J-L Treviño-Gonzalez, K-M Santos-Santillana, J-R Cortes-Ponce, B Gonzalez-Andrade, J-A Morales-Del-Angel
{"title":"早期拔除牙源性病灶在深颈部感染中的作用。","authors":"J-L Treviño-Gonzalez, K-M Santos-Santillana, J-R Cortes-Ponce, B Gonzalez-Andrade, J-A Morales-Del-Angel","doi":"10.4317/medoral.25536","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Odontogenic deep neck infections remain a common condition that presents a challenging issue due to the complex involvement of the neck and adjacent structures and its potential life-threatening risk. Periapical infection of the second or third molar with spread to the submandibular and parapharyngeal spaces is the most commonly observed scenario. However, the time of dental extraction of the infection focus remains controversial. The aim of this study is to provide an overview of the epidemiology, clinical and radiological features, and management in patients diagnosed with ODNI and to identify the role of early dental extraction on patient outcomes and recovery.</p><p><strong>Material and methods: </strong>This retrospective study included patients over 18 years old with a diagnosis of ODNI who were admitted to the University Hospital \"Dr Jose Eleuterio Gonzalez\" from January 2017 to January 2022. ODNI diagnosis was based on clinical and radiological evidence of the disease supplemented by dental and maxillofacial evaluation for an odontogenic aetiology.</p><p><strong>Results: </strong>A total of 68 patients were included in the study. The patients' mean age was 40.96 ± 14.9. Diabetes mellitus was the most common comorbidity. The submandibular space was the most common deep neck space involved (n=59, 86.8%). Mediastinitis, marginal nerve injury and orocervical fistula were observed in 7.5% of patients, with no fatality in this series. A delay of >3 days for dental extraction of the involved tooth was associated with an increased rate of mediastinitis (n=3, 100%, p= 0.022), number of surgical interventions (1.45 ± 0.61, p= 0.006), ICU stay (n=8, 40%, p= 0.019), and ICU length of stay (0.85 ± 0.8, p= 0.001).</p><p><strong>Conclusions: </strong>Expedited management with surgical drainage and intravenous antibiotic treatment, along with early extraction of the involved tooth, is mandatory.</p>","PeriodicalId":18351,"journal":{"name":"Medicina oral, patologia oral y cirugia bucal","volume":"28 1","pages":"e25-e31"},"PeriodicalIF":2.2000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9805327/pdf/","citationCount":"1","resultStr":"{\"title\":\"Role of early extraction of odontogenic focus in deep neck infections.\",\"authors\":\"J-L Treviño-Gonzalez, K-M Santos-Santillana, J-R Cortes-Ponce, B Gonzalez-Andrade, J-A Morales-Del-Angel\",\"doi\":\"10.4317/medoral.25536\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Odontogenic deep neck infections remain a common condition that presents a challenging issue due to the complex involvement of the neck and adjacent structures and its potential life-threatening risk. Periapical infection of the second or third molar with spread to the submandibular and parapharyngeal spaces is the most commonly observed scenario. However, the time of dental extraction of the infection focus remains controversial. The aim of this study is to provide an overview of the epidemiology, clinical and radiological features, and management in patients diagnosed with ODNI and to identify the role of early dental extraction on patient outcomes and recovery.</p><p><strong>Material and methods: </strong>This retrospective study included patients over 18 years old with a diagnosis of ODNI who were admitted to the University Hospital \\\"Dr Jose Eleuterio Gonzalez\\\" from January 2017 to January 2022. ODNI diagnosis was based on clinical and radiological evidence of the disease supplemented by dental and maxillofacial evaluation for an odontogenic aetiology.</p><p><strong>Results: </strong>A total of 68 patients were included in the study. The patients' mean age was 40.96 ± 14.9. Diabetes mellitus was the most common comorbidity. The submandibular space was the most common deep neck space involved (n=59, 86.8%). Mediastinitis, marginal nerve injury and orocervical fistula were observed in 7.5% of patients, with no fatality in this series. A delay of >3 days for dental extraction of the involved tooth was associated with an increased rate of mediastinitis (n=3, 100%, p= 0.022), number of surgical interventions (1.45 ± 0.61, p= 0.006), ICU stay (n=8, 40%, p= 0.019), and ICU length of stay (0.85 ± 0.8, p= 0.001).</p><p><strong>Conclusions: </strong>Expedited management with surgical drainage and intravenous antibiotic treatment, along with early extraction of the involved tooth, is mandatory.</p>\",\"PeriodicalId\":18351,\"journal\":{\"name\":\"Medicina oral, patologia oral y cirugia bucal\",\"volume\":\"28 1\",\"pages\":\"e25-e31\"},\"PeriodicalIF\":2.2000,\"publicationDate\":\"2023-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9805327/pdf/\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Medicina oral, patologia oral y cirugia bucal\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.4317/medoral.25536\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Medicina oral, patologia oral y cirugia bucal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.4317/medoral.25536","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Role of early extraction of odontogenic focus in deep neck infections.
Background: Odontogenic deep neck infections remain a common condition that presents a challenging issue due to the complex involvement of the neck and adjacent structures and its potential life-threatening risk. Periapical infection of the second or third molar with spread to the submandibular and parapharyngeal spaces is the most commonly observed scenario. However, the time of dental extraction of the infection focus remains controversial. The aim of this study is to provide an overview of the epidemiology, clinical and radiological features, and management in patients diagnosed with ODNI and to identify the role of early dental extraction on patient outcomes and recovery.
Material and methods: This retrospective study included patients over 18 years old with a diagnosis of ODNI who were admitted to the University Hospital "Dr Jose Eleuterio Gonzalez" from January 2017 to January 2022. ODNI diagnosis was based on clinical and radiological evidence of the disease supplemented by dental and maxillofacial evaluation for an odontogenic aetiology.
Results: A total of 68 patients were included in the study. The patients' mean age was 40.96 ± 14.9. Diabetes mellitus was the most common comorbidity. The submandibular space was the most common deep neck space involved (n=59, 86.8%). Mediastinitis, marginal nerve injury and orocervical fistula were observed in 7.5% of patients, with no fatality in this series. A delay of >3 days for dental extraction of the involved tooth was associated with an increased rate of mediastinitis (n=3, 100%, p= 0.022), number of surgical interventions (1.45 ± 0.61, p= 0.006), ICU stay (n=8, 40%, p= 0.019), and ICU length of stay (0.85 ± 0.8, p= 0.001).
Conclusions: Expedited management with surgical drainage and intravenous antibiotic treatment, along with early extraction of the involved tooth, is mandatory.
期刊介绍:
1. Oral Medicine and Pathology:
Clinicopathological as well as medical or surgical management aspects of
diseases affecting oral mucosa, salivary glands, maxillary bones, as well as
orofacial neurological disorders, and systemic conditions with an impact on
the oral cavity.
2. Oral Surgery:
Surgical management aspects of diseases affecting oral mucosa, salivary glands,
maxillary bones, teeth, implants, oral surgical procedures. Surgical management
of diseases affecting head and neck areas.
3. Medically compromised patients in Dentistry:
Articles discussing medical problems in Odontology will also be included, with
a special focus on the clinico-odontological management of medically compromised patients, and considerations regarding high-risk or disabled patients.
4. Implantology
5. Periodontology