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Results for “Periapical Abscess”

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PubMed2001

Molecular detection of black-pigmented bacteria in infections of endodontic origin.

A 16S rDNA-directed polymerase chain reaction method was used to assess the occurrence of four black-pigmented anaerobic rods in root canal infections. Samples were obtained from 54 infected teeth. Ten cases were diagnosed as acute periradicular abscesses. DNA was extracted from the samples and analyzed using a polymerase chain reaction-based identification assay. The method allowed detection of black-pigmented bacteria anaerobes in 59.3% of the examined teeth. Twelve cases yielded more than one black-pigmented species. In general Porphyromonas endodontalis was found in 42.6%, Porphyromonas gingivalis in 27.8%, Prevotella nigrescens in 7.4%, and Prevotella intermedia in 5.6% of the cases. P. endodontalis was found in 70% of the pus samples, P. gingivalis in 40%, and P. intermedia in 10%. P. gingivalis was always found associated with P. endodontalis in abscessed teeth. P. nigrescens was not found in any pus sample. The high prevalence of P. endodontalis and P. gingivalis suggests that they can play an important role in the pathogenesis of periradicular diseases.

Bacterial Typing Techniques↗

PubMed1993

An unexpected death associated with an acute dentoalveolar abscess--report of a case.

A case which was reported in the national press, is described where a fatality occurred as a result of an acute dentoalveolar abscess, and the subsequent development of septicaemia with Disseminated Intravascular Coagulation (DIC). A review of the English literature shows that there are no reported cases of death associated with acute dentoalveolar infection and DIC.

Adult↗

PubMed2004

Dental alterations associated with X-linked hypophosphatemic rickets.

The X-linked hypophosphatemic rickets is a rare metabolic disorder characterized by low serum phosphate levels caused by a decreased renal tubular reabsorption of inorganic phosphates. The initial complaints are a delay in the development of walking caused by deformity of the legs. Oral findings include poorly mineralized dentin, enlarged pulp chambers and root canals, and periradicular abscesses in caries-free teeth. We present three patients from the same family with X-linked hypophosphatemic rickets showing bone and dental alterations.

Adult↗

PubMed2003

A 16S rDNA-based nested PCR protocol to detect Campylobacter gracilis in oral infections.

The aim of this study was to describe a 16S rDNA-based nested polymerase chain reaction (nPCR) assay to investigate the occurrence of Campylobacter gracilis in oral infections. Samples were collected from ten infected root canals, ten cases of acute periradicular abscesses and eight cases of adult marginal periodontitis. DNA extracted from the samples was initially amplified using universal 16S rDNA primers. A second round of amplification used the first PCR products to detect C. gracilis using oligonucleotide primers designed from species-specific 16S rDNA signature sequences. The nPCR assay used in this study showed a detection limit of 10 C. gracilis cells and no cross-reactivity was observed with nontarget bacteria. C. gracilis was detected in the three types of oral infections investigated - 4/10 infected root canals; 2/10 acute periradicular abscesses; and 1/8 subgingival specimens from adult periodontitis. The method proposed in this study showed both high sensitivity and high specificity to directly detect C. gracilis in samples from root canal infections, abscesses, and subgingival plaque. Our findings confirmed that C. gracilis may be a member of the microbiota associated with distinct oral infections, and its specific role in such diseases requires further clarification.

Adolescent↗

PubMedDate not supplied

Rare complications of a dental abscess.

This article describes a case involving a poorly treated odontogenic infection, which was complicated by mediastinitis, thoracic empyema, pericarditis, and ascites. A posterolateral thoracotomy was necessary as incisional surgical drainage proved to be inadequate. A multidisciplinary approach of descending necrotizing mediastinitis and its complications is essential.

Adult↗

PubMed2006

X-linked hypophosphatemia: dental and histologic findings.

The recurrent spontaneous formation of abscesses affecting multiple noncarious primary as well as permanent teeth is the principle clinical dental feature in cases of hypophosphatemia, a condition inherited through the X chromosome. Patients often have high pulp horns, large pulp chambers and dentinal clefts. We report a case of hypophosphatemic vitamin D-resistant rickets in a patient who reported to our department on multiple occasions with spontaneous abscesses in relation to his primary teeth. The aim of this article is to review the features of this disorder and to discuss the risks and benefits of the treatment options suggested in the literature.

Child, Preschool↗

PubMed2005

Mediastinitis from odontogenic infection. A case report.

We report a case of mediastinitis complicating a dental infection in a 40-year-old male. Despite drainage of the localised neck abscess and the administration of systemic antibiotics, his submandibular abscess extended to involve the pericardial and pleural cavities. Drainage procedures and thoracotomies were required to treat the empyema and purulent pericarditis. Computed tomography was used to follow the progression of disease and assess the efficacy of treatment.

Acute Disease↗

PubMed2003

Incidence of endodontic treatment: a 48-month prospective study.

The purpose of this study was to determine the incidence of endodontic services provided to participants in a longitudinal cohort study. The "Florida Dental Care Study" was a prospective cohort study using a representative baseline sample of 873 dentate adults. An in-person interview and clinical dental exam were conducted at baseline, 24, and 48 months after baseline, with telephone interviews every 6 months between those times. Dental record information was abstracted afterward. Thirteen percent of participants received at least one endodontic procedure after baseline. Endodontic services constituted approximately 2% of all dental procedures performed. Conventional root canal therapy comprised 94% of the endodontic services and was approximately evenly distributed among anterior teeth, premolars, and molars. Retreatment and apicoectomy each accounted for 3% of the endodontic procedures. The most common self-reported reasons for the dental visit in which a root canal occurred were "toothache," "abscess," and "dental sensitivity." A significant percentage of persons received some type of endodontic treatment in this diverse adult sample. Dental abscesses or toothaches were the main reason(s) for endodontic treatment, but not all persons with these conditions during follow-up sought dental treatment of any variety.

Aged↗

PubMedDate not supplied

[Acute apical abscess: emergency treatment].

The author discusses the different philosophies concerning the emergency treatment of the acute apical abcess, proposing the corresponding attitudes in this case: immediate transradicular drainage, complete chemo-mechanical cleaning of the root canal and closing the access to the root canal as soon as possible. In the most serious situations we can make an incision for drainage through the soft tissues. Pain and infection control.

Emergencies↗

PubMed2000

Grievances in cases using antibiotics due to orodental problems and assessment of the need for antibiotics.

OBJECTIVE: To assess the complaints of patients who were prescribed antibiotics following orodental problems and the need for antibiotics prescribed for this purpose. SETTING: Examinations were carried out in the Department of Oral Diagnosis and Radiology, Ege University, Turkey. PARTICIPANTS: A total of 203 patients (129 females and 74 males) between 8-70 years of age (mean age 37.7 +/- 13.9). INTERVENTION: Examination and report. MAIN OUTCOME MEASURES: Frequency of unnecessary antibiotic use. RESULTS: Antibiotic therapy was not necessary for 151 (74.4 per cent) cases. Antibiotics were unnecessarily prescribed in 45 cases of acute irreversible pulpitis, 10 chronic apical abscess, 6 acute apical paradontitis, 7 gingivitis, 10 periodontitis, 4 epulis, 2 TMJ (temporomandibular junction) dysfunction, 2 sharp ridge of alveolar bone, 1 burning mouth syndrome and 1 recurrent aphthous stomatitis. In 108 (53.2 per cent) of the cases, the prescribed antibiotics were found to be penicillins, 102 of which were broad-spectrum. It was also determined that only 6 (7.7 per cent) of the 78 cases diagnosed as acute apical abscess were given drainage as local therapy. CONCLUSIONS: Principles for treating dental infections suggest that an antibiotic should only be used to supplement and not substitute for conventional surgical methods. Therefore, in cases with acute apical abscess, mechanical treatment (drainage) should be the first step. Inappropriate antibiotic use is quite widespread in dentistry. Dentists should avoid inappropriate use of antibiotics. To prevent inappropriate administration, necessary precautions need to be taken against dispensing antibiotics without prescription.

Adolescent↗

PubMed1987

An unusual case of necrotising fasciitis.

A case of subcutaneous necrotising ulceration presenting on the chest wall following a dental abscess is described. The course, surgical treatment, chemotherapy and successful outcome of the case are annotated. The bacteriological findings in this and other cases presenting similarly are discussed, and the possible implication of bacteroides species, alone or in conjunction with Str. milleri, as an aetiological factor in this condition is discussed.

Adult↗

PubMed1997

[A case of severe odontogenic infection with allergic skin reaction for beta-lactam antibiotics].

A 54-aged woman consulted with right buccal phlegmon caused by lower apical periodontitis. The primary chemotherapy using flomoxef induced allergic skin eruption. A decision was made for using clindamycin, levofloxacin and fosfomycin as chemotherapeutic agents. Cultured organisms from the abscess revealed the mixed infection with Streptococcus sanguis, Veillonella sp., Prevotella loescheii, Wolinella spp. On 12th hospital day, her serum CRP turned to negative. This case carried numerous implications for the use of antibiotics as chemotherapy agents.

Adult↗

PubMed2003

Emergency management of acute apical abscesses in the permanent dentition: a systematic review of the literature.

OBJECTIVE: To perform a systematic literature review and meta-analysis on the effectiveness of interventions used in the management of acute apical abscess in the permanent dentition. METHODS: Electronic databases were searched from their inception to March 2002. These searches, combined with manual searching, yielded 85 citations, of which 35 were relevant. Independent application of inclusion criteria by 3 reviewers yielded 8 eligible randomized controlled studies. Data on population, interventions, outcomes (reduction of pain or swelling or both, as reported by patients or clinicians) and methodological quality were determined by independent triplicate review. Disagreements were resolved by consensus. RESULTS: All papers included in the meta-analysis compared an antibiotic with an active control, a placebo or no pharmacotherapy as an adjunct for patients who had received concomitant therapy (i.e., incision and drainage, endodontic therapy or extraction). The 8 trials were randomized; in 3 of these, the method of randomization was described and appropriate. Five studies were double-blinded, and 2 of these described the method of blinding. Four trials described withdrawals, but none included an intention-to-treat analysis. Six studies compared 2 antibiotics. For the outcomes "absence of infection"and "absence of pain" the pooled odds ratios (ORs) were not statistically significant; for the outcome "absence of pain and infection," 3 studies showed an equivalent treatment effect in both treatment and control groups. One open-label study (with a quality score of 2) showed a result favouring azithromycin over co-amoxiclav (OR 0.58, 95% confidence interval 0.35-0.96). Two studies compared adjunctive antibiotic therapy with placebo; no benefit to patients was demonstrated with this intervention. CONCLUSIONS: In the management of localized acute apical abscess in the permanent dentition, the abscess should be drained through a pulpectomy or incision and drainage. This analysis indicated that antibiotics are of no additional benefit. In the event of systemic complications (e.g., fever, lymphadenopathy or cellulitis), or for an immunocompromised patient, antibiotics may be prescribed in addition to drainage of the tooth.

Anti-Bacterial Agents↗

PubMed1978

[Effect of weather on odontogenic abscesses].

An increased frequency of odontogenous abcesses was observed on certain days in the course of routine clinical practice. We therefore investigated the possibility of a statistically significant weather-related odontogenous soft-tissue purulence originating from chronic apical periodontitis. Medical reports of patients treated between 1970 and 1977 were used. Our study indicated that the frequency of odontogenous abcesses was significantly higher with cyclonic weather conditions, i.e., weather with low barometric pressure.

Atmospheric Pressure↗

PubMed1999

Heart transplants--assessment of dental procedures.

The object of this study was to evaluate the effects of dental foci on survival rates and rejection episodes in heart transplant recipients. Therefore, in a retrospective longitudinal study we studied 74 heart transplant recipients at the Department of Maxillofacial Surgery and Department of Thoracic and Cardiovascular Surgery, University of Münster. Study patients were divided into groups: those in which dental foci had been verified (n = 31) and those without dental foci (n = 43). Statistical analysis was performed using the chi-square test, Kaplan-Meier life table analysis, and the log-rank test. Before heart transplantation, patients were screened clinically and radiographically to determine the extent of dental foci. Postoperatively, patients were evaluated dentally and medically to identify the impact of dental foci on the incidence of systemic and oral infections, frequency and severity of rejection episodes, mortality, and complications arising during dental treatment. By comparing the mortality, infection and rejection rates in the various groups no statistically significant differences (P > 0.05) were found between patients. Despite immunosuppression, extended inflammatory processes such as abscess formation or viral stomatitis were not found in the oral cavity. We therefore suggest that patients suffering from the symptoms of severe heart failure need not be subjected to rigorous preoperative dental treatment.

Bacteremia↗

PubMed2005

Streptococcus oralis as a risk factor for middle cerebral artery thrombosis.

We reported a case of an 8-year-old boy who was presented to the emergency department with left-sided hemiparesis. Computed tomography showed hypodense areas in the territory of the right middle cerebral artery, indicating acute cerebral infarct. Diagnostic evaluation was performed to identify the etiology. On the eighteenth day of hospitalization, cerebrospinal fluid cultures yielded Streptococcus oralis. We hypothesized that the source of the oral pathogen was an abscess belonging to his upper left fourth tooth, which, by a transient bacteremia, had invaded the central nervous system, and skipping the meninges caused local inflammatory arteritis of the carotid artery, leading to cerebral infarction. Sulbactam-ampicillin therapy was initiated for 14 days, and he was discharged with anticoagulation therapy.

Child↗

PubMed2004

Distribution of CD8 and CD20 lymphocytes in chronic periapical inflammatory lesions.

The objective of this study was to investigate the distribution of CD8+ and CD20+ lymphocytes in chronic periapical inflammatory lesions. A total of 90 periapical inflammatory lesions (chronic abscesses, abscessed cysts, and inflammatory cysts) were evaluated. The biotin-streptavidin immunohistochemical technique was used to identify cytotoxic/suppressor T-lymphocytes (CD8) and B-lymphocytes (CD20). Age ranged from 10 to 67 years. Patients between 26 and 45 years old (54.4%), females (52.2%), and white patients (74.4%) were more frequently affected. CD8+ cell distribution was as follows: 1) fibrous capsule: diffuse in 58.8% of chronic abscesses and absent in 64.1% of abscessed cysts and in 70.6% of inflammatory cysts; 2) infiltration zone: diffuse in 100% of abscessed cysts and in 82.4% of inflammatory cysts; 3) sub-epithelial zone: absent in 53.0% of inflammatory cysts and diffuse in 56.4% of abscessed cysts; 4) suppurative zone: diffuse in 100% of chronic abscesses and in 97.5% of abscessed cysts. CD20+ cell distribution was as follows: 1) fibrous capsule: absent in 100% of inflammatory cysts, in 94.8% of abscessed cysts, and in 88.3% of chronic abscesses; 2) infiltration zone: diffuse in 100% of abscessed cysts and in 53% of inflammatory cysts; 3) sub-epithelial zone: absent in 58.8% of inflammatory cysts and focal in 46.2% of abscessed cysts; 4) suppurative zone: diffuse in 100% of abscessed cysts and in 100% of chronic abscesses. The distribution of the lymphocytic infiltrate in the lesions was usually diffuse for both types of lymphocytes.

Adolescent↗

PubMed1999

The clinical significance of beta hemolytic streptococci of the milleri group in oral abscesses.

Aspirated exudate from 50 patients with oral abscesses were cultured and bacterial growth was assessed qualitatively and semi-quantitatively. Bacteria were recovered from all specimens. The mean number of species isolated per specimen was 3.6 Both facultative and obligate anaerobes were isolated from 39 (78%) specimens. The most commonly isolated facultative anaerobic species was Streptococcus virdans group, while pigmented gram negative bacilli were the most commonly isolated obligate anaerobes. Beta-hemolytic Streptococci of the "milleri" groups were recovered from 11 (22%) of the abscesses. Eight of those isolates were determined to carry Lancefield group F antigen, 2 group C, and 1 isolate was not groupable for any Lancefield antigen. These abscesses may be sequelae of oral infectious disease or trauma. Patients with oral abscesses infected with beta hemolytic Streptococci are apt to be male, and less than 35 years old. They are also likely to have a more rapid onset of infection and to require hospitalization for intensive treatment of a life threatening condition.

Adolescent↗