Epidemiological Analysis and Management of Patients with Facial Space Infections of Odontogenic Origin: A Retrospective Evaluation of Two Years

Year 2023, , 58 - 66, 28.03.2023

Ömer Ekici

https://doi.org/10.33808/clinexphealthsci.994256

Abstract

Objective: Odontogenic infections are one of the most common pathologies in the oral and maxillofacial regions. The spread of odontogenic infections after unsuccessful or late treatment can lead to serious complications. The aim of this study is to examine the epidemiological features and treatment management of patients with odontogenic facial abscesses.
Methods: This retrospective study included 88 patients with odontogenic facial area abscesses treated at Afyonkarahisar health sciences university, faculty of dentistry’s maxillofacial surgery clinic between 2019-2021. The socio-demographic, socio-economic characteristics and clinical examination findings of the patients and treatment methods for odontogenic abscess were analyzed comprehensively. Data were
evaluated using SPSS-20 and the level of significance was set at p < .05.
Results: In the two-year period between 2019 and 2021, 88 patients (44 male and 44 female, mean age was 39.72±16.42) were treated for diffuse facial infections of odontogenic origin. The most commonly involved area was the submandibular area (38.6%), the most affected tooth was mandibular 1st molar and mandibular 3rd molars (18.2%), and the most common cause was dental caries (65.90%). Incision and drainage were performed in half of the patients (36.4% intraoral, 13.6% extraoral). The most commonly used drugs were clindamycin (36.4%), amoxicillin-clavulanate, and ornidazole combination (27.3%).
Conclusion: The results of this study confirm that odontogenic abscesses can heal without complications with timely and effective basic interventions such as incision and drainage. In this study, successful results were obtained with the parenteral clindamycin, and a combination of oral amoxicillin-clavulanate and ornidazole in the treatment of odontogenic abscesses.

Keywords

Epidemiological analysis, facial area abscess, odontogenic infection, treatment management

References

• Sánchez R, Mirada E, Arias J, Paño JR, Burgueño M. Severe odontogenic infections: Epidemiological, microbiological and therapeutic factors. Med Oral Patol Oral Cir Bucal. 2011;16(5). DOI:10.4317/medoral.16995
• Bassiony M, Yang J, Abdel-Monem TM, Elmogy S, Elnagdy M. Exploration of ultrasonography in assessment of fascial space spread of odontogenic infections. Oral Surgery, Oral Med Oral Pathol Oral Radiol Endodontology. 2009;107(6):861-869. DOI:10.1016/j.tripleo.2009.02.016
• Akinbami BO, Akadiri O, Gbujie DC. Spread of odontogenic infections in Port Harcourt, Nigeria. J Oral Maxillofac Surg. 2010;68(10):2472-2477. DOI:10.1016/j.joms.2010.01.019
• Seppänen L, Lauhio A, Lindqvist C, Suuronen R, Rautemaa R. Analysis of systemic and local odontogenic infection complications requiring hospital care. J Infect. 2008;57(2):116-122. DOI:10.1016/j.jinf.2008.06.002
• Juncar M, Popa AR, Baciuţ MF. Evolution assessment of head and neck infections in diabetic patients - A case control study. J Cranio-Maxillofacial Surg. 2014;42(5):498-502. DOI:10.1016/j.jcms.2013.06.009
• Sandner A, Börgermann J. Update on necrotizing mediastinitis: Causes, approaches to management, and outcomes. Curr Infect Dis Rep. 2011;13(3):278-286. DOI:10.1007/s11908-011-0174-z
• Leyva P, Herrero M, Eslava JM, Acero J. Cervical necrotizing fasciitis and diabetic ketoacidosis: Literature review and case report. Int J Oral Maxillofac Surg. 2013;42(12):1592-1595. DOI:10.1016/j.ijom.2013.05.006
• Ogle OE. Odontogenic Infections. Dent Clin North Am. 2017;61(2):235-252. DOI:10.1016/j.cden.2016.11.004
• Jundt JS, Gutta R. Characteristics and cost impact of severe odontogenic infections. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012;114(5):558-566. DOI:10.1016/j.oooo.2011.10.044
• Poeschl PW, Spusta L, Russmueller G. Antibiotic susceptibility and resistance of the odontogenic microbiological spectrum and its clinical impact on severe deep space head and neck infections. Oral Surgery, Oral Med Oral Pathol Oral Radiol Endodontology. 2010;110(2):151-156. DOI:10.1016/j.tripleo.2009.12.039
• Roccia F, Pecorari GC, Oliaro A. Ten Years of Descending Necrotizing Mediastinitis: Management of 23 Cases. J Oral Maxillofac Surg. 2007;65(9):1716-1724. DOI:10.1016/j.joms.2006.10.060
• Flynn TR, Shanti RM, Levi MH, Adamo AK, Kraut RA, Trieger N. Severe Odontogenic Infections, Part 1: Prospective Report. J Oral Maxillofac Surg. 2006;64(7):1093-1103. DOI:10.1016/j.joms.2006.03.015
• Agarwal AK, Sethi A, Sethi D, Mrig S, Chopra S. Role of socioeconomic factors in deep neck abscess: A prospective study of 120 patients. Br J Oral Maxillofac Surg. 2007;45(7):553-555. DOI:10.1016/j.bjoms.2007.01.001
• Nadig K, Taylor NG. Management of odontogenic infection at a district general hospital. Br Dent J. 2018;224(12):962-966. DOI:10.1038/sj.bdj.2018.445
• Bertossi D, Barone A, Iurlaro A. Odontogenic orofacial infections. J Craniofac Surg. 2017;28(1):197-202. DOI:10.1097/SCS.0000000000003250
• Igoumenakis D, Gkinis G, Kostakis G, Mezitis M, Rallis G. Severe odontogenic infections: Causes of spread and their management. Surg Infect (Larchmt). 2014;15(1):64-68. DOI:10.1089/sur.2012.178
• Igoumenakis D, Giannakopoulos NN, Parara E, Mourouzis C, Rallis G. Effect of Causative Tooth Extraction on Clinical and Biological Parameters of Odontogenic Infection: A Prospective Clinical Trial. J Oral Maxillofac Surg. 2015;73(7):1254-1258. DOI:10.1016/j.joms.2015.02.008
• Seppänen L, Lauhio A, Lindqvist C, Suuronen R, Rautemaa R. Analysis of systemic and local odontogenic infection complications requiring hospital care. J Infect. 2008;57(2):116-122. DOI:10.1016/J.JINF.2008.06.002
• Mathew GC, Ranganathan LK, Gandhi S. Odontogenic maxillofacial space infections at a tertiary care center in North India: a five-year retrospective study. Int J Infect Dis. 2012;16(4). DOI:10.1016/J.IJID.2011.12.014
• Çalış AS, Koyuncu BÖ, Öztürk K, Mert A, Bilgen C. General approach to the treatment of odontogenic abscesses and cost analysis. J Istanbul Univ Fac Dent. 2015;49(2):17. DOI:10.17096/JIUFD.90557
• Rega AJ, Aziz SR, Ziccardi VB. Microbiology and antibiotic sensitivities of head and neck space infections of odontogenic origin. J Oral Maxillofac Surg. 2006;64(9):1377-1380. DOI:10.1016/j.joms.2006.05.023
• Katoumas K, Anterriotis D, Fyrgiola M, Lianou V, Triantafylou D, Dimopoulos I. Epidemiological analysis of management of severe odontogenic infections before referral to the emergency department. J Cranio-Maxillofacial Surg. 2019;47(8):1292-1299. DOI:10.1016/j.jcms.2019.05.002
• Daramola OO, Flanagan CE, Maisel RH, Odland RM. Diagnosis and treatment of deep neck space abscesses. Otolaryngol - Head Neck Surg. 2009;141(1):123-130. DOI:10.1016/j.otohns.2009.03.033
• Boffano P, Roccia F, Pittoni D, Di Dio D, Forni P, Gallesio C. Management of 112 hospitalized patients with spreading odontogenic infections: Correlation with DMFT and Oral Health Impact Profile 14 indexes. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012;113(2):207-213. DOI:10.1016/j.tripleo.2011.02.006
• Lorenzini G, Picciotti M, Di Vece L. Cervical necrotizing fasciitis of odontogenic origin involving the temporal region - A case report. J Cranio-Maxillofacial Surg. 2011;39(8):570-573. DOI:10.1016/j.jcms.2010.05.002
• Sakamoto H, Aoki T, Kise Y, Watanabe D, Sasaki J. Descending necrotizing mediastinitis due to odontogenic infections. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000;89(4):412-419. DOI:10.1016/S1079-2104(00)70121-1
• Ariji Y, Gotoh M, Kimura Y. Odontogenic infection pathway to the submandibular space: Imaging assessment. Int J Oral Maxillofac Surg. 2002;31(2):165-169. DOI:10.1054/ijom.2001.0190
• Haug RH, Hoffman MJ, Indresano AT. An epidemiologic and anatomic survey of odontogenic infections. J Oral Maxillofac Surg. 1991;49(9):976-980. DOI:10.1016/0278-2391(91)90063-R
• Kuriyama T, Karasawa T, Nakagawa K, Saiki Y, Yamamoto E, Nakamura S. Bacteriologic features and antimicrobial susceptibility in isolates from orofacial odontogenic infections. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000;90(5):600-608. DOI:10.1067/moe.2000.109639
• Flynn TR, Shanti RM, Hayes C. Severe odontogenic infections, Part 2: Prospective Outcomes Study. J Oral Maxillofac Surg. 2006;64(7):1104-1113. DOI:10.1016/j.joms.2006.03.031
• Stefanopoulos PK, Kolokotronis AE. The clinical significance of anaerobic bacteria in acute orofacial odontogenic infections. Oral Surgery, Oral Med Oral Pathol Oral Radiol Endodontology. 2004;98(4):398-408. DOI:10.1016/j.tripleo.2004.01.016
• Sato FRL, Hajala FAC, Filho FWVF, Moreira RWF, de Moraes M. Eight-Year retrospective study of odontogenic origin infections in a postgraduation program on oral and maxillofacial surgery. J Oral Maxillofac Surg. 2009;67(5):1092-1097. DOI:10.1016/j.joms.2008.09.008
• Warnke PH, Becker ST, Springer ING. Penicillin compared with other advanced broad spectrum antibiotics regarding antibacterial activity against oral pathogens isolated from odontogenic abscesses. J Cranio-Maxillofacial Surg. 2008;36(8):462-467. DOI:10.1016/j.jcms.2008.07.001