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PubMed2004

[Pre-septal orbital cellulitis from odentogenic origin--combined surgical and endodontic approach: a case report].

Orbital abscesses are common infectious diseases. The etiology of orbital abscesses may vary from common sinusitis in most of the cases, to cocaine sniffing. As a result of the proximity to the brain, orbital abscesses may complicate to life threatening situations. The infectious process spreads to the orbit in several ways: hematogenous, via anatomic spaces in the maxillofacial region, direct invasion. The treatment philosophy combines surgical and Antibiotic therapy to resolve the acute phase of the disease, followed by elimination of the source. The purpose of this paper is to report a case of pre septal orbital cellulitis, that was treated surgically combined with endodontic therapy. To describe the different subtypes of orbital abscesses, differential diagnosis, imaging and treatment options.

Adolescent↗
PubMed1979

[Preventive removal of displaced teeth].

Using the data acquired from our catamnestic survey, we were able to establish a broad catalogue of complications involved with impacted and displaced teeth. Given these complications, it is not medically responsible to leave impacted and displaced teeth in the jaw, even if they are asymptomatic. The risks increase considerably with age. Late operative removal of such teeth can be a dangerous intervention due to local complications such as abscesses, cysts, osteomyelitis, tumors, systemic diseases, and age-related changes in the cardiovascular system.

Adult↗
PubMed1995

An approach to some dilemmas and complications of office oral surgery.

This article reviews an eclectic collection of problems. There is no particular reason why any one of them was chosen other than that they are more likely to occur in the course of practice than some other complications such as an oro-antral fistula or trauma to the lingual nerve or tissue emphysema. These latter and some other predicaments were discussed in the course of the talks given by the author at the 28th Australian Dental Congress in March 1995. The problems discussed in this paper are: 1. Dentoalveolar abscess anaesthesia. 2. Inability to obtain effective anaesthesia. The complications: 1. Post-extraction haemorrhage. 2. Syncope. 3. Postoperative infection.

Ambulatory Surgical Procedures↗
PubMed2003

[Brain abscesses after extracranial infections of the head and neck area].

The authors report on 20 immunocompetent patients with brain abscess after 12 cases of middle ear, seven tooth and a single frontal sinus infection. The clinical aspects, hematochemical and microbiological data, the role of imaging diagnostics (CT, MR) and the type of treatment are analysed. Neurosurgery was performed on 17 patients (85%), eight of whom subsequently underwent evacuation of the primary source of infection (four mastoidectomies, two timpanoplasties, two tooth extractions). Mastoidectomy was eventually carried out on one of the three patients who did not undergo neurosurgery. Microbiological diagnosis was possible in nine patients through culture examination: Proteus mirabilis in three cases, Peptostreptococcus sp. in two, Micrococcus varians, Proteus vulgaris, Streptococcus sanguis and Streptococcus viridans not typed in single cases. The pus was sterile in eight patients (47.1% of those operated). An association of two antimicrobial agents was used in 18 patients, while in two cases monotherapy was preferred, based on the isolated bacteria. Treatment lasted on average 38 days. The most frequently used therapy regimen (75%) was the association of a beta-lactam drug with chloramphenicol or metronidazole. Therapy was successful in 19/20 patients; one patient died. There was no significant difference in prognostic terms with regard to sex, age, duration of symptoms prior to diagnosis, clinical picture at onset, number and size of abscesses or type of treatment. Recognising the first clinical signs and symptoms (headache, fever, alterations in consciousness, focal neurological deficit, epileptic seizures) is extremely important for prompt diagnosis of brain abscess.

Adolescent↗
PubMed1991

Tooth dislocation: the relationship with tooth wear and dental abscesses.

Tooth dislocation (tilting) was recorded in 1,200 skulls from 34 museum collections. The findings of dislocation by tooth type, tooth wear, and abscess location are presented. A model for dislocation based upon the progressive loss of tooth support provides a rational explanation for the phenomenon. Physiological continuous tooth eruption was considered to account for a component of the progressive loss of tooth attachment. The process of attrition, pulp perforation, and dental abscess cavity formation resulted in further, more severe loss of tooth support. Heavy functional forces, in association with greatly reduced bone support, tilted the crown lingually and root buccally. When the tooth had tilted to such an extent that the root apices protruded from the bone and, presumably (in life) through the gingival/mucosal tissues, the infected root canals were effectively isolated from the internal environment. The tooth continued to function. The more typical consequence of severe attrition and dental abscess formation was tooth loss; it also isolated an infected tooth from living tissue, but without the benefit of retaining function.

Bicuspid↗
PubMed1996

Severe dens invaginatus malformation: report of two cases.

Two cases of severe dens invaginatus malformation of teeth are presented. In the first case apical abscess formation occurred before root end closure. In the second case the dysmorphic tooth form may be considered a possible cause of retarded eruption.

Child↗
PubMed2004

Severe extrusion from an apical abscess: a case report.

A 10-year-old boy presented with an acute apical abscess with extensive extrusion of a maxillary central incisor. The tooth, the maxillary right central incisor, had a history of trauma and subsequent apical abscesses. This article describes the presentation, management of the abscess and the subsequent results of treatment. The reasons for the extrusion and success of the treatment are discussed.

Anti-Bacterial Agents↗
PubMed2002

Actinomyces species, streptococci, and Enterococcus faecalis in primary root canal infections.

The purpose of this study was to evaluate the prevalence of Actinomyces species, streptococci, and Enterococcus faecalis in primary root canal infections by using a molecular genetic method. Samples were obtained from 53 infected teeth, of which 27 cases were diagnosed as acute periradicular abscesses. DNA was extracted to evaluate the occurrence of 13 bacterial species by using whole genomic DNA probes and checkerboard DNA-DNA hybridization. Polymerase chain reaction using an ubiquitous bacterial primer was undertaken to check the presence of bacterial DNA in clinical samples. All root canal samples contained bacteria as demonstrated by polymerase chain reaction. The checkerboard DNA-DNA hybridization assay allowed the detection of streptococci in 22.6% of the samples, Actinomyces species in 9.4%, and E. faecalis in 7.5%. The most prevalent species were members of the Streptococcus anginosus group. With regard to the asymptomatic lesions, the most prevalent species were S. intermedius (11.5% of the cases), E. faecalis (11.5%), and S. anginosus (7.7%). S. constellatus was the most prevalent species in pus samples (25.9% of the cases). The other most prevalent species in abscessed teeth were A. gerencseriae (14.8%), S. gordonii (11.1%), S. intermedius (11.1%), A. israelii (7.4%), S. anginosus (7.4%), and S. sanguis (7.4%). S. constellatus was the only species positively associated with acute periradicular abscess (p < 0.01).

Actinomyces↗
PubMed1975

[Treatment of odontogenic abscesses].

Histories of 311 abscesses of odontogenic origin found in different tissue spaces were evaluated. Location, cause, age distribution, pathogenic germs, and therapeutical measures were discussed. The perimandibular abscess was found most frequently, the second most common was the submadibular abscess. The parapharyngeal and paratonsillary abscesses were the rarest. The age of the patients was mainly between 30 and 50 years. Most often the lower molars were the starting point of the abscess. The spectrum of pathogenic germs comprised 14 different germs. Surgical therapy which is always necessary is performed under analgo-sedation in adults, and in ketamine anesthesia in children. The tooth responsible for the abscess was removed seven days after the abscess incision, on the average. If indicated, post-operative therapy should be applied after the testing of germ resistance.

Adolescent↗
PubMed1996

Tooth root abscesses in New World camelids: 23 cases (1972-1994).

OBJECTIVE: To determine typical clinical and radiographic findings in a group of New World camelids with tooth root abscesses and to determine outcome after medical and surgical treatment. DESIGN: Retrospective case series. ANIMALS: 23 llamas and alpacas with radiographic and clinical evidence of tooth root abscesses. PROCEDURE: Disease history, signalment, physical and radiographic examination findings, bacteriologic culture results, treatment, and short-term and long-term outcome were retrieved from the medical records. RESULTS: Local swelling was the most common clinical abnormality in camelids with tooth root abscesses. Mandibular molars were affected most commonly, and bacteriologic culture of samples from lesions often revealed facultative anaerobic bacteria. Antibiotic treatment for at least 30 days, surgical extraction of the affected tooth, and a root canal procedure were used successfully to treat tooth root abscesses. CLINICAL IMPLICATIONS: Both surgical and medical treatment of tooth root abscesses may lead to successful resolution of clinical signs in New World camelids.

Animals↗
PubMed1994

Changing trends in deep neck abscess. A retrospective study of 110 patients.

We have conducted a retrospective study of 110 patients with the diagnosis of deep neck abscess who had been seen between 1981 and 1990. Etiologic factors, common pathogens, and antimicrobial therapy were reviewed with reference to diagnostic methods of choice and management principles. The findings were compared with the literature. We have identified trends of change in the following aspects of deep neck abscess: cause, presentation, diagnostic methods, and bacteriology. Management principles of airway protection, intravenous antibiotics, and drainage have not changed.

Abscess↗
PubMed2001

Microbiological evaluation of acute periradicular abscesses by DNA-DNA hybridization.

OBJECTIVE: The purpose of the present investigation was to examine the microbiota of acute periradicular abscesses of endodontic origin by using a molecular genetic method. STUDY DESIGN: Pus was collected by aspiration from 27 cases diagnosed as acute abscesses of endodontic origin, and DNA was extracted to evaluate the occurrence of 49 bacterial species by using whole genomic DNA probes and checkerboard DNA-DNA hybridization. The presence of bacterial DNA in clinical samples was confirmed by polymerase chain reaction with ubiquitous bacterial 16S rRNA gene primers. RESULTS: The results of the checkerboard DNA-DNA hybridization analysis revealed that 37 of the 49 DNA probes tested were reactive with one or more samples. The number of bacterial species in the pus samples ranged from 1 to 33 (mean, 5.9). Eighteen of the 27 pus samples were positive for at least one DNA probe. The most prevalent species found were: Bacteroides forsythus (29.6% of the cases); Porphyromonas gingivalis (29.6%); Streptococcus constellatus (25.9%), Prevotella intermedia (22.2%), Prevotella nigrescens (22.2%), Fusobacterium periodonticum (18.5%), Fusobacterium nucleatum subspecies nucleatum (18.5%), and Eikenella corrodens (18.5%). CONCLUSIONS: The microbiologic data of the present investigation indicated that molecular genetic methods could provide additional knowledge regarding the microbiota of acute periradicular abscesses by detecting bacterial species that are difficult--or even impossible--to grow.

Adult↗
PubMed1986

Quantitative bacteriology of acute dento-alveolar abscesses.

A qualitative and quantitative bacteriological study was performed on pus specimens obtained by needle aspiration of 50 acute dento-alveolar abscesses. Most samples contained a mixture of species (average 3.3); 20 (40%) of the abscesses contained anaerobes alone, 3 (6%) contained facultative anaerobes only and the remaining 27 (54%) contained mixtures of both types of bacteria, with anaerobes predominating. In total, 166 bacterial strains were isolated, 75% of which were strictly anaerobic; the most common species were Peptococcus spp, Bacteroides oralis and B. melaninogenicus. Among facultative anaerobes, Streptococcus milleri was particularly common. The mean concentration of bacteria in each abscess was 10(6.9 +/- 0.2). The mean concentration of anaerobic bacteria was 10(6.2 +/- 0.1) and of facultatively anaerobic bacteria 10(5.7 +/- 0.2).

Adult↗
PubMed1989

[Orbital cellulitis after a dental infection].

Blindness as a complication of a dental infection is rare. A nineteen-year-old male is presented with an apical abscess, leading to a maxillary sinusitis, orbital cellulitis and an imminent cavernous sinus thrombosis.

Adult↗
PubMed1980

Incidence of caries and abscesses in archeological Eskimo skeletal samples from Point Hope and Kodiak Island, Alaska.

The incidence of caries and abscesses in 246 archeologically derived skeletal specimens from the Ipiutak and Tigara levels at Point Hope, Alaska, and 79 specimens excavated from Jones Point, Kodiak Island, Alaska were investigated. All three collections span long periods of time. Only pre-white contact specimens were used. Each specimen was sexed and aged in five year groupings, using standard techniques. Caries and abscesses were recorded by type and degree of severity and correlated with age, sex, and site of origin. All samples displayed very low caries rates and few abscesses per tooth and per individual (both observed frequencies, and frequencies corrected for postmortem loss of teeth). DMF scores were tabulated using both observed and corrected frequencies. Very heavy occlusal wear in all three samples could account for the majority of abscesses and pulp exposures, while the low caries rates are attributable to traditional diets totally devoid of refined sugars, starches, and food additives.

Age Factors↗
PubMed1983

[1st observations on soft-laser therapy in odontostomatology].

The authors present their results on the use of Soft-Laser-Therapy in dentistry. The successes obtained in the few number of cases treated with this technique on dental abscess, apical granulomas, gingivitis and facial pain are encouraging and induce the authors to carry on further researches on this topics.

Gingivitis↗
PubMed2001

Are antibiotics being used appropriately for emergency dental treatment?

AIM: To investigate the therapeutic prescribing of antibiotics to patients presenting for emergency dental treatment. DESIGN: A prospective clinical study. METHOD: Information was collected via a questionnaire concerning the patient's reason for attendance and treatment undertaken at emergency dental clinics in North and South Cheshire. RESULTS: Over an 11-week period 1,069 patients attended the five clinics, 1,011 questionnaires were analyzed. The majority of the attendees had pain (879/1011). 35% (311/879) of these patient had pulpitis and 74% (230/311) had been issued a prescription for antibiotics, without any active surgical intervention. Th principal antibiotic prescribed for both adult and child patients was amoxicillin. CONCLUSION: The majority of patients attending the emergency dental clinics had pain, with a large proportion having localised infections either as pulpitis or localised dental abscess. Three quarters of these patients had no surgical intervention and were inappropriately prescribed antibiotics.

Adolescent↗