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Results for “Periapical Abscess”

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PubMed1998

Metastatic carcinoma to the mandible that mimicked pulpal/periodontal disease.

An oral cavity metastasis from a poorly differentiated carcinoma, presumed to have originated in the pancreas, mimicked a dental abscess. An additional metastasis to the lung caused a postobstructive lobar pneumonia that masked the lesion, thereby delaying the diagnosis of malignancy. This case report illustrates how the clinical manifestations of a widely disseminated neoplasm led to initial medical confusion and subsequent dental misdiagnosis, and serves to caution of a possible pitfall in the dental evaluation of endodontic lesions.

Carcinoma↗

PubMed1975

Radiographic examination of mandibular lesions in barren-ground caribou.

Dental anomalies were observed in 43 of 1,226 barren-ground caribou (Rangifer tarandus groenlandicus) taken between 1966 and 1968. In five of these 43 animals, the mandibles had deformities which radiography showed to be the result of dental abscesses in four cases and probably of a trauma in the other. The absence of actinomycotic lesions of the jaw bones of these 1,226 animals, and of more than 500 examined previously, indicates that "lumpy jaw" is rare in barren-ground caribou. The authors suggest the use of radiography to determine the nature of bone growth on skeletal remains, in the absence of soft tissues for examination for Actinomyces, either microscopically or by cultural methods.

Animals↗

PubMedDate not supplied

Chronic submasseteric abscess: anatomic, radiologic, and pathologic features.

Herein we present five cases of submasseteric abscess that most commonly occurred in patients with a history dental disease. CT has been the main imaging method for diagnosing lesions in the masticator space and adjacent to the mandible; however, we found that, in some of our cases, CT defined the lesion poorly or not at all. In some cases, MR imaging defined the lesion better. Radiologic manifestations of this condition and pathologic correlations are discussed.

Adolescent↗

PubMedDate not supplied

Pulp response to ferric sulfate, diluted formocresol and IRM in pulpotomized primary baboon teeth.

This study investigated the pulp response to a 15.5 percent ferric sulfate solution (FS) and a 20 percent dilution of formocresol (DFC) in pulpotomized primary teeth of baboons, after four and eight weeks. Pulpotomies were performed in seventy-nine primary teeth of 4 baboons. After coronal pulp resection, the pulp stumps were painted with ferric sulfate for fifteen seconds, in thirty-two teeth (group 1); in another thirty-two teeth, a cotton pellet moistened with dilution of formocresol was placed over the pulp stumps for five minutes, and removed (group 2). In fifteen teeth, IRM was placed directly over the pulp stumps after hemostasis (group 3--control). The teeth of all groups were sealed with IRM, and examined for inflammatory changes under a microscope by two blinded examiners. Seventy-seven teeth were assessed. Mild or no inflammation was found in 58 percent (18/31) of the teeth of group 1, in 48 percent (15/31) of those of group 2, and in 73 percent (11/15) of those of group 3. Severe inflammation was found in 35 percent (11/31) of group 1, 29 percent (9/31) of group 2, and in 7 percent (1/15) of group 3. No statistically significant difference between the three groups was observed for degree of inflammation, periradicular or interradicular abscess or inflammatory root resorption (chi-square p > 0.05). Dentin bridges were observed in 52 percent (16/31) of the teeth in group 1, 52 percent (16/31) of those of group 2, and in 73 percent (11/15) of those of group 3. No difference was found between the experimental and control groups for the presence of dentin bridge, (p > 0.05). Ferric sulfate produced pulp responses that compared favorably to those of diluted formocresol.

Animals↗

PubMed2003

[A rare case of gaseous gangrenous mediastinitis].

We report a case of a cervical phlegmone and mediastinitis descending from peridental abscess in 32-year old student. Emergency left thoracotomy was performed after CT evaluation in which multiple fluid levels and gas spaces were found. After 72 hours bacterial strains showed Clostridium perfringens in fluid taken from left pleural cavity and patient was sent to Hiberbaric Center in Gdynia, where he underwent hyperbaric oxygen therapy. After 10 days the patient was brought back in good condition to our Department. After 3 days he died because of sudden massive bleeding caused by necrosis of aorta wall.

Adult↗

PubMed1994

Acute and chronic alveolitis/osteomyelitis ("lumpy jaw") in small exotic ruminants.

Tooth-related abscesses in small captive ruminants are most likely foreign body-induced periodontic-endodontic lesions. The instigating cause may be abnormal texture of dietary material. Bacteria, though probably not the initiating cause, significantly contribute to pathology and morbidity. Extraction of severely affected teeth is an effective although sometimes challenging mode of treatment. Periodically complications may arise, which vary in difficulty of treatment. Prevention may be the alteration of the major forage component of the diet to textures that are less coarse and stemmy, and the alleviation of any crowding and sanitation problems.

Animals↗

PubMed2006

Autoaggregation and coaggregation of bacteria associated with acute endodontic infections.

Biofilms and microbial aggregates are a common mechanism for the survival of bacteria in nature. Microbial aggregates have been associated with intraradicular and extraradicular endodontic disease. One objective of this study was to assess bacteria isolated from acute endodontic infections for autoaggregation and coaggregation. Another objective was to use both a conventional visual assay and a novel fluorescent dye-staining technique to study bacterial aggregation. Sixty-two strains of bacteria were isolated from 10 clinical samples of endodontic abscesses or cellulitis. Autoaggregation was detected in 35/62 (56.45%) of the bacteria using the visual assay. Coaggregation of bacteria from each of the samples was demonstrated for 29/183 (15.85%) bacterial pairs using the visual assay and 148/183 (80.87%) using the dye-staining assay. Coaggregation was observed for each of the 15 genera assayed, especially Prevotella, Streptococcus, and Fusobacterium. The dye-staining assay using a confocal microscope was a highly sensitive method to detect aggregation of bacteria.

Acute Disease↗

PubMed1992

Ludwig's angina following dental treatment of a five-year-old male patient: report of a case.

A five-year-old male child presented to the dental clinic with dental disease. This patient was otherwise healthy, with evidence of odontogenic infection (pulpal abscess) on tooth "T". Extraction of the tooth followed. Five days postoperative, the child was diagnosed as suffering from Ludwig's angina. This case of Ludwig's angina was found to be odontogenic in origin, but not originating from extraction of the offending tooth. Ludwig's angina is an aggressive infectious process of the submandibular, sublingual, and submental fascial spaces. It remains a potentially fatal cellulitis with a mortality rate of approximately 8%, in spite of appropriate antibiotic therapy. Early recognition and treatment of Ludwig's angina is extremely important due to its invasive nature.

Anti-Bacterial Agents↗

PubMed2006

Multiplex polymerase chain reaction detection of black-pigmented bacteria in infections of endodontic origin.

The purpose of this study was to detect the presence of Porphyromonas endodontalis, P. gingivalis, Prevotella intermedia, P. nigrescens, and P. tannerae from clinical samples using multiplex polymerase chain reactions (PCR). Two different multiplex PCR protocols were used (one for the two Porphyromonas species and the other for the three Prevotella species), each one using a primer pair specific for each target species. The results were compared to those of the conventional culture procedures. Microbial samples were taken aseptically from 40 infected root canals and abscesses from patients. Samples were cultured in an anaerobic condition for conventional identification using a Rapid ID 32 A kit. Multiplex PCR was processed using the DNA extracted from each sample. At least one of the five species of black-pigmented bacteria (BPB) were detected in 65% (26 of 40) of the samples using multiplex PCR, and in 15% (6 of 40) using the conventional culture procedures. Multiplex PCR was more rapid, sensitive, specific, and effective in detecting BPB than the conventional culture procedures.

Bacteroidaceae Infections↗

PubMed1992

Porphyromonas (Bacteroides) endodontalis: its role in endodontal infections.

Porphyromonas endodontalis (formerly Bacteroides endodontalis) is a black-pigmented anaerobic Gram-negative rod which is associated with endodontal infections. It has been isolated from infected dental root canals and submucous abscesses of endodontal origin. The presence of P. endodontalis in infected dental root canals has been correlated with symptoms of an acute infection. It is occasionally found on oral mucous membranes and periodontal pockets. P. endodontalis has shown relatively low virulence in experimental monoinfections. In anaerobic mixed infections it can play an essential role. Differences in virulence between strains have been related to capsular material. On the basis of different types of capsules, three serotypes have been described. P. endodontalis is sensitive to a wide range of antibiotics, including the penicillins, the tetracyclines, and metronidazole.

DNA Fingerprinting↗

PubMed1993

A comparative study of cephradine, amoxycillin and phenoxymethylpenicillin in the treatment of acute dentoalveolar infection.

A comparative double blind trial was undertaken of the efficacy of cephradine, amoxycillin and phenoxymethylpenicillin in the treatment of acute dentoalveolar abscesses. Patients were admitted to the trial with acute dentoalveolar abscesses with systemic involvement and assessments were made of pain, swelling, temperature and lymphadenopathy. After admission to the trial appropriate surgical therapy was undertaken. The patients were then given either phenoxymethylpenicillin 250 mg four times daily, cephradine 500 mg twice daily or amoxycillin 250 mg three times daily, all for 5 days. The patients were assessed after 2 days and 5 days. All the patients recovered with those taking cephradine showing the best recovery in the first two days of treatment.

Actinomyces↗

PubMed1985

Further characterization of Bacteroides endodontalis, an asaccharolytic black-pigmented Bacteroides species from the oral S cavity.

In this study, the isolation, characterization, and identification of Bacteroides endodontalis is described. It was found that this asaccharolytic black-pigmented Bacteroides species is associated with infected dental root canals and oral submucous abscesses. B. endodontalis could be differentiated from B. gingivalis by a negative direct hemagglutination test and the absence of trypsin and N-acetyl-beta-glucosamidase. B. endodontalis could be differentiated from B. asaccharolyticus by the absence of alpha-fucosidase, its inability to grow in an atmosphere of 95% N2-5% H2, and a growth requirement for menadione. Immune serum raised against B. endodontalis strain HG 370T agglutinated only B. endodontalis cells. Precautions for the isolation of B. endodontalis are discussed.

Acetylglucosaminidase↗

PubMed2005

Pyostomatitis vegetans. Report of two cases and review of the literature.

Pyostomatitis vegetans (PV) is a rare benign chronic mucocutaneous pustular disorder of unknown etiology, though it is usually associated with chronic inflammatory disease of the bowel-particularly ulcerative colitis. At the oral level PV manifests as an exophytic lesion with an erythematous perimeter and a creamy-yellow surface presenting a friable covering membrane which easily disintegrates, giving rise to the development of small ulcers or superficial erosions. The histology shows epithelial acanthosis and superficial ulceration. The underlying connective tissue exhibits neutrophil and eosinophil infiltration, with miliary abscesses in some cases. The present study describes 2 cases of PV associated with ulcerative colitis. The differential diagnosis should be established with Neumann type pemphigus vegetans, since in both cases the lesions are clinically similar and the histology reveals an important eosinophil response, acanthosis, and the formation of intraepithelial miliary microabscesses. The treatment of PV focuses on control of the disease. In the event the orofacial lesions persist, topical oral drugs such as corticoids, with additional antibiotherapy, multivitamin complexes, and nutritional supplements, can be provided.

Adult↗

PubMed1978

[Spectrum of pathogens in odontogenous abscesses in the patients of the Tübingen Department of Maxillofacial Surgery].

Bacteriological examination and evaluation of 475 smears of pus taken from odontogenous abcesses showed that the spectrum of pathogens is extremely broad. Chemotherapy therefore should not be started before the pathogen has been identified and an antibiogram has been made due to possible resistance on the part of the microorganisms. Clindamycin may be used for "blind treatment" until the bacteriologic findings are available because it is effective against streptococcus and staphylococcus as well as gram-negative asporous anaerobes. The risk of the possible ineffectiveness of clindamycin against gramnegative anaerobes however must be taken. Clindamycin and gentamicin together may be helpful in life-threatening situations because the combination covers an extremely broad spectrum of possible pathogens.

Clindamycin↗

PubMed1989

Dental pathologies in ten free-ranging chimpanzees from Gombe National Park, Tanzania.

The dental remains of ten adult chimpanzees from Gombe National Park, Tanzania, were examined for enamel attrition, caries, abscesses, periodontal disease, and tooth loss. Age was the underlying factor in the development of dental pathology, in that enamel wear was present to some extent in all ten but was uniformly severe only in the three for whom estimated age at death was 39-43 years. In turn, enamel wear appears to have been the direct cause of abscess development, periodontal disease, and tooth loss. Periodontal disease was commonly expressed as alveolar resorption, particularly around the premolars and molars. This involvement was variable in all except the two youngest. Some interesting wear patterns were evident in the form of deep grooves in the upper incisors and dramatic notching of the lower canines. These patterns, and enamel attrition in general, were attributed to normal mastication and to various stripping activities. Only one carious lesion was observed, in a male with an estimated age of 26 years. An accurate assessment of the actual prevalence of caries was obscured by enamel wear and tooth loss in the older individuals.

Age Factors↗

PubMedDate not supplied

Infections in total hips secondary to a primary source elsewhere.

This is a report of 3 cases in which a primary infection in a site other than a total hip led to infection in the hip itself. One hip infection appeared to arise in a tooth abscess, a second in the urinary tract, and one from the respiratory tract. All infections resulted in the necessity of removing the components of the total hip. It is suggested that patients who have had previous total hip replacement should be warned to consult their physician when the possibility of an infection is present, and that antibiotic coverage be given during this period of time. Cultures of infected sites should be made in patients who have had total hip replacements, in order that organisms and their sensitivity may be identified in the event that antibiotic therapy is needed, subsequently.

Aged↗

PubMed2004

Geographical differences in bacteria detected in endodontic infections using polymerase chain reaction.

The polymerase chain reaction (PCR) is an innovative nucleic acid-based assay that has the highest sensitivity of any microbiological technique for the detection of bacteria. The purpose of this study was to use PCR to detect the presence of specific species of bacteria in samples collected from two geographical locations. Microbial samples from abscesses of endodontic origin were collected from patients in Portland, Oregon, and Rio de Janeiro, Brazil. PCRs with species-specific oligonucleotide primers for the 16S ribosomal RNA gene were used for detection of the bacteria after DNA extraction from each clinical sample. Statistical analysis revealed that there was a significant difference in detection of the bacteria between the two geographical locations for Prevotella intermedia, Prevotella nigrescens, Prevotella tannerae, Fusobacterium nucleatum, and Porphyromonas gingivalis, but not for Porphyromonas endodontalis, Fusobacterium necrophorum, and Enterococcus faecalis. These results suggest that differences in bacteria detected or cultured in studies can be associated with geographical location.

Adult↗

PubMed2006

A case of tularemia presenting as a dental abscess: case report.

OBJECTIVE: The purpose of this report is to present a tularemia case accompanied by a neck mass that easily may be confounded with dental abscess. SUMMARY: Francisella tularensis is a potential agent of biologic terrorism. Thirty percent of the symptoms seen in tularemia localize in the head and neck region and are sometimes mistaken for complications of a dental abscess. To our knowledge, reports of the differential diagnostic characteristics of tularemia are lacking in the dental literature and, to date, no dental journal articles have focused on the disease. In this present case, a 51-year-old woman arrived at the public health department with high fever and facial swelling. The findings suggested a dental origin and the patient was directed to dentistry. Radiology and a detailed intraoral and extraoral examination failed to reveal a dental problem. Fortunately, the patient was known to come from a tularemia region; with the suspicion of tularemia the patient was referred to the faculty of medicine. Serologic tests showed that the patient had a Francisella tularensis infection.

Diagnosis, Differential↗