Role of early extraction of odontogenic focus in deep neck infections.

IF 2.2 3区 医学
J-L Treviño-Gonzalez, K-M Santos-Santillana, J-R Cortes-Ponce, B Gonzalez-Andrade, J-A Morales-Del-Angel
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引用次数: 1

Abstract

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.

Abstract Image

Abstract Image

Abstract Image

早期拔除牙源性病灶在深颈部感染中的作用。
背景:牙源性深颈部感染仍然是一种常见的疾病,由于颈部和邻近结构的复杂累及及其潜在的危及生命的风险,它提出了一个具有挑战性的问题。第二或第三磨牙根尖周围感染并扩散到下颌下和咽旁间隙是最常见的情况。然而,对感染病灶的拔除时间仍有争议。本研究的目的是概述ODNI患者的流行病学、临床和放射学特征以及治疗方法,并确定早期拔牙对患者预后和康复的作用。材料和方法:本回顾性研究纳入了2017年1月至2022年1月在大学医院Dr Jose Eleuterio Gonzalez就诊的18岁以上ODNI诊断患者。ODNI诊断基于疾病的临床和放射学证据,辅以牙源性病因学的牙科和颌面评估。结果:共纳入68例患者。患者平均年龄40.96±14.9岁。糖尿病是最常见的合并症。下颌下间隙是最常见的深颈间隙受累(n=59, 86.8%)。在7.5%的患者中观察到纵隔炎、边缘神经损伤和颈瘘,在这个系列中没有死亡。延迟拔牙超过3天与纵隔炎发生率(n=3, 100%, p= 0.022)、手术次数(1.45±0.61,p= 0.006)、ICU住院时间(n=8, 40%, p= 0.019)和ICU住院时间(0.85±0.8,p= 0.001)增加相关。结论:快速手术引流和静脉抗生素治疗,以及早期拔牙是必要的。
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来源期刊
CiteScore
4.50
自引率
0.00%
发文量
52
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
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