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[Abscesses caused by deciduous teeth].

Abscesses in children, caused by deciduous teeth, ar not so frequently as seen in the permanent dentition. In most cases caries or an odontogenic infection of the associated deciduous tooth have already been treated by the dentist or oral surgeon at an earlier stage, i.e. before the infection exacerbates to an abscess. At the department of Oral and Maxillofacial Surgery of the Academic Hospital Nijmegen, between April 1997 and April 1998 20 children have been treated on a total of 1,693 patients with an odontogenic infection. Of this group, nine young children had an abscess caused by a deciduous tooth. In most cases the mandibular deciduous molars were involved. In one case an osteomyelitis of the mandible was diagnosed. All abscesses and infections could be treated adequately. The use of antibiotics is of paramount importance in the treatment of these abscesses in children.

Anti-Bacterial Agents↗

Fatal mediastinitis after a dental infection.

The pertinent features of life-threatening complications of dental infections have been briefly reviewed with particular emphasis on the alterations of the clinical features of these conditions induced by antibiotic therapy. The clinician who deals with dental infections must exercise a high index of suspicion to consistently abort the development of these complications, especially when treating debilitated patients or individuals with compromised immune functions.

Abscess↗

Treponema species associated with abscesses of endodontic origin.

Spirochetes have been frequently observed in abscesses of endodontic origin, but they have rarely been identified. This study sought to investigate the prevalence of eight oral treponemes in acute periradicular abscesses using a species-specific nested polymerase chain reaction assay. Purulent exudate was collected by aspiration from 19 cases diagnosed as acute periradicular abscesses and DNA extracted from the samples was initially amplified using universal 16S rDNA primers. A second round of amplification used the first polymerase chain reaction products to detect a specific fragment of the 16S rDNA of each Treponema species. The species-specific nPCR assay used in this study allowed the detection of Treponema denticola in 79%(15 of 19), Treponema socranskii in 26%(5 of 19), Treponema pectinovorum in 21% (4 of 19), Treponema amylovorum in 16% (3 of 19), and Treponema medium in 5% (1 of 19) of the cases. Spirochetal DNA was found in 89% of the cases (17 of 19). The number of Treponema species per case ranged from 1 to 3 (mean, 1.5). Treponema vincentii, Treponema lecithinolyticum and Treponema maltophilum were not detected in any pus sample. The present data lend support to the assertion that Treponema species, particularly T. denticola and T. socranskii, may be involved in the pathogenesis of acute periradicular abscesses.

Adolescent↗