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Louizakis A, Tatsis D, Paraskevopoulos K, Antoniou A, Kyrgidis A, Vahtsevanos K. The Effect of the COVID-19 Pandemic on Odontogenic Cervicofacial Infections in a Single Center in Greece. Cureus 2024; 16:e61333. [PMID: 38947612 PMCID: PMC11213832 DOI: 10.7759/cureus.61333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2024] [Indexed: 07/02/2024] Open
Abstract
INTRODUCTION Odontogenic cervicofacial infections are still an ongoing problem, requiring immediate hospital admittance and management. The aim of this study is to reflect the number of patients with cervicofacial infections who were admitted during the coronavirus disease 2019 (COVID-19) pandemic period in a single, point of reference center in Northern Greece as well as analyze the quantitative and qualitative parameters of patient characteristics and management data. METHODS This was a retrospective cohort study that included all the patients with cervicofacial infections who were admitted to our unit during the COVID-19 pandemic, specifically between 2020 and 2021. For comparative reasons, patients admitted with cervicofacial infections between 2019 and 2020 (pre-COVID period) were analyzed. RESULTS In total, 341 patients fulfilled the criteria for this study. Specifically, the number of admitted patients was 151 in the pre-COVID era instead of 190 patients in the pandemic. The mean age of the patients was 45.3 years, with a slight male predominance (54.7% males to 45.3%). The mean duration of hospitalization was 2.5 days in the pre-COVID period instead of 3.42 days in the pandemic. Interestingly, in the pandemic, eight times more patients were admitted to the ICU post-operatively, in contrast to the pre-COVID period (23 vs 3 patients). Also in the COVID period, almost 54.9% of the patients presented with fever and 49.6% with trismus. Moreover, the submandibular space involvement was the most common space of infection in both COVID and pre-COVID groups with (58.9% and 49.7%) respectively. In one-third of all cases, a post-extraction infection of a third molar was the main cause of abscess. CONCLUSION Cervicofacial infections during the COVID-19 pandemic appeared with more severe symptoms and resulted in an increased number of patients who needed admittance to the intensive care unit, in contrast to the pre-COVID era. Also, the mean length of stay was increased for a day at the same period. This study could be used as an example for further research, in case of similar pandemic situations in the future.
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Affiliation(s)
- Alexandros Louizakis
- Department of Oral and Maxillofacial Surgery, George Papanikolaou General Hospital, Aristotle University of Thessaloniki, Thessaloniki, GRC
| | - Dimitris Tatsis
- Department of Oral and Maxillofacial Surgery, George Papanikolaou General Hospital, Aristotle University of Thessaloniki, Thessaloniki, GRC
| | - Konstantinos Paraskevopoulos
- Department of Oral and Maxillofacial Surgery, George Papanikolaou General Hospital, Aristotle University of Thessaloniki, Thessaloniki, GRC
| | - Asterios Antoniou
- Department of Oral and Maxillofacial Surgery, George Papanikolaou General Hospital, Aristotle University of Thessaloniki, Thessaloniki, GRC
| | - Athanasios Kyrgidis
- Department of Oral and Maxillofacial Surgery, George Papanikolaou General Hospital, Aristotle University of Thessaloniki, Thessaloniki, GRC
| | - Konstantinos Vahtsevanos
- Department of Oral and Maxillofacial Surgery, George Papanikolaou General Hospital, Aristotle University of Thessaloniki, Thessaloniki, GRC
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Lou Y, Sun Z, Ma H, Cao D, Sun M, Wang Q, Wang J, Zhuo Q, Tao R, Ying B, Liu Y, Yu M, Wang H. Odontogenic infections in the antibiotic era: approach to diagnosis, management, and prevention. Infection 2024; 52:301-311. [PMID: 37926767 DOI: 10.1007/s15010-023-02117-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 10/13/2023] [Indexed: 11/07/2023]
Abstract
PURPOSE The prevalence of odontogenic infections remains one of the highest in the world. If untreated, odontogenic infections can break through the limitation, disseminate to other organs or spaces, and cause high mortality rates. However, it is still difficult to rapidly target limited or disseminated infections in clinical practice. The type of disseminated odontogenic infections and the responsible bacteria have not been described in detail. METHODS Search databases (e.g., PubMed, MEDLINE, Web of Science, Embase) for reports published from 2018.1 to 2022.9. Use search strategies: ("odontogenic infections" OR "pulpitis" OR "periapical lesions" OR "periodontal diseases") AND ("disseminated infections" OR "complication"). RESULTS Fourteen different types of disseminated odontogenic infections, most of which are polymicrobial infections, can spread through the body either direct or through hematogenous diffusion. Multiple microbial infections can be more invasive in the transmission of infection. Secondary infections are commonly associated with bacteria like Fusobacterium spp., Streptococcus spp., Peptostreptococcus spp., Prevotella spp., and Staphylococcus spp. Antibiotics with broad-spectrum activity are fundamental as first-line antimicrobial agents based on the microorganisms isolated from disseminated infections. CONCLUSION This review elaborates on the epidemiology, microorganisms, risk factors, and dissemination routes, and provides evidence-based opinions on the diagnosis, multidisciplinary management, and prevention of odontogenic infections for dentists and clinicians.
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Affiliation(s)
- Yiting Lou
- School of Stomatology, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, Zhejiang, China
| | - Zheyuan Sun
- School of Stomatology, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, Zhejiang, China
| | - Haiying Ma
- School of Stomatology, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, Zhejiang, China
| | - Danna Cao
- Department of Stomatology, The First Affiliated Hospital of Ningbo University, Ningbo, 315000, Zhejiang, China
| | - Mouyuan Sun
- School of Stomatology, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, Zhejiang, China
| | - Qianting Wang
- School of Stomatology, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, Zhejiang, China
| | - Jingyu Wang
- School of Stomatology, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, Zhejiang, China
| | - Qunhao Zhuo
- Department of Stomatology, The First Affiliated Hospital of Ningbo University, Ningbo, 315000, Zhejiang, China
| | - Ran Tao
- Department of Biomedical Sciences, Texas A&M University School of Dentistry, Dallas, TX, USA
| | - Binbin Ying
- Department of Stomatology, The First Affiliated Hospital of Ningbo University, Ningbo, 315000, Zhejiang, China.
| | - Yu Liu
- School of Stomatology, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, Zhejiang, China.
| | - Mengfei Yu
- School of Stomatology, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, Zhejiang, China.
| | - Huiming Wang
- School of Stomatology, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, Zhejiang, China
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Grill FD, Rothlauf P, Ritschl LM, Deppe H, Stimmer H, Scheufele F, Schwarz M, Wolff KD, Fichter AM. The COVID-19 pandemic and its possible impact on the treatment of odontogenic and intraoral abscesses. Head Face Med 2023; 19:36. [PMID: 37598212 PMCID: PMC10439607 DOI: 10.1186/s13005-023-00381-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 08/08/2023] [Indexed: 08/21/2023] Open
Abstract
Most odontogenic and intraoral abscesses can be treated on an outpatient basis with local anesthesia. However, severe disease progression may require an incision under general anesthesia (GA) with postoperative inpatient treatment. This study aimed to evaluate the first "COVID-19 year" in Germany and compare the first "COVID-19 year" with the two previous years. All consecutive cases with odontogenic or intraoral abscesses treated in an outpatient or inpatient setting between 2018 and 2021 were included in this study. Data were collected, including the type of anesthesia, length of hospital stay, and healthcare costs. Despite the lower total number of abscess treatments in the first year of COVID-19 (n = 298 patients) than that in the two previous years (n = 663 patients), the number of advanced abscesses requiring intervention under GA was significantly higher (p < 0.001). This increased burden of care was also reflected in increased healthcare costs. The measures taken against the COVID-19 pandemic had an impact on the course of other diseases, for example, odontogenic and intraoral abscesses. The results showed an emerging conflict in patient care during the pandemic crisis that should be considered in possible future pandemics.
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Affiliation(s)
- Florian D Grill
- Department of Oral and Maxillofacial Surgery, School of Medicine, Technical University of Munich, Ismaninger Str. 22, Munich, 81675 , Germany.
| | - Paulina Rothlauf
- Department of Oral and Maxillofacial Surgery, School of Medicine, Technical University of Munich, Ismaninger Str. 22, Munich, 81675 , Germany
| | - Lucas M Ritschl
- Department of Oral and Maxillofacial Surgery, School of Medicine, Technical University of Munich, Ismaninger Str. 22, Munich, 81675 , Germany
| | - Herbert Deppe
- Department of Oral and Maxillofacial Surgery, School of Medicine, Technical University of Munich, Ismaninger Str. 22, Munich, 81675 , Germany
| | - Herbert Stimmer
- Department of Diagnostic and Interventional Radiology, School of Medicine, Technical University of Munich, Munich, Germany
| | - Florian Scheufele
- Department of Surgery, School of Medicine, Technical University of Munich, Munich, Germany
| | - Matthias Schwarz
- Department of Oral and Maxillofacial Surgery, School of Medicine, Technical University of Munich, Ismaninger Str. 22, Munich, 81675 , Germany
| | - Klaus-Dietrich Wolff
- Department of Oral and Maxillofacial Surgery, School of Medicine, Technical University of Munich, Ismaninger Str. 22, Munich, 81675 , Germany
| | - Andreas M Fichter
- Department of Oral and Maxillofacial Surgery, School of Medicine, Technical University of Munich, Ismaninger Str. 22, Munich, 81675 , Germany
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Moser CH, Peeler A, Long R, Schoneboom B, Budhathoki C, Pelosi PP, Brenner MJ, Pandian V. Prevention of Tracheostomy-Related Pressure Injury: A Systematic Review and Meta-analysis. Am J Crit Care 2022; 31:499-507. [PMID: 36316177 DOI: 10.4037/ajcc2022659] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND In the critical care environment, individuals who undergo tracheostomy are highly susceptible to tracheostomy-related pressure injuries. OBJECTIVE To evaluate the effectiveness of interventions to reduce tracheostomy-related pressure injury in the critical care setting. METHODS MEDLINE, Embase, CINAHL, and the Cochrane Library were searched for studies of pediatric or adult patients in intensive care units conducted to evaluate interventions to reduce tracheostomy-related pressure injury. Reviewers independently extracted data on study and patient characteristics, incidence of tracheostomy-related pressure injury, characteristics of the interventions, and outcomes. Study quality was assessed using the Cochrane Collaboration's risk-of-bias criteria. RESULTS Ten studies (2 randomized clinical trials, 5 quasi-experimental, 3 observational) involving 2023 critically ill adult and pediatric patients met eligibility criteria. The incidence of tracheostomy-related pressure injury was 17.0% before intervention and 3.5% after intervention, a 79% decrease. Pressure injury most commonly involved skin in the peristomal area and under tracheostomy ties and flanges. Interventions to mitigate risk of tracheostomy-related pressure injury included modifications to tracheostomy flange securement with foam collars, hydrophilic dressings, and extended-length tracheostomy tubes. Interventions were often investigated as part of care bundles, and there was limited standardization of interventions between studies. Meta-analysis supported the benefit of hydrophilic dressings under tracheostomy flanges for decreasing tracheostomy-related pressure injury. CONCLUSIONS Use of hydrophilic dressings and foam collars decreases the incidence of tracheostomy-related pressure injury in critically ill patients. Evidence regarding individual interventions is limited by lack of sensitive measurement tools and by use of bundled interventions. Further research is necessary to delineate optimal interventions for preventing tracheostomy-related pressure injury.
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Affiliation(s)
- Chandler H Moser
- Chandler H. Moser is a PhD candidate, School of Nursing, Johns Hopkins University, Baltimore, Maryland
| | - Anna Peeler
- Anna Peeler is a PhD candidate, School of Nursing, Johns Hopkins University, Baltimore, Maryland
| | - Robert Long
- Robert Long is chief of anesthesia nursing, Walter Reed National Military Medical Center, Bethesda, Maryland
| | - Bruce Schoneboom
- Bruce Schoneboom (retired) was associate dean for Practice, Innovation, and Leadership, School of Nursing, Johns Hopkins University, Baltimore, Maryland
| | - Chakra Budhathoki
- Chakra Budhathoki is a biostatistician, School of Nursing and Biostatistics Core, Johns Hopkins University
| | - Paolo P Pelosi
- Paolo P. Pelosi is a chief professor, Anaesthesia and Intensive Care, and director, Specialty School in Anaesthesiology, University of Genoa, and head of the Anaesthesia and Intensive Care Unit at IRCCS San Martino-IST Hospital, Genoa, Italy
| | - Michael J Brenner
- Michael J. Brenner is an associate professor, Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, and President, Global Tracheostomy Collaborative, Raleigh, North Carolina
| | - Vinciya Pandian
- Vinciya Pandian is an associate professor, School of Nursing and Outcomes After Critical Illness and Surgery (OACIS) Research Group, Johns Hopkins University
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Okoye GO, Saheeb BD, Egbor EP, Edetanlen EB. A Clinicobiochemical Study of C - reactive protein among Patients with Odontogenic Infections in a Nigerian Tertiary Hospital. Niger Med J 2022; 63:356-363. [PMID: 38867747 PMCID: PMC11165330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2024] Open
Abstract
Background It appears that studies on the association between CRP levels and odontogenic infections are limited. The aim of this study is to determine the difference in CPR levels between the different types of odontogenic infections. Methodology All consecutive patients that were diagnosed and treated for dentoalveolar and fascial space infections of odontogenic origin that met the inclusion criteria were studied. The data collected were age, gender, tobacco use, alcohol intake, and drug abuse. Other collected data were pain, trismus, dysphagia, antibiotics abuse, pre-existing medical condition, pulse rate, blood pressure, respiratory rate, body temperature, white blood cell, type of odontogenic infection, type of treatment, length of hospital stay and C-reactive protein. All analysis were done using IBM SPSS version 21.0 (IBM Corp, New York, USA). P- Value less than 5% was considered statistically significant. Results A total of 44 patients with a mean age of 45.3±1.39 years ranging from 10 to 60 years were enrolled in this study. The C-reactive protein was significantly higher among patients with positive history of pain compared to those without pain (P = 0.01). The patients with fascial space infection had C-reactive protein levels higher than those with dentoalveolar infection and the difference in their means was statistically significant (P = 0.02). Likewise, the C-reactive protein was 17.5mg/dl significantly higher in the patients that stayed more than 5days in the hospital compared to those that stayed less than the same days(P = 0.03). Conclusions The total mean of C-reactive protein of 75.4±3.53 mg/dl was greater than the critical level while the 9.62 X 109/L of WBC counts was lower than that of the reference value. Patients that had pain, fascial space infection and stayed more than five days in the hospital had higher levels of C-reactive protein following odontogenic infections.
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Affiliation(s)
- Godfrey Okhalosomi Okoye
- Department of Oral and Maxillofacial Surgery, University of Benin Teaching Hospital, Benin-City, Nigeria
| | - Birch Dauda Saheeb
- Department of Oral and Maxillofacial Surgery, University of Benin Teaching Hospital, Benin-City, Nigeria
| | - Esezobor Peter Egbor
- Department of Oral and Maxillofacial Surgery, University of Benin Teaching Hospital, Benin-City, Nigeria
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McGoldrick DM, Edwards J, Praveen P, Parmar S. Admission patterns and outcomes of patients admitted to critical care in the UK with surgically treated facial infecion: an analysis of the Intensive Care National Audit and Research Centre Case Mix Programme database. Br J Oral Maxillofac Surg 2022; 60:1074-1079. [DOI: 10.1016/j.bjoms.2022.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 03/09/2022] [Accepted: 03/28/2022] [Indexed: 11/25/2022]
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Giovanditto F, Soma D, Vaira LA, Pispero A, Lombardi N, Ristoldo F, Mariani U, Pizzi S, Isola A, Smania P, Albanese M, D'Agostino A, Appendino P, Scatà E, Raho MT, Gobbi R, Carta E, Massarelli O, Lumbau A, Spano G, De Riu G. Recommendations for a safe restart of elective aerosol-generating oral surgery procedures following the COVID-19 pandemic outbreak: An Italian multicenter study. J Craniomaxillofac Surg 2022; 50:462-467. [PMID: 35430134 PMCID: PMC8889877 DOI: 10.1016/j.jcms.2022.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 01/27/2022] [Accepted: 02/12/2022] [Indexed: 01/26/2023] Open
Abstract
Among healthcare workers, oral and maxillofacial surgeons are some of the most exposed to coronavirus disease (COVID-19). The aim of this retrospective study was to develop suggestions for continuing the work of oral and maxillofacial surgeons using a safe protocol for elective and urgent aerosol-generating procedures that could prevent the onset of new clusters. Based on the results obtained and a guidelines review of those Asian countries that had promptly managed the current pandemic, the following safety protocol was developed:
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Affiliation(s)
- Federica Giovanditto
- Department of Maxillofacial Surgery, Azienda Ospedaliero-Universitaria, Sassari, Italy.
| | - Damiano Soma
- Department of Maxillofacial Surgery, Azienda Ospedaliero-Universitaria, Sassari, Italy
| | - Luigi Angelo Vaira
- Department of Maxillofacial Surgery, Azienda Ospedaliero-Universitaria, Sassari, Italy
| | - Alberto Pispero
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Niccolò Lombardi
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | | | - Umberto Mariani
- Department of Dentistry, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Silvia Pizzi
- Department of Dentistry, Azienda Ospedaliero-Universitaria, Parma, Italy
| | - Antonio Isola
- Department of Dentistry, Cittadella Hospital, Padua, Italy
| | | | - Massimo Albanese
- Department of Maxillofacial Surgery and Dentistry, Azienda Ospedaliero-Universitaria Integrata, Verona, Italy
| | - Antonio D'Agostino
- Department of Maxillofacial Surgery and Dentistry, Azienda Ospedaliero-Universitaria Integrata, Verona, Italy
| | - Paolo Appendino
- Department of Dentistry and Oral Surgery, Mauriziano Umberto I Hospital, Corso Turati 62, 10128, Turin, Italy
| | - Ernesto Scatà
- Department of Dentistry and Oral Surgery, Mauriziano Umberto I Hospital, Corso Turati 62, 10128, Turin, Italy
| | - Maria Teresa Raho
- Department of Maxillofacial Surgery, Azienda Ospedaliero-Universitaria, Sassari, Italy
| | - Roberta Gobbi
- Department of Dentistry, AUSL Della Romagna, Ravenna, Italy
| | - Elena Carta
- Department of Maxillofacial Surgery, Azienda Ospedaliero-Universitaria, Sassari, Italy
| | - Olindo Massarelli
- Department of Maxillofacial Surgery, Azienda Ospedaliero-Universitaria, Sassari, Italy
| | - Aurea Lumbau
- Department of Dentistry, Azienda Ospedaliero-Universitaria, Sassari, Italy
| | - Giovanni Spano
- Department of Dentistry, Azienda Ospedaliero-Universitaria, Sassari, Italy
| | - Giacomo De Riu
- Department of Maxillofacial Surgery, Azienda Ospedaliero-Universitaria, Sassari, Italy
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