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Maxillofacial infections of dental origin
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Keywords

Hospitals
Risk factors
Time-to-treatment
Focal infection
Dental

How to Cite

1.
Fornari V, Souza MA, Dallepiane FG, Pasqualotti A, Conto F de. Maxillofacial infections of dental origin: risk factors for hospital admission. Braz. J. Oral Sci. [Internet]. 2024 Mar. 13 [cited 2024 Dec. 13];23(00):e243442. Available from: https://periodicos.sbu.unicamp.br/ojs/index.php/bjos/article/view/8673442

Abstract

Aim: to evaluate the occurrence of maxillofacial infection cases, which were treated at local hospital, identifying the main risk factors that determine the need for hospitalization of patients and the factors associated with staying length. Methods: A retrospective review of 191 records of patients with maxillofacial infection of odontogenic origin was performed, statistically evaluated by frequency and percentage of involvement, p values (based on the chi-square test) and odds ratio with a 95% confidence interval. A p-value <0.05 was considered statistically significant. Results: Among all the 191 patients, 31 had some harmful habits, such as smokers (13%) and alcoholics (1%). In addition, 39 patients reported some general health problem, such as systemic arterial hypertension (8.3%), depression (6.8%), diabetes (3.6%) and some immunosuppression (1.57%). Involvement of infection in deep facial spaces was present, with 119 patients presenting a deeper infection (62.3%) and 72 patients a superficial infection (37.7%). The most prevalent clinical signs and symptoms in the initial evaluation were pain (91.1%) and edema (90.1%), followed by erythema/hyperemia (44.5%), trismus (37.7%), abscess (30.9%), cellulitis (27.7%), f istula (16.8%), fever (16.8%), dysphagia (11%), dehydration (9.9%), odynophagia (7.9% ) and dyspnea (3.7%). Pulp necrosis was considered a risk factor for treatment in a hospital environment (0.032) and root canal treatment decreases the risk of hospitalization (p=0.002). Considering the evaluated patients, 146 (76.4%) were admitted and 45 (37.7%) were not admitted for hospitalization after initial clinical evaluation. Conclusion: there is a high occurrence of maxillofacial infection cases of dental origin, considering that involvement of infection in deeper facial spaces, as well as presence of pain, edema, erythema/hyperemia, trismus, abscess, cellulitis and pulp necrosis, represent the main risk factors for hospitalization and staying length.

https://doi.org/10.20396/bjos.v23i00.8673442
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References

Krishnan V, Johnson JV, Helfrick JF. Management of maxillofacial infections: a review of 50 cases. J Oral Maxillofac Surg. 1993 Aug;51(8):868-74. doi: 10.1016/s0278- 2391(10)80105-3.

Ogle OE. Odontogenic Infections. Dent Clin North Am. 2017 Apr;61(2):235-52. doi: 10.1016/j.cden.2016.11.004.

Hwang T, Antoun JS, Lee KH. Features of odontogenic infections in hospitalised and non-hospitalised settings. Emerg Med J. 2011 Aug;28(9):766-9. doi: 10.1136/emj.2010.095562.

Har-El G, Aroesty JH, Shaha A, Lucente, FE. Changing trends in deep neck abscess. A retrospective study of 110 patients. Oral Surg Oral Med Oral Pathol Oral Radiol. 1994 May;77(5):446-50. doi: 10.1016/0030-4220(94)90221-6.

Parhiscar A, Har-El G. Deep neck abscess: a retrospective review of 210 cases. Ann Otol Rhinol Laryngol. 2001 Nov;110(11):1051-4. doi: 10.1177/000348940111001111.

Alotaibi N, Cloutier L, Khaldoun E, Bois E, Chirat M, Salvan D. Criteria for admission of odontogenic infections at high risk of deep neck space infection. Eur Ann Otorhinolaryngol Head Neck Dis. 2015 Nov;132(5):261-4. doi: 10.1016/j.anorl.2015.08.007.

Shah N, Patel S, Rupawala T, Makwana S, Mansuri S, Bhimani K. Evaluation of efficacy of ultrasonography as an additional diagnostic tool for deciding management protocol of odontogenic superficial fascial space infections: a prospective clinical study. J Maxillofac Oral Surg. 2022 Dec;21(4):1148-54. doi: 10.1007/s12663-021-01560-x.

Park J, Lee JY, Hwang DS, Kim YD, Shin SH, Kim UK, et al. A retrospective analysis of risk factors of oromaxillofacial infection in patients presenting to a hospital emergency ward. Maxillofac Plast Reconstr Surg. 2019 Nov;41(1):49. doi: 10.1186/s40902-019-0238-9.

Grönholm L, Lemberg KK, Tjäderhane L, Lauhio A, Lindqvist C, Rautemaa-Richardson, R. The role of unfinished root canal treatment in odontogenic maxillofacial infections requiring hospital care. Clin Oral Investig. 2013 Mar;17(1):113-21. doi: 10.1007/s00784-012-0710-8.

Sato FRL, Hajala FAC, Freire Filho FWV, Moreira RWF, de Moraes M. Eight-year retrospective study of odontogenic origin infections in a postgraduation program on oral and maxillofacial surgery. J Oral Maxillofac Surg. 2009 May;67(5):1092-7. doi: 10.1016/j.joms.2008.09.008.

Kamiński B, Błochowiak K, Kołomański K, Sikora M, Karwan S, Chlubek D. Oral and maxillofacial infections-a bacterial and clinical cross-section. J Clin Med. 2022 May;11(10):2731. doi: 10.3390/jcm11102731.

Kisely S, Sawyer E, Siskind D, Lalloo R. The oral health of people with anxiety and depressive disorders - a systematic review and meta-analysis. J Affect Disords. 2016 Aug;200:119-32. doi: 10.1016/j.jad.2016.04.040.

Cirkel LL, Jacob L, Smith L, López-Sánchez GF, Konrad M, Kostev K. Relationship between chronic gingivitis and subsequent depression in 13,088 patients followed in general practices. J Psychiatr Res. 2021 Jun;138:103-6. doi: 10.1016/j.jpsychires.2021.03.059.

Friedlander, A.H., Marder, S.R. The psychopathology, medical management and dental implications of schizophrenia. J. Am. Dent. Assoc. 2002 May;133(5):603-10; quiz 624-5. doi: 10.14219/jada.archive.2002.0236.

Ohshima A, Ariji Y, Goto M, Izumi M, Naitoh M, Kurita K, et al. Anatomical considerations for the spread of odontogenic infection originating from the pericoronitis of impacted mandibular third molar: computed tomographic analyses. Oral Surg Oral Med Oral Pathol Oral Radiol. 2004 Nov;98(5):589-97. doi: 10.1016/S1079210404005074.

Sánchez R, Mirada E, Arias J, Paño Pardo JR, Burgueño García M. Severe odontogenic infections: epidemiological, microbiological and therapeutic factors. Med Oral Patol Oral Cir Bucal. 2011;16(5):e670-6. doi: 10.4317/medoral.16995.

Peñarrocha-Diago M, Camps-Font O, Sánchez-Torres A, Figueiredo R, Sánchez-Garcés MA, Gay-Escoda C. Indications of the extraction of symptomatic impacted third molars. A systematic review. J Clin Exp Dent. 2021 Mar;13(3):e278-86. doi: 10.4317/jced.56887.

Beech N, Goh R, Lynham A. Management of dental infections by medical practitioners. Aust Fam Physician. 2014 May;43(5):289-91.

Gholami M, Mohammadi H, Amiri N, Khalife H. Key factors of odontogenic infections requiring hospitalization: a retrospective study of 102 cases. J Oral Maxillofac Surg Med Pathol. 2017 Sep;29(5):395-9. doi: 10.1016/j.ajoms.2017.03.016.

Lopes ABS, Ramos-Jorge ML, Machado GF, Vieira-Andrade RG, Ramos-Jorge J, Fernandes IB. Longitudinal evaluation of determinants of the clinical consequences of untreated dental caries in early childhood. Community Dent Oral Epidemiol. 2022 Apr;50(2):91-8. doi: 10.1111/cdoe.12635.

Qian Y, Ge Q, Zuo W, Cheng X, Xing D, Yang J, et al. Maxillofacial space infection experience and risk factors: a retrospective study of 222 cases. Ir J Med Sci. 2021 Aug;190(3):1045-53. doi: 10.1007/s11845-020-02431-z.

Brajkovic D, Zjalic S, Aleksandar K. Evaluation of clinical parameters affecting the prognosis in surgically treated patients with descending necrotizing mediastinitis - A retrospective study. J Stomatol Oral Maxillofac Surg. 2022 Nov;123(6):e731-7. doi: 10.1016/j.jormas.2022.05.017.

Weise H, Naros A, Weise C, Reinert S, Hoefert S. Severe odontogenic infections with septic progress - a constant and increasing challenge: a retrospective analysis. BMC Oral health. 2019 Aug;19(1):173. doi: 10.1186/s12903-019-0866-6.

Sainuddin S, Hague R, Howson K, Clark S. New admission scoring criteria for patients with odontogenic infections: a pilot study. Br J Oral Maxillofac Surg 2017 Jan;55(1):86-9 doi: 10.1016/j.bjoms.2016.05.003.

Mannan S, Tordik PA, Martinho FC, Chivian N, Hirschberg CS. Dental abscess to septic shock: a case report and literature review. J Endod. 2021 Apr;47(4):663-70. doi: 10.1016/j.joen.2020.12.016.

Delbet-Dupas C, Devoize L, Mulliez A, Barthélémy I, Dang NP. Does anti-inflammatory drugs modify the severe odontogenic infection prognosis? A 10-year's experience. Med Oral Patol Oral Cir Bucal. 2020 Jan;26(1):e28-35. doi: 10.4317/medoral.23926.

Vilén ST, Ahde H, Puolakka T, Mäkitie A, Uittamo J, Snäll J. Differences in characteristics and infection severity between odontogenic and other bacterial oro-naso-pharyngeal infections. Head Face Med. 2023 Mar;19(1):10. doi: 10.1186/s13005-023-00354-5.

Kamat RD, Dhupar V, Akkara F, Shetye O. A comparative analysis of odontogenic maxillofacial infections in diabetic and nondiabetic patients: an institutional study. J Korean Assoc Oral Maxillofac Surg. 2015 41(4):176-80. doi: 10.5125/jkaoms.2015.41.4.176.

Rautemaa R, Lauhio A, Cullinan MP, Seymour G. Oral infections and systemic disease - an emerging problem in medicine. Clin Microbiol Infect. 2007 Nov;13(11):1041-7. doi: 10.1111/j.1469-0691.2007.01802.x.

Priyamvada S, Motwani GA. Study on Deep Neck Space Infections. Indian J Otolaryngol. 2019;71 (Suppl 1):912-7. doi: 10.1007/s12070-019-01583-4.

Caprioli S, Tagliafico A, Fiannacca M, Borda F, Picasso R, Conforti C, et al. Imaging assessment of deep neck spaces infections: an anatomical approach. Radiol Med. 2023 Jan;128(1):81-92. doi: 10.1007/s11547-022-01572-8.

Christensen BJ, Park EP, Suau S, Beran D, King BJ. Evidence-based clinical criteria for computed tomography imaging in odontogenic infections. J Oral Maxillofac Surg. 2019 Feb;77(2):299-306. doi: 10.1016/j.joms.2018.09.022.

Fu B, McGowan K, Sun H, Batstone M. Increasing use of intensive care unit for odontogenic infection over one decade: incidence and predictors. J Oral Maxillofac Surg. 2018 Nov;76(11):2340-7. doi: 10.1016/j.joms.2018.05.021.

Fu B, McGowan K, Sun JH, Batstone M. Increasing frequency and severity of odontogenic infection requiring hospital admission and surgical management. Br J Oral Maxillofac Surg. 2020 May;58(4):409-15. doi: 10.1016/j.bjoms.2020.01.011.

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Copyright (c) 2024 Vinicios Fornari, Matheus Albino Souza, Felipe Gomes Dallepiane, Adriano Pasqualotti, Ferdinando de Conto

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