Research Article
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ODONTOJENİK KAYNAKLI FASİYAL ŞİŞLİKLERİN KLİNİK, ULTRASONOGRAFİK VE BİYOKİMYASAL BULGULARININ DEĞERLENDİRİLMESİ

Year 2020, , 173 - 179, 30.11.2020
https://doi.org/10.34108/eujhs.738746

Abstract

Bu çalışmanın amacı fasiyal şişliği olan hastaların selülit ve apse teşhisinde klinik muayene ve buna yardımcı bir tanı aracı olan ultrasonografi ile elde edilen bulguları incelemek ve hastaların biyokimyasal bulguları ile karşılaştırmaktır. Kliniğimize fasiyal şişlikle başvuran 34 hastadan, panoramik radyografi alınarak etken diş belirlenip kaydedildi. Enfeksiyon safhaları sonografik olarak selülit, preapse ve apse safhası olmak üzere 3 grupta, yüksek çözünürlüklü ultrasonografi cihazı kullanılarak sınıflandırıldı. Hemoglobin, hematokrit, trombositler, beyaz kan hücresi, diferansiyel sayımlar ve yüzdeler ADVIA 2120 Hematoloji Sistemi kullanılarak belirlendi. Çalışmamızda yer alan 34 bireyden 19’u kadın (%56) ve 15’i erkekti (%44). Apse veya selülit şikâyeti ile hasteneye en yoğun başvuruların 0-10 (%35.3) yaş aralığında olduğu bulundu. Apse ile selülit gruplarının biyokimyasal bulguları karşılaştırıldığında hs-CRP, WBC ve nötrofil sayımı değerlerinin ortalamalarının apse grubunda selülit grubundan daha düşük bulundu. WBC değerleri apse grubunda; 10.18±2.31 mm3, selülit grubunda 11.95±3.48 mm3 bulundu. hs-CRP değerleri apse grubunda 38.22 mg/L (min:3.14-max:118), selülit grubunda 72.21 mg/L (min:3.17-max:159.17) bulundu. Nötrofil değerleri apse grubunda; 6.57±2.12 mm3, selülit grubunda 9.4±3.93 mm3 olarak bulundu. Her üç parametrenin selülite göre daha lokal bir klinik cevap olan apsede düşük olması klinik bulgular ile uyumludur. Yirmi altı apse vakasının on dördü (% 53.84) mandibular posterior diş kaynaklıydı. Orofasiyal bölge enfeksiyonu şikâyeti ile hastanede yatan hastalar için tekrarlanan takip muayenelerinde USG yararlı bir teknik olabilir.

Thanks

Yazarlar, Erciyes Üniversitesi Ağız, Diş ve Çene Cerrahisi Anabilim Dalı asistan ve öğretim üyelerine katkılarından dolayı teşekkür eder.

References

  • 1. Adhikari S, Blaivas M, Lander L. Comparison of bedside ultrasound and panorex radiography in the diagnosis of a dental abscess in the ED. Am J Emerg Med. 2011 Sep;29(7):790-5. doi: 10.1016/j.ajem.2010.03.005. Epub 2010 May 1.
  • 2. Shah A, Ahmed I, Hassan S, Samoon A, Ali B. Evaluation of ultrasonography as a diagnostic tool in the management of head and neck facial space infections: A clinical study. Natl J Maxillofac Surg. 2015 Jan-Jun;6(1):55-61. doi: 10.4103/0975-5950.168213.
  • 3. Bassiony M, Yang J, Abdel-Monem TM, Elmogy S, Elnagdy M. Exploration of ultrasonography in assessment of fascial space spread of odontogenic infections. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009 Jun;107(6):861-9. doi: 10.1016/j.tripleo.2009.02.016.
  • 4. Poweski L, Drum M, Reader A, Nusstein J, Beck M, Chaudhry J. Role of ultrasonography in differentiating facial swellings of odontogenic origin. J Endod. 2014 Apr;40(4):495-8. doi: 10.1016/j.joen.2014.01.002. Epub 2014 Feb 10.
  • 5. Dogruel F, Gonen ZB, Gunay-Canpolat D, Zararsiz G, Alkan A. The Neutrophil-to-Lymphocyte ratio as a marker of recovery status in patients with severe dental infection. Med Oral Patol Oral Cir Bucal. 2017 Jul 1;22 (4):e440-5.
  • 6. Alotaibi N, Cloutier L, Khaldoun E, Bois E, Chirat M, Salvan D. Criteria for admission of odontogenic infections at high risk of deep neck space infection. Eur Ann Otorhinolaryngol Head Neck Dis. 2015; 132:261-4.
  • 7. Laine M, Ventä I, Hyrkäs T, Ma J, Konttinen YT. Chronic inflam¬mation around painless partially erupted third molars. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003; 95:277-82.
  • 8. Siegert R. Ultrasonography of inflammatory soft tissue swellings of the head and neck. J Oral Maxillofac Surg 1987; 45:842‑6.
  • 9. Squire BT1, Fox JC, Anderson C. ABSCESS: applied bedside sonography for convenient evaluation of superficial soft tissue infections. Acad Emerg Med. 2005; 12(7):601-6.
  • 10. Peleg M, Heyman Z, Ardekian L, Taicher S. The use of ultrasonography as a diagnostic tool for superficial fascial space infections. J Oral Maxillofac Surg. 1998; 56(10):1129-32.
  • 11. Ramirez-Schrempp D, Dorfman DH, Baker WE, Liteplo AS. Ultrasound soft-tissue applications in the pediatric emergency department: to drain or not to drain? Pediatr Emerg Care. 2009; 25(1):44-8. doi: 10.1097/PEC.0b013e318191d963. Review.
  • 12. Peterson L. Management of infections. In: Peterson L, Ellis E, Hupp J, et al. Contemporary Oral and Maxillofacial Surgery,4th ed. St Louis: Mosby; 2003: 352-4.
  • 13. Matthews DC, Sutherland S, Basrani B. Emergency management of acute apical abscesses in the permanent dentition: a systematic review of the literature. J Can Dent Assoc. 2003; 69(10):660. Review.
  • 14. Wolcott J, Rossman LE, Hasselgren G. Management of endodontic emergencies. In Hargreaves KM, Cohen S, eds. Cohen’s Pathways of the Pulp, 10th ed. St Louis: Mosby Elsevier; 2011: 42. 45, 590, 594.
  • 15. Pandey PK, Umarani M, Kotrashetti S, Baliga S. Evaluation of ultrasonography as a diagnostic tool in maxillofacial space infections. J Oral Maxillofac Res. 2012; 2(4):e4. doi: 10.5037/jomr.2011.2404.

EVALUATION OF CLINICAL, ULTRASONOGRAPHIC AND BIOCHEMICAL FINDINGS OF ODONTOGENIC ORIGINATED SWELLING

Year 2020, , 173 - 179, 30.11.2020
https://doi.org/10.34108/eujhs.738746

Abstract

The aim of this study is to examine the findings obtained through clinical examinations and ultrasonography in the diagnosis of cellulite and abscess in patients with facial swelling and to compare with the biochemical findings of the patients. Panoramic radiography was obtained from 34 patients who applied to our clinic with facial swelling and the active tooth was identified and recorded. Infection stages were classified sonographically in 3 groups as cellulite, preapse and abscess using high resolution ultrasonography device. Hemoglobin, hematocrit, platelets, white blood cell, differential counts, and percentages were determined using the ADVIA 2120 Hematology System. Of the 34 individuals in our study, 19 were female (56%) and 15 were male (44%). With the complaint of abscess or cellulite, it was found that the most frequent applications to hospital were in the 0-10 (35.3%) age range. When the biochemical findings of abscess and cellulite groups were compared, the mean of hs-CRP, WBC and neutrophil counts were lower than the cellulite group in the abscess group. WBC values were 10.18±2.31 mm3 in the abscess group; In the cellulite group, it was found to be 11.95±3.48 mm3. The hs-CRP values were 38.22 mg/L (min: 3.14-max: 118) in the abscess group and 72.21 mg/L (min: 3.17-max: 159.17) in the cellulite group. Neutrophil values in the abscess group; It was found to be 6.57±2.12 mm3 and 9.47±3.93 mm3 in the cellulite group. The low level of all three parameters in abscess, which is a more local clinical response than cellulite, is consistent with clinical findings. Fourteen (53.8%) of the twenty-six abscess cases originated from the mandibular posterior tooth. USG can be a useful technique for repeated follow-up examinations for hospitalized patients with complaints of orofacial region infection.

References

  • 1. Adhikari S, Blaivas M, Lander L. Comparison of bedside ultrasound and panorex radiography in the diagnosis of a dental abscess in the ED. Am J Emerg Med. 2011 Sep;29(7):790-5. doi: 10.1016/j.ajem.2010.03.005. Epub 2010 May 1.
  • 2. Shah A, Ahmed I, Hassan S, Samoon A, Ali B. Evaluation of ultrasonography as a diagnostic tool in the management of head and neck facial space infections: A clinical study. Natl J Maxillofac Surg. 2015 Jan-Jun;6(1):55-61. doi: 10.4103/0975-5950.168213.
  • 3. Bassiony M, Yang J, Abdel-Monem TM, Elmogy S, Elnagdy M. Exploration of ultrasonography in assessment of fascial space spread of odontogenic infections. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009 Jun;107(6):861-9. doi: 10.1016/j.tripleo.2009.02.016.
  • 4. Poweski L, Drum M, Reader A, Nusstein J, Beck M, Chaudhry J. Role of ultrasonography in differentiating facial swellings of odontogenic origin. J Endod. 2014 Apr;40(4):495-8. doi: 10.1016/j.joen.2014.01.002. Epub 2014 Feb 10.
  • 5. Dogruel F, Gonen ZB, Gunay-Canpolat D, Zararsiz G, Alkan A. The Neutrophil-to-Lymphocyte ratio as a marker of recovery status in patients with severe dental infection. Med Oral Patol Oral Cir Bucal. 2017 Jul 1;22 (4):e440-5.
  • 6. Alotaibi N, Cloutier L, Khaldoun E, Bois E, Chirat M, Salvan D. Criteria for admission of odontogenic infections at high risk of deep neck space infection. Eur Ann Otorhinolaryngol Head Neck Dis. 2015; 132:261-4.
  • 7. Laine M, Ventä I, Hyrkäs T, Ma J, Konttinen YT. Chronic inflam¬mation around painless partially erupted third molars. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003; 95:277-82.
  • 8. Siegert R. Ultrasonography of inflammatory soft tissue swellings of the head and neck. J Oral Maxillofac Surg 1987; 45:842‑6.
  • 9. Squire BT1, Fox JC, Anderson C. ABSCESS: applied bedside sonography for convenient evaluation of superficial soft tissue infections. Acad Emerg Med. 2005; 12(7):601-6.
  • 10. Peleg M, Heyman Z, Ardekian L, Taicher S. The use of ultrasonography as a diagnostic tool for superficial fascial space infections. J Oral Maxillofac Surg. 1998; 56(10):1129-32.
  • 11. Ramirez-Schrempp D, Dorfman DH, Baker WE, Liteplo AS. Ultrasound soft-tissue applications in the pediatric emergency department: to drain or not to drain? Pediatr Emerg Care. 2009; 25(1):44-8. doi: 10.1097/PEC.0b013e318191d963. Review.
  • 12. Peterson L. Management of infections. In: Peterson L, Ellis E, Hupp J, et al. Contemporary Oral and Maxillofacial Surgery,4th ed. St Louis: Mosby; 2003: 352-4.
  • 13. Matthews DC, Sutherland S, Basrani B. Emergency management of acute apical abscesses in the permanent dentition: a systematic review of the literature. J Can Dent Assoc. 2003; 69(10):660. Review.
  • 14. Wolcott J, Rossman LE, Hasselgren G. Management of endodontic emergencies. In Hargreaves KM, Cohen S, eds. Cohen’s Pathways of the Pulp, 10th ed. St Louis: Mosby Elsevier; 2011: 42. 45, 590, 594.
  • 15. Pandey PK, Umarani M, Kotrashetti S, Baliga S. Evaluation of ultrasonography as a diagnostic tool in maxillofacial space infections. J Oral Maxillofac Res. 2012; 2(4):e4. doi: 10.5037/jomr.2011.2404.
There are 15 citations in total.

Details

Primary Language Turkish
Subjects Dentistry
Journal Section Research Article
Authors

Meryem Etöz

Firdevs Aşantoğrol 0000-0002-0625-1359

Fatma Doğruel

Publication Date November 30, 2020
Submission Date May 17, 2020
Published in Issue Year 2020

Cite

APA Etöz, M., Aşantoğrol, F., & Doğruel, F. (2020). ODONTOJENİK KAYNAKLI FASİYAL ŞİŞLİKLERİN KLİNİK, ULTRASONOGRAFİK VE BİYOKİMYASAL BULGULARININ DEĞERLENDİRİLMESİ. Sağlık Bilimleri Dergisi, 29(3), 173-179. https://doi.org/10.34108/eujhs.738746
AMA Etöz M, Aşantoğrol F, Doğruel F. ODONTOJENİK KAYNAKLI FASİYAL ŞİŞLİKLERİN KLİNİK, ULTRASONOGRAFİK VE BİYOKİMYASAL BULGULARININ DEĞERLENDİRİLMESİ. JHS. November 2020;29(3):173-179. doi:10.34108/eujhs.738746
Chicago Etöz, Meryem, Firdevs Aşantoğrol, and Fatma Doğruel. “ODONTOJENİK KAYNAKLI FASİYAL ŞİŞLİKLERİN KLİNİK, ULTRASONOGRAFİK VE BİYOKİMYASAL BULGULARININ DEĞERLENDİRİLMESİ”. Sağlık Bilimleri Dergisi 29, no. 3 (November 2020): 173-79. https://doi.org/10.34108/eujhs.738746.
EndNote Etöz M, Aşantoğrol F, Doğruel F (November 1, 2020) ODONTOJENİK KAYNAKLI FASİYAL ŞİŞLİKLERİN KLİNİK, ULTRASONOGRAFİK VE BİYOKİMYASAL BULGULARININ DEĞERLENDİRİLMESİ. Sağlık Bilimleri Dergisi 29 3 173–179.
IEEE M. Etöz, F. Aşantoğrol, and F. Doğruel, “ODONTOJENİK KAYNAKLI FASİYAL ŞİŞLİKLERİN KLİNİK, ULTRASONOGRAFİK VE BİYOKİMYASAL BULGULARININ DEĞERLENDİRİLMESİ”, JHS, vol. 29, no. 3, pp. 173–179, 2020, doi: 10.34108/eujhs.738746.
ISNAD Etöz, Meryem et al. “ODONTOJENİK KAYNAKLI FASİYAL ŞİŞLİKLERİN KLİNİK, ULTRASONOGRAFİK VE BİYOKİMYASAL BULGULARININ DEĞERLENDİRİLMESİ”. Sağlık Bilimleri Dergisi 29/3 (November 2020), 173-179. https://doi.org/10.34108/eujhs.738746.
JAMA Etöz M, Aşantoğrol F, Doğruel F. ODONTOJENİK KAYNAKLI FASİYAL ŞİŞLİKLERİN KLİNİK, ULTRASONOGRAFİK VE BİYOKİMYASAL BULGULARININ DEĞERLENDİRİLMESİ. JHS. 2020;29:173–179.
MLA Etöz, Meryem et al. “ODONTOJENİK KAYNAKLI FASİYAL ŞİŞLİKLERİN KLİNİK, ULTRASONOGRAFİK VE BİYOKİMYASAL BULGULARININ DEĞERLENDİRİLMESİ”. Sağlık Bilimleri Dergisi, vol. 29, no. 3, 2020, pp. 173-9, doi:10.34108/eujhs.738746.
Vancouver Etöz M, Aşantoğrol F, Doğruel F. ODONTOJENİK KAYNAKLI FASİYAL ŞİŞLİKLERİN KLİNİK, ULTRASONOGRAFİK VE BİYOKİMYASAL BULGULARININ DEĞERLENDİRİLMESİ. JHS. 2020;29(3):173-9.