Deep neck infection with dental origin: analysis of 85 consecutive cases (2000-2006).

Abstract

CONCLUSIONS:

Diagnostic work-up should include contrast-enhanced computed tomography (CT) and mandible orthopantogram. When a dental origin of deep neck infection is suspected, the intravenous antibiotic regimen has to be active against gram-positive bacteria, both aerobes and anaerobes. Surgical exploration and drainage may be mandatory at presentation, or in cases not responding to medical therapy within the first 24 h.

OBJECTIVES:

Deep neck infections are still associated with significant morbidity and mortality rates when complications occur. Despite worldwide improvement in dental care and oral hygiene, a significant prevalence of deep neck infections caused by dental infections has been described recently (> 40%).

PATIENTS AND METHODS:

We analysed retrospectively 85 cases of deep neck infection with dental origin out of 206 consecutive cases of deep neck infection diagnosed in our institution between 2000 and 2006.

RESULTS:

The most frequent dental source was a periapical infection of the first mandibular molar, followed by second and third molar, respectively. Submandibular space infection involvement was diagnosed in 73 of 85 patients (85.9%), masticatory space infection in 28 (32.9%); in 56 patients (65.9%) the infection involved more than one space. Twenty-four patients (28.2%) were treated only with intravenous antibiotic therapy; 61 patients (71.8%) required both medical and surgical procedures.

• Authors: Gino Marioni, Roberto Rinaldi, Claudia Staffieri, Rosario Marchese-Ragona, Giorgia Saia, Roberto Stramare, Andy Bertolin, Roberto Dal Borgo, Fabrizio Ragno, Alberto Staffieri
• Journal: Acta oto-laryngologica (Acta Otolaryngol) Vol. 128 Issue 2 Pg. 201-6 (Feb 2008) ISSN: 0001-6489 [Print] England
• PMID: 17851946 (Publication Type: Journal Article)

Chemical References

• Anti-Bacterial Agents

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Anti-Bacterial Agents (therapeutic use)
• Bacterial Infections (diagnosis, etiology, surgery)
• Combined Modality Therapy
• Comorbidity
• Diagnosis, Differential
• Female
• Humans
• Magnetic Resonance Imaging
• Male
• Middle Aged
• Neck (surgery)
• Otorhinolaryngologic Diseases (diagnosis, etiology, surgery)
• Periapical Abscess (complications, diagnosis, surgery)
• Periapical Periodontitis (complications, diagnosis, surgery)
• Radiography, Panoramic
• Risk Factors
• Soft Tissue Infections (diagnosis, etiology, surgery)
• Tomography, X-Ray Computed
• Tooth Diseases (complications, diagnosis, surgery)
• Ultrasonography