J Korean Assoc Maxillofac Plast Reconstr Surg.  2013 Jul;35(4):236-242.

Cervico-facial Infection Due to Dental Origin: A Retrospective Clinical Study

Affiliations
  • 1Department of Oral and Maxillofacial Surgery, Inje University Busan Paik Hospital, Korea. dwjty@hanmail.net

Abstract

PURPOSE
The objective of this retrospective study is to evaluate the factors affecting the spread of odontogenic infection. Furthermore, this study was performed to apply to future treatments.
METHODS
A total of 65 patients, who had received treatment for odontogenic infections from 2010 to 2012 for 3 years, were enrolled in this study. The causes of infection, presence of systemic disease, and complications, durations of treatment, treatment methods, and inflammation levels were compared with the data.
RESULTS
Patients over 70 years with systemic disease required immediate drainage, systemic antibiotic therapy and hospitalization. We can determine the direction of the early diagnosis and treatment through blood tests (white blood cells, neutrophil, C-reactive protein [CRP]) and computed tomography. Patients over 70 years with systemic disease had the highest percentage. In addition, these patients showed high levels of inflammation index, such as CRP average of 24.8 and needed for a long-term treatment period and a wide range of surgical incision & drainage several times. Systemic diseases, particularly diabetes mellitus and hypertension, accelerate the spread of infection and had a negative effect that delays healing. Eventually, five of the 65 patients showed serious systemic complications.
CONCLUSION
When evaluating cervico-facial infected patients due to odontogenic infection, the most important thing is deciding the appropriate diagnosis and degree of disease. Considering the patient's systemic status and age, we need to decide the treatment plan. Especially, those patients over 70 years with systemic disease should be treated with rapid surgical approach, and the use of a wide range of antibiotics and intensive care. If proper treatment principle does not apply, severe life-threatening complications will result, such as necrotizing fascitis, acute airway obstruction, mediastinitis, and others.

Keyword

Odontogenic infection; Cervico-facial infection

MeSH Terms

Airway Obstruction
Anti-Bacterial Agents
Blood Cells
C-Reactive Protein
Diabetes Mellitus
Drainage
Early Diagnosis
Fasciitis, Necrotizing
Hematologic Tests
Hospitalization
Humans
Hypertension
Inflammation
Critical Care
Mediastinitis
Neutrophils
Retrospective Studies
Anti-Bacterial Agents
C-Reactive Protein
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