth or in the adjacent tissues that hold the tooth. N this volume of periodontology 2000 is dedicated to nonodontogenic infections that may be present in patients attending dental clinics. Jul 22, 2019 to investigate the outpatient and inpatient management of odontogenic infections among paediatric patients attending a university hospital. A 75yearold japanese woman was examined in the emergency department of this hospital due to a chief complaint of.
Potentially lethal consequences can quickly occur once the mediastinum is subjected to the ravages of an anaerobic infection. The infection is normally located in the tissues of the dental organ itself, and follows a chronic. Odontogenic infections are mainly a consequence of pulpitis that leads initially to periapical infection and a dental abscess. Odontogenic infection has plagued human kind for as long as the human species has existed. Pdf odontogenic infections widhariyani purnomoputri. Orofacial odontogenic infections oral surgery, oral medicine, oral. The sepsis syndrome in odontogenic infection t handley, m devlin, d koppel, j mccaul odontogenic infection is a common cause of sepsis in the head and neck.
We have recently encountered five such cases, with a rapid spread of the inflammatory process into the mediastinum resulting in a number of local and systemic. A 75yearold japanese woman was examined in the emergency department of this hospital due to a chief complaint of worsened buccal swelling on the left side. They may involve paranasal sinuses and cervicofascial spaces. Definition and management of odontogenic maxillary sinusitis.
They affect people of all ages, and most of them respond well. Odontogenic is a medical term for tissues that gives origin to teeth. Generally, in the orofascial region, most bacterial infections involve either a disturbance of the normal flora or a displacement of the normal organisms. Poor oral hygiene, selfmedication, inadequate utilization of antibiotics, lack of treatment of the causative tooth, delayed presentation at the hospital, and bacterial resistance to empirically administered antibiotics appear to correlate with the spread of odontogenic. They are mixed aerobicanaerobic with 60% caused by anaerobic and aerobic bacteria, 35% by aerobic bacteria, and 5% by anaerobic bacteria only. Pdf antibiotics in odontogenic infections an update.
Methods ct scans of 45 patients with extensive spread of odontogenic infection into the facial and neck spaces were analyzed to document pathways of spread. A clinical trial was conducted on 90 patients with head and neck infections of odontogenic origin. Furthermore, about 70% of odontogenic infections occur as periapical inflammation, i. Factors that influence the spread of odontogenic infections virulence of microorganism patient immune system anatomical factors that influence the direction of infection spread. Odontogenic infections one of the most difficult problems range from low grade to severe, life threatening most are easily managed with minor surgery and antibiotics 3. Improved oral hygiene, prompt recognition and treatment of infection, and the availability of antibiotic therapy have practically eliminated this rapidly spreading type of infection. Antibiotics, pain and fever relief using appropriate analgesics, and removal of the source of infection once the patient has stabilized e. Infection frequently spreads in a predictable pattern within the fascial spaces of the neck and can result in airway compromise. Pdf lifethreatening infections of odontogenic or upper airway origin may extend to potential spaces formed by fascial planes of the lower. To the best of our knowledge, this is the first report describing a patient with crowned dens syndrome with coexisting odontogenic infection. A fiveyear retrospective study of odontogenic maxillofacial infections in a large urban public hospital. Early diagnosis and treatment of pediatric facial cellulitis are challenging because of its variable clinical presentations, including multiple potential sources of infection and multiple organisms within the head and neck area. Infections of the oral cavity are most commonly odontogenic in origin and include dentoalveolar, periodontal, and deep fascial space infections. In the united states during 2011 to 2016, 1 in 4 adults aged 20 to 64 years and 1 in 6 adults 65 years or older had untreated tooth decay.
A number of clinical trials have demonstrated clindamycins efficacy in treating odontogenic infections. Such infections are usually selflimiting, but on rare occasions may result in lifethreatening complications such as mediastinal or intracranial extension, retropharyngeal spread with airway. Periodontology 2000 nonodontogenic infections in dentistry. Lower socioeconomic status has been associated with poor oral health 11, which is an important predisposing factor for dnsi. A case of odontogenic infection by streptococcus constellatus. Odontogenic infection is a common cause of sepsis in the head and neck. Severity score as a prognostic factor for management of. Odontogenic infections are one of the most prevalent diseases worldwide and the principal reason for seeking dental care. Apr 21, 20 odontogenic infections systematic approach to infection patient typical microbiology natural history of odontogenic infections principles of infection management indications for referral to oms 4.
Introduction odontogenic infections ois are potentially severe complications resulting from untreated dental pathologies or incorrect dentistry procedures. The 2016 jaidjsc guidelines for clinical management of infectious. Mohamed rahil maxillofacial surgeon tikrit dentistry college. Etiology of acute odontogenic infections most common etiological factors of odontogenic infections are periapical lesions 66% 70% and dental caries 33% 80%, other local infection causative factors are pricoronitis, alveolar osteitis, periodontitis and odontogenic and nonodon togenic cystic lesions.
Odontogenic infections are caused by the normal commensal oral flora that spread, most often, through a pathway from the roots of the teeth to enter the periapical region and can subsequently spread to the deeper fascial spaces of the head and neck. Rather, it was due to application of the principles of the initial establishment of airway security, followed by early and aggressive surgical drainage of all. Dental prescriptions account for nearly 7% to 11% of all common antibiotic prescriptions. Odontogenic infection an overview sciencedirect topics. Principles of treatment of odontogenic infections in order to treat an acute dent alveolar infection as well as a fascial space abscess correctly, the following are considered absolutely necessary. Principles of treatment of odontogenic infections pdf. Odontogenic infection, treatment, odontogenic infection. Acute odontogenic infection combined with crowned dens. Often the condition results in significant morbidity and a prolonged hospital stay.
The risk of potential serious consequences arising from the spread of a dental abscess is still relevant today with many hospital admissions for dental sepsis. Individuals of odontogenic infections were seen more in the patients of the third and fourth decade age groups. Clinical picture can be misleading and relation with dental pathology unapparent, making their diagnosis challenging. Ulrich klein dmd, dds ms, in bermans pediatric decision making fifth edition, 2011. In the united states, it is estimated that 25 percent of adults over the age of 60 have lost all their teeth edentulism, approximately one. Odontogenic infections are known to be the main cause of dnis. Clinical guideline for the management of odontogenic. Most odontogenic infections are caused by more than 1 species of the bacteria normally found within the oral cavity.
Drainage of pus, when its presence in tissues is established. However, abscess formation occurs when these bacteria and their toxic products breach into the periapical tissues through the apical foramen and induce acute inflammation and pus formation. This finding is in concurrence with those of kannangara et al. This reduction in mortality was not due to the first use of penicillin in the treatment of these infections. What is odontogenic infectioncausessymptomstreatment. They can be caused by the sequlae of dental caries, periodontal disease or due to trauma. Infections the prerequisites for any infection include a susceptible host, virulent organisms and the appropriate circumstances. The study was aimed to finding the description of the. Tooth andor its supporting structures are often source of. Most odontogenic and many orofacial infections arise from the commensal oral mixed flora, with a substantial proportion of anaerobes.
Odontogenic infections are generally secondary to pulp necrosis, periodontal disease, pericoronitis, apical lesions or complications of certain dental procedures 2. Odontogenic orofacial infections find journal full text. Odontogenic infections are generally polymicrobial and from endogenous oral flora. May, 2019 to the best of our knowledge, this is the first report describing a patient with crowned dens syndrome with coexisting odontogenic infection. Odontogenic infections oi are a major reason for consultation in dental practice. The objective of this study was to provide an evidence. A retrospective study 202015 was carried out which involved retrieving relevant data from past records manualelectronic of paediatric patients under 18yearsold who presented with odontogenic infections to the paediatric dentistry and oral and. Epidemiological, microbiological and therapeutic factors r. Despite being a wellknown disease entity, many cases are referred to otorhinolaryngologists by both doctors and dentists. Odontogenic causes are the most common source for spreading maxillofacial infections. The commonest emergency odontogenic infections are periapical abscess 25%, pericoronitis 11%, and periodontal abscess 7%. Jun 21, 2018 odontogenic is a medical term for tissues that gives origin to teeth. Management of odontogenic infection of pulpal and periodontal origin. Although odontogenic infections are usually confined to the alveolar ridge vicinity, they can spread into deep fascial spaces.
Results odontogenic infections arising in the mandible first spread upward, into the masseter andor medial pterygoid. Odontogenic infections can be severe if not treated and are associated with mortality rate of 10 to 40%. The incidence, severity, morbidity, and mortality of odontogenic infections have declined dramatically over the years. Pdf odontogenic infection is an infection that originates within a tooth or in the closely surrounding tissues and can extend beyond natural barriers. The spread of an infection depends on the balance between the patient condition and microbial factors.
The acute dental abscess is frequently underestimated in terms of its morbidity and mortality. Amoxicillinclavulanic acid for the treatment of odontogenic. Mediastinitis from odontogenic or deep cervical infections is extremely rare in the era of antibiotic drugs. Know the causes, signs, symptoms, treatment and spread of odontogenic infections. Pdf description of odontogenic infection cases at the oral surgery. In somes cases, however, the aetiology is uncertain.
In order to understand how odontogenic infections are treated, the dentist must be familiar with the terminology concerning infection and the pathophysiology of inflammation, which are described below. Management of odontogenic infection in paediatric patients. Mcqs on odontogenic infections oral and maxillofacial. Yet, even after centuries of research, mankind has not succeeded in eradicating bacterial infections. Mediastinitis from odontogenic and deep cervical infection. Contributing factors for severe progression of an odontogenic infection are deficiencies. Abstract background odontogenic infections are a common presentation to emergency departments of australian hospitals. Odontogenic abscessrelated emergency hospital admissions. The vast majority of dental abscesses respond to antibiotic treatment, however, in some patients. Nonodontogenic infections in dentistry gunnar dahle. The sepsis syndrome in odontogenic infection sage journals. The journal of contemporary dental practice, april 2015. It is important to be aware of the signs and symptoms.
Definition and management of odontogenic maxillary sinusitis soung min kim1,2 abstract background. Both dental caries and periodontal disease are prevalent in the united states and other countries, and odontogenic infections are a major source of disease burden globally. Jun 22, 2018 a fiveyear retrospective study of odontogenic maxillofacial infections in a large urban public hospital. The main signs and symptoms of the acute dental abscess often referred to as a periapical abscess or infection are pain, swelling, erythema, and suppuration usually localized to the affected tooth, even if the abscess can eventually spread causing a severe odontogenic infection which is characterized by local and systemic involvement. The odontogenic cause is the most frequent in adulthood and, usually, it is a polymicrobial infection. Mcqs in odontogenic infections oral and maxillofacial surgery. Management of odontogenic infection at a district general. Most authors cite odontogenic infections in the submandibular space as the most common source of infection, with 3490% of cases being cited as odontogenic in origin 1, 3, 12 16.
An odontogenic infection is an infection that originates within a tooth or in the closely surrounding tissues. Because the spaces communicate through fascial planes, infection spreads by continuity rather by lymphatics or blood vessels 5, 9 11. The sepsis syndrome in odontogenic infection thomas pb. Streptococcus viridans streptococcus anginosus peptostreptococci prevotella fusobacterium porphyromonas bacteroides spp veilonella actinomyces. The most common causes for odontogenic infection to be established are dental caries, deep fillings, failed root canal. Clinical guideline for the management of odontogenic infections in. Odontogenic infections, antibiotics, and infection. Severe odontogenic infection remains an important public health concern and ha become a significant economic burden to public healts h care facilities. Severe odontogenic infections e670 journal section. Odontogenic infectionsdr mohammad akheel omfs pg 2.
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