Clinical, Radiographic, and Laboratory Evaluation of Patients with Dental Abscesses in Samawah City, Iraq
Abstract
Odontogenic infections, if left untreated, can lead to serious complications, including the development of life-threatening maxillofacial space abscesses. The purpose of this study was to study the clinical, radiological, and laboratory characteristics of the patients with dental abscesses in Samawah City, Iraq, and the role of advanced imaging (such as ultrasound) and microbial culture in making the diagnosis. This study utilized a prospective study methodology. All clinical evaluations were carried out on patients who arrived at the maxillofacial emergency department of the hospital. The clinical evaluations included assessment of the airway and determination of systemic toxicity scores. CT scans were performed for the evaluation of radiographic criteria. Point-of-care ultrasound was also performed to differentiate abscess from cellulitis. Laboratory analyses included a complete blood count, CRP measurement, and renal function tests. Samples of pus were subjected to aerobic and anaerobic microbial culture, followed by susceptibility testing. A remarkable finding was that patients with uncontrolled systemic comorbidities, such as Type 1 diabetes, had multi-space infections (infections affecting several parts of the body). Ultrasound was successfully employed for identifying fluid accumulation in patients who would require further surgery. Microbiological analyses of pus showed that the infections were polymicrobial, with the majority of pathogens being viridans streptococci. This study stressed the need to implement CT, ultrasound, and culture analyses to treat serious odontogenic infections efficiently.
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References
Flynn TR. The swollen face: severe odontogenic infections. Emerg Med Clin North Am. 2000;18(3):481-519.
Storoe W, Haug RH, Lillich TT. The changing face of odontogenic infections. J Oral Maxillofac Surg. 2001;59(7):739-748.
Rega AJ, Aziz SR, Ziccardi VB. Microbiology and antibiotic sensitivities of head and neck space infections of odontogenic origin. J Oral Maxillofac Surg. 2008;66(12):2525-2530.
Al-Shayyab MH. Odontogenic infections: a 5-year retrospective study in a Jordanian teaching hospital. J Oral Maxillofac Surg. 2010;68(9):2216-2220.
Kinzer S, Pfeiffer J, Becker S, et al. Severe odontogenic infections requiring intensive care treatment: a clinical evaluation. J Craniomaxillofac Surg. 2016;44(2):211-217.
Boscolo-Rizzo P, Marchiori C, Montolli F, et al. Deep neck infections: a constant challenge. ORL J Otorhinolaryngol Relat Spec. 2006;68(5):259-265.
Haug RH, Picard U, Indresano AT. Management of trismus associated with odontogenic infections. J Oral Maxillofac Surg. 1992;50(11):1158-1162.
Ledingham IM, McArdle CS, McDonald IG, et al. The pathophysiology of severe infection. J Infect. 1980;2(Suppl 1):29-39.
Greenberg RJ, Glick M, Cohen SG. Diabetes mellitus and its effect on the healing of oral hard and soft tissues. Compend Contin Educ Dent. 2001;22(3):244-250.
Murillo J, Llamas R, Zamora E, et al. Evaluation of the role of diabetes mellitus in the prognosis of severe odontogenic infections. Med Oral Patol Oral Cir Bucal. 2018;23(5):e567-e572.
Maroldi R, Farina D, Ravanelli M, et al. Emergency imaging assessment of deep neck space infections. Semin Ultrasound CT MR. 2012;33(5):432-442.
Huang TT, Liu TC, Chen PR, et al. Deep neck infection: analysis of 185 cases. Head Neck. 2004;26(10):854-860.
Bridges K, Welch K. The role of computed tomography in the diagnosis of deep neck space infections. Br J Oral Maxillofac Surg. 1991;29(1):34-37.
Daramola OO, Flanagan CE, Maisel RH, Odland RM. Diagnosis and treatment of deep neck space abscesses. Otolaryngol Head Neck Surg. 2009;141(2):123-130.
Giti S, Shishegar M, Arab HR. The value of ultrasound in the diagnosis of maxillofacial space infections. Iran J Radiol. 2014;11(3):e15735.
Bahl R, Sandhu S, Singh K, et al. Role of ultrasound in diagnosing maxillofacial space infections. Natl J Maxillofac Surg. 2016;7(2):166-171.
Ariji Y, Ariji E, Yoshiura K, et al. Ultrasonographic evaluation of inflammatory changes in the masseter muscle. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1994;78(3):382-388.
Thomason JM, Girdler NM, Kendall-Taylor P, et al. An investigation into the role of facio-cervical ultrasound in the management of severe odontogenic infections. Int J Oral Maxillofac Surg. 2000;29(3):206-209.
Seppänen L, Rautemaa R, Lindqvist C, et al. Microbiology of odontogenic infections in a Finnish university hospital. Int J Oral Maxillofac Surg. 2008;37(10):922-927.
Ylijoki H, Suuronen R, Jousimies-Somer H, et al. Differences between patients with or without the need for intensive care due to severe odontogenic infections. J Oral Maxillofac Surg. 2001;59(8):867-872.
Larawin V, Naipao J, Dubey SP. Head and neck space infections. Otolaryngol Head Neck Surg. 2006;135(6):889-893.
Ahmad M, Khurshid Z, Hasan MI. Current concepts in the management of odontogenic infections. J Coll Physicians Surg Pak. 2014;24(9):669-673.
Brook I. Microbiology and management of deep facial space infections. Anaerobe. 2009;15(1-2):36-40.
Al-Muharraqi MA. Antibiotic prescription in dentistry: a 5-year review. J Int Med Res. 2018;46(3):1005-1013.
Eufinger H, Machtens E. Ultrasound-guided drainage of maxillofacial abscesses. Int J Oral Maxillofac Surg. 1993;22(6):360-362.
Kuriyama T, Nakagawa K, Karasawa T, et al. Outbreak of severe penetrating odontogenic infections: clinical and microbiological aspects. J Med Microbiol. 2005;54(Pt 6):577-581.
Swelem AA, Hassan MH, Al-Fotawi AM. Microbiology and antibiotic sensitivity of odontogenic space infections. Egypt J Oral Maxillofac Surg. 2015;6(1):38-43.
Wang J, Ahani A, Pogrel MA. A five-year retrospective study of odontogenic maxillofacial infections in a large urban public hospital. Int J Oral Maxillofac Surg. 2005;34(4):464-468.
Owusu JA, Boakye-Yiadom K, Agyeman-Badu F. Deep neck space infections of odontogenic origin: a 5-year review at a tertiary hospital in Ghana. Ghana Med J. 2021;55(2):135-141.
Peltola J, Kärkkäinen S, Jousimies-Somer H, Lindqvist C. Abscesses in the head and neck region: a clinical and bacteriological study. Infection. 1993;21(1):35-39.
Peterson LJ. Contemporary management of deep infections of the neck. J Oral Maxillofac Surg. 1993;51(3):226-231.
Sakaguchi M, Sato S, Ishigami T, et al. Characterization and management of deep neck infections. Int J Oral Maxillofac Surg. 1997;26(1):39-43.
Parhiscar A, Har-El G. Deep neck space infections: diagnosis and management. Otolaryngol Clin North Am. 2001;34(2):357-367.
Britt JC, Josephson GD, Gross CW. Deep neck space infections: a retrospective review of 112 cases. Otolaryngol Head Neck Surg. 2000;123(4):421-426.
Bradley PJ, Grobman LR, Goodman WS. The value of ultrasound in the diagnosis of neck abscesses. J Otolaryngol. 1984;13(2):97-100.
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