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PubMed2003

Specific PCR detection of Peptostreptococcus magnus.

Peptostreptococcus magnus is the most pathogenic and one of the most common Gram-positive anaerobic cocci found in human clinical specimens. The organism has been isolated in pure culture from a range of serious infections, including meningitis and endocarditis. However, isolation of Peptostreptococcus magnus from the oral cavity has rarely been attempted. Identification of Peptostreptococcus magnus in clinical specimens is reliant upon microbiological culture and biochemical methods, which often give ambiguous results. The aim of this study was to develop a PCR assay for the specific detection of Peptostreptococcus magnus in oral clinical specimens. PCR primers specific for Peptostreptococcus magnus DNA were derived by comparison of 16S rRNA gene sequences and selection of primers that demonstrated specificity at their 3' ends for Peptostreptococcus magnus. PCR positivity for Peptostreptococcus magnus DNA was indicated by the amplification of a 553 bp product. The PCR assay was then used to attempt detection of Peptostreptococcus magnus DNA in subgingival plaque samples from adult periodontitis patients and pus aspirates from subjects with acute dento-alveolar abscesses. The PCR assay was demonstrated to be highly specific for Peptostreptococcus magnus DNA, since no PCR products were obtained when genomic DNA from a wide range of other oral bacteria, including closely related Peptostreptococcus species, was used in the PCR assay. Confirmation of specific amplification of Peptostreptococcus magnus DNA was obtained by digestion of PCR products with the restriction endonuclease RsaI, which gives a unique restriction profile for Peptostreptococcus magnus. Of the 33 subgingival plaque samples analysed, 2 (6 %) were positive for Peptostreptococcus magnus DNA. None of the 60 pus aspirates analysed was positive for Peptostreptococcus magnus DNA. It is concluded that Peptostreptococcus magnus is not a major pathogen in adult periodontitis or dento-alveolar abscesses. The PCR assay provides a more rapid, specific and sensitive alternative to conventional methods for identification of Peptostreptococcus magnus in clinical specimens.

Adult↗
PubMed2006

Self-treatment using a power drill: a case report.

UNLABELLED: The intense pain of dental origin which patients suffer can be underestimated. This can lead them to self-harm or carry out self-treatment, sometimes with only the rudiments of how to achieve pain relief. A case is reported of a patient who attempted to relieve the intense pressure of an abscess arising in a maxillary cyst by using a home power drill. He drilled through the side of the tooth and drained the abscess but, unfortunately, fractured the drill. This was discovered at operation and meant the tooth had to be extracted. The patient had only received antibiotics prior to this for his abscess, with no drainage being undertaken. CLINICAL RELEVANCE: This case highlights the inappropriate use of antibiotics when drainage of an abscess is the correct treatment. It demonstrates the extreme measures some patients may take in order to relieve their symptoms by self-treating themselves physically, in addition to self-prescribed medication.

Adult↗
PubMed1983

Orofacial infections of odontogenic origin.

Purulent infections of the orofacial region are often of odontogenic origin. The clinical manifestations are largely dependent on the complex microbiota and the anatomical routes of spread. Serious complications may ensue, especially if hematogenous spread occurs. Direct invasion of different anatomical spaces may cause mediastinitis, airway obstruction and intracranial spread. Proper surgical treatment is mandatory to evacuate pus as soon as abscess formation is recognized. Anaerobic bacteria belonging to the normal oropharyngeal flora are usually isolated from these abscesses. The drug of choice for antimicrobial therapy is penicillin. However, antimicrobial treatment may have to be altered due to emergence of antimicrobial-resistant anaerobic bacteria.

Anti-Bacterial Agents↗
PubMed1979

Fatal acute bacterial myocarditis after dentoalveolar abscess.

A 19 year old woman presented with chest pain after a dental extraction for a dentoalveolar abscess. Electrocardiographic and serum isoenzyme changes were consistent with acute anterior myocardial infarction. At autopsy bacteria were demonstrated, within the myocardium in the absence of a myocardial abscess or endocarditis. This case illustrates the occurrence of isolated acute bacterial myocarditis after a dental extraction.

Adult↗
PubMed1996

Bacteriology of dentoalveolar abscesses in patients who have received empirical antibiotic therapy.

We investigated aspirates of pus from dentoalveolar abscesses in 13 patients who had received empirical antibiotic therapy within 1 month before presentation at our facility. The antibiotics administered were lincomycin, amoxicillin, ampicillin, or a cephalosporin. Information on antibiotic therapy was obtained from the patients' medical histories. Cultures of all dentoalveolar abscesses yielded organisms. A total of 70 isolates (42 anaerobes and 28 facultative organisms) were recovered, representing 5.3 isolates (3.2 anaerobes and 2.1 facultative organisms) per specimen. The counts of bacteria ranged from 5 X 10(7) cfu/mL to 8 X 10(11) cfu/mL (mean count, 1.4 X 10(11) cfu/mL; median count, 2.3 X 10(10) cfu/mL). The predominant isolates were Prevotella species (25.7% of isolates), Peptostreptococcus species (17.1%), and Streptococcus species (14.2%). This study illustrates the polymicrobial nature of dentoalveolar abscesses as well as the predominant role played by anaerobic bacteria.

Adolescent↗
PubMed1997

[Rational use of antibiotics by the dentist can prevent microbial resistance].

Worldwide resistance of microorganisms to antibiotics is becoming a problem of major concern. An antibiotic policy which tries to control the development of resistance by rational use is needed in all fields where antibiotics are prescribed. In dental practice, apart from endocarditisprophylaxis, prophylaxis is leukopenic patients and prophylaxis after dental implants, antibiotics can be used to support local therapy of an dentoalveolar abscess or refractory periodontitis. In the majority of these cases, a small spectrum penicillin is therapy of choice.

Anti-Bacterial Agents↗
PubMed1992

Dentocutaneous fistula.

Chronic dental infection is the most common cause of draining sinus tracts of the face and neck. These lesions can be a diagnostic challenge to the clinician who is not familiar with dentocutaneous fistula. Diagnostic errors can result in multiple excisions, biopsies, and ineffective long-term antibiotic therapy. Patients may require excision of the fistula once the dental abscess has been successfully treated by root-canal therapy or extraction. Nine patients are reported.

Adolescent↗
PubMed1978

[Bacteriology of odontogenic abscesses].

The primary bacteria strains and their sensitivity to antibiotic drugs were examined in 329 patients with extraoral split abscess who were treated on an in-patient basis. Combination therapy using various antibiotics together with gentamycin was recommended. An antibiogram however should be completed if antibiotic therapy is to be purposeful.

Anti-Bacterial Agents↗
PubMed1978

A draining sinus tract of the chin. Report of a case.

A case of a relatively rare occurrence--a draining sinus tract on the chin which originated from an abscessed lower incisor--is presented. The sequence of treatment and mode of healing are discussed, and the importance of an awareness of this phenomenon for the differential diagnosis is stressed.

Adult↗
PubMed1998

[Correlation of odontogenic soft tissue infection and thermal effects with special reference to temperature sense. Statistical analysis of 2,111 patients].

A possible correlation between the thermal effects of the weather and the frequency of odontogenic soft-tissue infections was investigated with special regard to the so-called felt temperature (gT). Clinical data of 2111 patients of the years 1992-1996 in whom an incision was made because of an odontogenic soft-tissue infection were evaluated retrospectively and correlated to meteorological data for Aachen, collected or calculated by the "Deutsche Wetterdienst". In order to describe the thermal exchange between the human organism and the surroundings in a satisfactory way, the gT was chosen. The gT is a complexly calculated meteorological parameter which allows physiologically adequate estimation of the thermic surroundings of humans. Over the whole study time there was no impressive correlation between course and changing of the gT and the frequency of odontogenic soft-tissue infections. This result agrees with our finding that there was no seasonal accumulation of odontogenic soft-tissue infections over the year in Aachen. Nevertheless, there was a statistically significant negative correlation between values or weighted changes of the gT and the frequency of abscess and/or infiltration in the winter and less in springtime. A similar statistically significant correlation could not be found for summer or autumn.

Adolescent↗
PubMed2004

Endodontic treatment of dens invaginatus type III with three root canals and open apical foramen.

AIM: To describe the conservative endodontic treatment and the 1-year follow-up of a permanent maxillary lateral incisor with dens invaginatus. SUMMARY: Frequently, the root canal treatment of invaginated teeth is challenging because of problems associated with gaining access to the root canals and with variations of canal morphology associated with this type of malformation. The present case describes the complex root canal treatment of dens invaginatus in a maxillary lateral incisor with three root canals (Oehler type III), incomplete apex formation, necrotic pulp and abscess formation. After gaining access to two root canals and the invagination with the help of a dental operating-microscope, the canals and the invagination were instrumented and calcium hydroxide dressing was applied for 6 months. Apexification and osseous bone repair were achieved, and the canals were filled with gutta-percha. A follow-up after 1 year showed that the tooth was free of any clinical symptoms and the periapical condition was normal. KEY LEARNING POINTS: The present case demonstrated that conservative root canal treatment can be performed successfully even in sever cases of dens invaginatus. The use of a dental operating microscope can help in the management of complicated cases of invaginated teeth through conventional root canal treatment.

Child↗
PubMed1977

Ecology of 350 isolates of group F Streptococcus.

The ecology of 350 strains of group F streptococci isolated from clinical material over a six-year period is described. The respiratory tract, particularly the throat, yielded the largest number of isolates. Wound swabs, mainly appendectomy, ranked second as a source of this organism, followed closely by the genitourinary tract. A significant proportion of strains was recovered from gastrointestinal sites. Dental abscess yielded several strains, often in pure culture, and the external auditory canal was identified as minor locale of the group F streptococcus. A few isolates were also obtained from blood, cerebrospinal fluid, and miscellaneous tissues.

Digestive System↗
PubMed1994

An unclassified Eubacterium taxon in acute dento-alveolar abscess.

The microflora of pus samples aspirated from 50 acute dento-alveolar abscesses was examined. A total of 143 bacterial strains was isolated, consisting predominantly of Prevotella spp., alpha-haemolytic Streptococcus spp., Peptostreptococcus spp. and Eubacterium spp. An unclassified asaccharolytic Eubacterium taxon was encountered in 17 (34%) of the abscesses. This taxon was found to have a positive association with Fusobacterium spp. and a negative association with alpha-haemolytic Streptococcus spp.

Acute Disease↗
PubMed1983

Bacteriology of dental abscesses of endodontic origin.

Aspirates have been cultured from 10 dental abscesses of endodontic origin, all of which had penetrated beyond the bony alveolus to produce fluctuant swelling. Sampling was by syringe aspiration. Strict anaerobic techniques, including the use of an anaerobic chamber, were used for serial dilution and plating. Randomly selected colonies (100) from each culture were purified, characterized, and identified. Seventy percent of the bacterial isolates were either strict anaerobes or microaerophilic. One abscess yielded a pure culture of a viridans streptococcus, Streptococcus milleri. Streptococcus intermedius dominated the flora in a second abscess. The common oral streptococcus, Streptococcus sanguis, constituted only 2% of the isolates from one additional infection. Fusobacterium nucleatum, Bacteroides melaninogenicus, other Bacteroides including B. oralis and B. ruminicola, anaerobic diphtheroids, Peptostreptococcus micros, and Staphylococcus epidermis were other predominant isolates.

Bacteria, Anaerobic↗
PubMed1980

Extension of dental abscess to the orbit.

A week after dental treatment, a dentoalveolar abscess developed in a 14-year-old boy. Surgical intervention was needed to evacuate pus and remove the cause of infection. It is suggested that initially establishing drainage after dental treatment would have prevented the sequela that ensued.

Adolescent↗
PubMed2000

Familial hypophosphatemic vitamin D-resistant rickets: dental findings and histologic study of teeth.

A case of familial hypophosphatemic vitamin D-resistant rickets or X-linked hypophosphatemia (XLH) accompanied by specific systemic and dental findings is reported. A 15-year-old boy with XLH visited our facility complaining of a toothache in the left lower canine region. Two other family members of the patient, his younger sister and their mother, also had XLH, whereas the other 2 members, his younger brother and father, are healthy. Those with XLH show systemic signs of the disease, such as growth retardation, limb deformity, and spinal curvature disorders; however, these symptoms are more severe in the patient than in the others. The patient had multiple periodontal abscesses, but no evidence of dental caries, trauma, or periodontal disease on the corresponding teeth at the time of his oral examination. A radiographic examination showed root dysplasia and enlarged pulp chambers.A histologic examination of an extracted third molar showed marked globular dentin and an increased predentin width. The abscess was thought to be caused by pulpal infection, which came from bacterial invasion through enamel cracks and dentinal microcleavage of the teeth. The treatments provided in this case are discussed.

Adolescent↗