1
|
Cruz AJS, Martins MAP, Batista VS, Santos JS, Santos TRD, de Castilho LS, Sohn W, Abreu MHNG. Rising trend of dentist-prescribed antibiotics in Brazil: 2011-2021. J Public Health Dent 2024. [PMID: 39364574 DOI: 10.1111/jphd.12645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 07/28/2024] [Accepted: 09/01/2024] [Indexed: 10/05/2024]
Abstract
OBJECTIVES To describe the trends in antibiotic prescribing by dental practitioners and to investigate the relationship between these trends and some factors of public oral health services in Minas Gerais (MG), Brazil. METHODS This was a time-series analysis of antibiotics prescribed by dental practitioners between January 2011 and December 2021. The outcome variables were number of defined daily doses (DDD) and DDD/1000 population/year in a sample of cities in MG. Covariates were public oral healthcare factors, such as coverage, estimates of dental procedures, and frequency of dental pain. Linear time-series regression models were used to examine trends and the influence of covariates on antibiotic prescribing. RESULTS Overall, the number of prescriptions increased by 334.69% between 2011 and 2021, with amoxicillin being the most commonly prescribed drug (78.53%). The number of DDD for all antibiotics increased from 17,147.13 to 77,346.67 and the average DDD/1000 inhabitants/year was 126.66 (SD: 130.28). The linear time-series regression model showed that for each one-year increase, the average log DDD/1000 inhabitants increased by 0.35 (standard error = 0.07, p < 0.001). No covariates were found to be associated with the outcome. CONCLUSIONS In Minas Gerais, Brazil, a significant upward trend was observed in the number of prescriptions and the number of DDD of antibiotics prescribed by dental practitioners. No influence of factors related to public oral healthcare services on the outcome was observed, thereby emphasizing the need for further research on factors influencing medication use in dental practice.
Collapse
Affiliation(s)
- Alex Junio Silva Cruz
- Department of Community and Preventive Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Victor Santos Batista
- Department of Community and Preventive Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Jacqueline Silva Santos
- Department of Community and Preventive Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Thiago Rezende Dos Santos
- Department of Statistics, Institute of Exact Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Lia Silva de Castilho
- Department of Operative Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Woosung Sohn
- Department of Population Oral Health, School of Medicine, The University of Sydney, Sydney, Australia
| | | |
Collapse
|
2
|
Kalas N, Nagy A, Kovács N, Dombrádi V, Bányai G, Bíró K, Boruzs K. Changes in Antibiotic Redemption Related to Hungarian Dental Care During COVID-19. Int Dent J 2024; 74:946-952. [PMID: 38461095 DOI: 10.1016/j.identj.2024.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 02/14/2024] [Accepted: 02/16/2024] [Indexed: 03/11/2024] Open
Abstract
INTRODUCTION AND AIMS Antibiotic resistance is a global health problem that can affect individuals, health systems, and the economy. Our aim was to investigate how the redemption of antibiotics and the associated dental care changed during COVID-19 in Hungary. METHODS The ICD codes for the infections for which antibiotics should be prescribed in dental care were identified based on the professional recommendation. The database was provided by the National Health Insurance Fund Manager of Hungary. Pearson's chi-squared test with Bonferroni correction was used to compare both the redemption of antibiotics and the associated dental care based on the recommendations in the year 2020 of the COVID-19 and the 2 preceding years. RESULTS There were fewer antibiotic redemptions and associated dental care in 2020 than in 2018 and 2019. The ratio of professionally relevant and nonrelevant antibiotics redeemed did not change significantly between 2018 and 2019, but the proportion of antibiotics redeemed following recommendations increased significantly during the COVID-19 year of 2020 compared to the previous 2 years. The proportion of all dental care involving antibiotic redemptions increased significantly from 2018 to 2019, and then showed a further increase in 2020. The sex and age of the patient did not affect these findings, while the type of dental care did alter the trends in some cases. CONCLUSIONS Antibiotics in dentistry are required only for very low proportion of cases, due to the nature of dental care where most infections such as caries and periodontal disease could be managed without resorting to antibiotics. Antibiotic redemptions during COVID-19 pandemic period increased compared to the pre-pandemic period in Hungary. Therefore, Hungarian policy makers need to develop control systems to promote the correct use of antibiotics in dental care. CLINICAL RELEVANCE It is important to reduce unjustified use of antibiotics so as to curb the emergence of antibiotic resistance organisms.
Collapse
Affiliation(s)
- Nándor Kalas
- Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary; Dental Care Service, University of Debrecen Clinical Center, University of Debrecen, Debrecen, Hungary
| | - Attila Nagy
- Department of Health Informatics, Institute of Health Sciences, Faculty of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Nóra Kovács
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Viktor Dombrádi
- Department of Patient Safety, Health Services Management Training Centre, Faculty of Health and Public Administration, Semmelweis University, Budapest, Hungary
| | - Gábor Bányai
- Institute of Health Economics and Management, Faculty of Economics and Business, University of Debrecen, Debrecen, Hungary
| | - Klára Bíró
- Institute of Health Economics and Management, Faculty of Economics and Business, University of Debrecen, Debrecen, Hungary
| | - Klára Boruzs
- Institute of Health Economics and Management, Faculty of Economics and Business, University of Debrecen, Debrecen, Hungary.
| |
Collapse
|
3
|
Grillo R, Balel Y, Brozoski MA, Ali K, Adebayo ET, Naclério-Homem MDG. A global science mapping analysis on odontogenic infections. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024; 125:101513. [PMID: 37207960 DOI: 10.1016/j.jormas.2023.101513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 05/16/2023] [Indexed: 05/21/2023]
Abstract
OBJECTIVES Odontogenic infections are common and a topic of core interest for dentists, and maxillofacial surgeons. The aim of this study was to conduct a bibliometric analysis of the global literature on odontogenic infection and explore the top 100 most cited papers to identify the common causes, sequelae and management trends. METHODS Following a comprehensive literature search, a list of top 100 most cited papers was created. The VOSviewer software (Leiden University, The Netherlands) was used to create a graphical representation of the data, and statistical analyses were performed to analyze the characteristics of the top 100 most cited papers. RESULTS A total of 1,661 articles were retrieved with the first article published in 1947. There is an exponential upward trend on the number of publications (R2 = 0.919) and a majority of papers are in English language (n = 1,577, 94.94%). A total of 22,041 citations were found with a mean of 13.27 per article. The highest number of publications were recorded from developed countries. There was a male predilection in the reported cases and the most common sites included the submandibular and parapharyngeal spaces. Diabetes mellitus was identified as the commonest co-morbidity. Surgical drainage was ascertained to be the preferred method of management. CONCLUSIONS Odontogenic infections remain prevalent and have a global distribution. Although prevention of odontogenic infection through meticulous dental care is ideal, early diagnosis and prompt management of established odontogenic infections is important to avoid morbidities and mortality. Surgical drainage is the most effective management strategy. There is lack of consensus regarding the role of antibiotics in the management of odontogenic infections.
Collapse
Affiliation(s)
- Ricardo Grillo
- Department of Oral & Maxillofacial Surgery, Traumatology and Prosthesis - Faculty of Dentistry of the University of São Paulo, Brazil; Department of Oral & Maxillofacial Surgery, Faculdade Patos de Minas, Brasília, Brazil.
| | - Yunus Balel
- Department of Oral and Maxillofacial Surgery, Gaziosmanpasa University, Gaziosmanpasa, Turkey
| | - Mariana Aparecida Brozoski
- Department of Oral & Maxillofacial Surgery, Traumatology and Prosthesis - Faculty of Dentistry of the University of São Paulo, Brazil
| | - Kamran Ali
- College of Dental Medicine, Qatar University, Doha, Qatar
| | - Ezekiel Taiwo Adebayo
- Department of Oral and Maxillofacial Surgery, University of Medical Sciences, Ondo, Nigeria
| | - Maria da Graça Naclério-Homem
- Department of Oral & Maxillofacial Surgery, Traumatology and Prosthesis - Faculty of Dentistry of the University of São Paulo, Brazil
| |
Collapse
|
4
|
Teal L, Sheller B, Susarla HK. Pediatric Odontogenic Infections. Oral Maxillofac Surg Clin North Am 2024; 36:391-399. [PMID: 38777729 DOI: 10.1016/j.coms.2024.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
Odontogenic infections are a broad group of head and neck conditions that arise from the teeth and surrounding periodontium. These largely preventable infections disproportionately affect members of ethnic and racial minorities and low-income/uninsured groups, and result in significant costs to our health care system. Left untreated, odontogenic infections can spread to deep spaces of the head and neck and can result in life-threatening complications. The mainstay of treatment includes timely treatment of the affected teeth. These infections are a global public health concern that could be diminished with improved access to routine dental care.
Collapse
Affiliation(s)
- Lindsey Teal
- Division of Plastic Surgery, Department of Surgery, University of Washington Medical Center, 325 9th Avenue, Seattle, WA 98013, USA
| | - Barbara Sheller
- Department of Dentistry, Seattle Children's Hospital, 4800 Sand Point Way NE, Seattle, WA 98105, USA
| | - Harlyn K Susarla
- Department of Dentistry, Seattle Children's Hospital, 4800 Sand Point Way NE, Seattle, WA 98105, USA.
| |
Collapse
|
5
|
Sudri S, Pharayra M, Ghantous Y, Abu El-Naaj I, Laviv A. Pediatric Maxillofacial Infections During COVID-19: What Have We Learned? J Oral Maxillofac Surg 2024; 82:976-983. [PMID: 38744420 DOI: 10.1016/j.joms.2024.04.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 04/05/2024] [Accepted: 04/19/2024] [Indexed: 05/16/2024]
Abstract
BACKGROUND The coronavirus (COVID-19) pandemic significantly affected health care systems worldwide, and the field of dentistry is no exception. Odontogenic infections in pediatric patients pose unique challenges to treatment and diagnosis. PURPOSE The purpose of this study was to evaluate the incidence, characteristics, and treatment of pediatric maxillofacial odontogenic infections during COVID-19 compared to pre-COVID-19. STUDY DESIGN, SETTING, SAMPLE This retrospective cohort study included all pediatric patients (0-18 years old) who visited the emergency department (ED) at Tzafon Medical Center, Israel, between March 2020 and February 2021 (COVID-19), or between March 2018 and February 2020 (pre-COVID-19), and were diagnosed with maxillofacial odontogenic infections. Patients with missing demographic data and patients who did not complete the medical examination were excluded. PREDICTOR/EXPOSURE/INDEPENDENT VARIABLE The exposure variable was the date of presentation, categorized as COVID-19 or pre-COVID-19. MAIN OUTCOME VARIABLE(S) The main outcome variables were the proportion of patients diagnosed with odontogenic infections, hospitalization rate, treatment methods, and length of hospital stay. COVARIATES Covariates included patient demographics, involved dentition and associated spaces, and the administration of antibiotics before ED arrival. ANALYSES The Fisher exact test and Pearson's χ2 test were applied to assess differences in categorical variables. The Wilcoxon rank-sum test was used for independent variables. A logistic regression model was used to predict outcome variables. P values were two-tailed, and statistical significance was defined as P < .05. RESULTS The study sample comprised 471 patients: 357 (76%) in the pre-COVID-19 period and 114 (24%) during COVID-19. The relative risk of visits to the ED out of total oral and maxillofacial ED visits was lower during COVID-19 (relative risk = 0.65, P = .0001). The hospitalization rate increased from 72% (257 patients) pre-COVID-19 to 86.8% (99 patients) during the COVID-19 period (P = .001). Length of hospital stay during COVID-19 was significantly shorter than pre-COVID-19 (P < .001). CONCLUSION AND RELEVANCE The findings of this study reveal a significant reduction in odontogenic infection incidents referred to the ED during the pandemic. This implies that many of these incidents can be successfully treated in community health care settings without referral to the ED.
Collapse
Affiliation(s)
- Shiran Sudri
- Department of Oral and Maxillofacial Surgery, Tzafon Medical Center, Affiliated with Azrieli Faculty of Medicine, Bar Ilan University, Israel.
| | - Maisa Pharayra
- Dental Student, Department of Oral and Maxillofacial Surgery, The Maurice & Gabriela Goldschlager School of Dental Medicine, Tel Aviv University, Tel Aviv
| | - Yasmin Ghantous
- Department of Oral and Maxillofacial Surgery, Tzafon Medical Center, Affiliated with Azrieli Faculty of Medicine, Bar Ilan University, Israel; Post Doctoral at Johns Hopkins Medicine (2017), Maxillofacial Surgeon, Tzafon Medical Center, Poria, Israel
| | - Imad Abu El-Naaj
- Department of Oral and Maxillofacial Surgery, Tzafon Medical Center, Affiliated with Azrieli Faculty of Medicine, Bar Ilan University, Israel; Head Department of Oral and Maxillofacial Surgery, Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Amir Laviv
- Senior Lecturer, Department of Oral and Maxillofacial Surgery, The Maurice & Gabriela Goldschlager School of Dental Medicine, Tel Aviv University, Tel Aviv
| |
Collapse
|
6
|
Faur CI, Moldovan MA, Paraschivescu T, Megieșan S, Roman RC. Epidemiology and Management Paradigm of Head and Neck Infections, Including COVID-19 Pandemic Period: A 10-Year Retrospective Study in a Maxillofacial Center of Cluj-Napoca. J Clin Med 2024; 13:4046. [PMID: 39064086 PMCID: PMC11277223 DOI: 10.3390/jcm13144046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Revised: 07/04/2024] [Accepted: 07/08/2024] [Indexed: 07/28/2024] Open
Abstract
Background. The management of odontogenic infections varies across the globe. To shed light on the subject, this study delves into the practices of the Oral and Maxillofacial Department at Cluj-Napoca County Hospital. Material and Methods. This comprehensive retrospective analysis of 10 years of clinical experience covered a range of factors, including demographics, clinical and investigations factors, medical and surgical treatment approaches, and follow-up. Additionally, the study examined the change in trends over the course of the COVID-19 pandemic. Results. While head and neck infection occurrence had a decreasing trend before the COVID-19 pandemic, during the pandemic era the number of patients almost doubled. The infections were prevalent in the submandibular space, teeth being the prevalent cause. Young adults are prone to suffer from odontogenic infections. High levels of C reactive protein, ASA II-IV risk, and hepatic dysfunction indicated a longer time of hospitalization. The majority of antibiograms were negative, and the positive ones indicated Streptococcus and Staphylococcus species as prevalent pathogens. Extra- or intraoral surgical drainage and wide-spectrum antibiotics proved to be the workhorse for odontogenic infections. Conclusion. This study advances our understanding of oral and maxillofacial surgery and offers actionable strategies for improving patient outcomes in similar healthcare institutions worldwide.
Collapse
Affiliation(s)
- Cosmin Ioan Faur
- Department of Oral Radiology, Iuliu Hatieganu University of Medicine and Pharmacy Cluj-Napoca, 400006 Cluj-Napoca, Romania;
| | - Mădălina Anca Moldovan
- Department of Oral and Maxillofacial Surgery and Implantology, Iuliu Hatieganu University of Medicine and Pharmacy Cluj-Napoca, 400006 Cluj-Napoca, Romania
| | - Tino Paraschivescu
- Faculty of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy Cluj-Napoca, 400006 Cluj-Napoca, Romania
| | - Sergiu Megieșan
- Applied Mathematics, Imperial College London Alumni, London SW7 2AZ, UK;
| | - Rareș Călin Roman
- Department of Oral and Maxillofacial Surgery and Implantology, Iuliu Hatieganu University of Medicine and Pharmacy Cluj-Napoca, 400006 Cluj-Napoca, Romania
| |
Collapse
|
7
|
Bond AT, Soubra YS, Aziz U, Read-Fuller AM, Reddy LV, Kesterke MJ, Amin D. Are Deep Odontogenic Infections Associated With an Increased Risk for Sepsis? J Oral Maxillofac Surg 2024; 82:852-861. [PMID: 38621664 DOI: 10.1016/j.joms.2024.03.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 03/22/2024] [Accepted: 03/22/2024] [Indexed: 04/17/2024]
Abstract
BACKGROUND Quick Sequential Organ Failure Assessment (qSOFA) is recommended to identify sepsis. Odontogenic infection (OI) can progress to sepsis, causing systematic inflammatory complications or organ failure. PURPOSE The purpose of the study was to measure the association between OI location and risk for sepsis at admission. STUDY DESIGN, SETTING, AND SAMPLE This retrospective cohort study included subjects treated for OI at Baylor University Medical Center in Dallas, TX, from January 9, 2019 to July 30, 2022. Subjects > 18 years old who were treated under general anesthesia were included. OI limited to periapical, vestibular, buccal, and/or canine spaces were excluded from the sample. PREDICTOR VARIABLE The primary predictor variable was OI anatomic location (superficial or deep). Superficial OI infection includes submental, submandibular, sublingual, submasseteric, and/or superficial temporal spaces. Deep OI includes pterygomandibular, deep temporal, lateral pharyngeal, retropharyngeal, pretracheal, and/or prevertebral. MAIN OUTCOME VARIABLES The primary outcome variable was risk for sepsis measured using a qSOFA score (0 to 3). A higher score (>0) indicates the patient has a high risk for sepsis. COVARIATES Covariates were demographics, clinical, laboratory, and radiological findings, antibiotic route, postoperative endotracheal intubation, tracheostomy, intensive care unit, admission, and length of stay. ANALYSES Descriptive and bivariate analyses were performed. A χ2 test was used for categorical variables. The Mann-Whitney U test was used for continuous variables. Statistical significance was P < .05. RESULTS The sample was composed of 168 subjects with a mean age of 42.8 ± 21.5 and 69 (48.6%) subjects were male. There were 11 (6.5%) subjects with a qSOFA score > 0. The relative risk of a qSOFA > 0 for a deep OI is 5.4 times greater than for a superficial OI (136 (95.8) versus 21 (80.8%): RR (95% confidence interval): 5.4 (1.51 to 19.27), P = .004). After adjusting for age, sex, American Society of Anesthesiologists score, and involved anatomical spaces, there was a significant correlation between laterality and the number of involved anatomical spaces and qSOFA score (odd ratio = 9.13, 95% confidence interval: 2.48 to 33.55, adjusted P = <.001). CONCLUSION AND RELEVANCE The study findings suggest that the OI location is associated with the qSOFA score >0.
Collapse
Affiliation(s)
- Austin T Bond
- Dental Student Researcher, Department of Oral & Maxillofacial Surgery, Texas A&M School of Dentistry, Dallas, TX
| | - Yasmine S Soubra
- Medical Student Researcher, Department of Surgery, Texas A&M School of Medicine, Dallas, TX
| | - Umaymah Aziz
- Medical Student Researcher, Department of Surgery, Texas A&M School of Medicine, Dallas, TX
| | - Andrew M Read-Fuller
- Clinical Assistant Professor, Residency Program Director, Department of Oral and Maxillofacial Surgery, Texas A&M University, Dallas, TX
| | - Likith V Reddy
- Clinical Professor, Chair of Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery, Texas A&M University, Dallas, TX
| | - Matthew J Kesterke
- Assistant Professor, Director of Research, Department of Orthodontics, Texas A&M University School of Dentistry, Dallas, TX
| | - Dina Amin
- Associate Professor, Residency Program Director, Department of Oral and Maxillofacial Surgery, University of Rochester, Rochester, NY.
| |
Collapse
|
8
|
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.
Collapse
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
| |
Collapse
|
9
|
Gadicherla S, Manglani K, Pentapati KC, Kudva A, Aramanadka C, Chandravel R. Profile of Patients with Maxillofacial Space Infections and Associated Risk Factors. ScientificWorldJournal 2024; 2024:9304671. [PMID: 38633105 PMCID: PMC11022519 DOI: 10.1155/2024/9304671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 03/27/2024] [Accepted: 03/30/2024] [Indexed: 04/19/2024] Open
Abstract
Objective To evaluate the profile of patients operated for maxillofacial space infections and associated risk factors for the length of hospital stay. Materials and Methods We conducted a retrospective study among patients operated for maxillofacial infections at our center from 2010 to 2020. Information collected from the records were age, sex, type and number of spaces involved, clinical signs and symptoms (pain, swelling, toothache, sore throat, otalgia, hoarseness, headache, cough, neck swelling, rancid breath, sialorrhea, gingival swelling, muffled voice, trismus, fever, dysphagia, odynophagia, malaise, lymphadenopathy, dyspnoea, pus discharge), treatment modality, total leukocyte count, evidence of bacterial growth, comorbidities, complications if any and length of hospital stay. Results A total of 128 medical records were examined, out of which 59 were female. The mean age was 38.59 ± 19.7 and the length of hospital stay was 7.56 ± 3.8 days. The most commonly involved space was submandibular space (46.1%) and the common symptoms reported were swelling (99.2%), pain (86.7%), and trismus (68%). Four patients had complications like necrotizing fasciitis (1.6%), pneumonia (0.8%), and death in one patient (0.8%). Logistic regression showed that patients more than 36 years of age, male sex, evidence of bacterial growth, and diabetics had higher odds of increased hospital stay (>6 days). Multiple logistic regression analysis showed that age (P = 0.015; OR: 2.98) and evidence of bacterial culture (P = 0.001; OR:6.64) were potential predictors associated with increased hospital stay. Conclusion Our study showed that the age of the patient and evidence of bacterial culture were potential predictors of prolonged hospital stay among patients operated for maxillofacial space infections.
Collapse
Affiliation(s)
- Srikanth Gadicherla
- Department of Oral and Maxillofacial Surgery, Manipal College of Dental Sciences, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India
| | - Kirti Manglani
- Department of Oral and Maxillofacial Surgery, Manipal College of Dental Sciences, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India
| | - Kalyana C. Pentapati
- Department of Public Health Dentistry, Manipal College of Dental Sciences, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India
| | - Adarsh Kudva
- Department of Oral and Maxillofacial Surgery, Manipal College of Dental Sciences, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India
| | - Chithra Aramanadka
- Department of Oral and Maxillofacial Surgery, Manipal College of Dental Sciences, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India
| | | |
Collapse
|
10
|
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.
Collapse
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
| |
Collapse
|
11
|
Mahmoud R, Arbel S, Ianculovici C, Peleg O, Kleinman S, Shuster A. Antimicrobial therapy in the management of odontogenic infections: the penicillin-allergic patient. Int J Oral Maxillofac Surg 2024; 53:251-257. [PMID: 37758642 DOI: 10.1016/j.ijom.2023.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 08/12/2023] [Accepted: 09/05/2023] [Indexed: 09/29/2023]
Abstract
This retrospective analysis was performed to investigate whether clindamycin remains the preferred antibiotic for penicillin-allergic patients with odontogenic infections. The medical records of 311 patients admitted to the study department with odontogenic infections between 2018 and 2022 and treated with either intravenous amoxicillin-clavulanic acid (Augmentin) or intravenous clindamycin were analyzed. The Augmentin-treated group included 268 patients (86.2%) and the clindamycin-treated group included 43 patients (13.8%). Severity parameters did not differ significantly between the two groups, except for a higher prevalence of abscesses in the clindamycin-treated group (58.1% vs 41.0% in the Augmentin-treated group; P = 0.035). The clindamycin-treated group required a longer duration of intravenous antibiotics (P = 0.001) and had a higher rate of treatment failure (14.0% vs 2.2%; P = 0.002) when compared to the Augmentin-treated group, with a seven-fold increased risk of treatment failure. Moreover, significantly more isolated organisms in the clindamycin-treated group were resistant to clindamycin (P = 0.015); these were all Streptococcus anginosus group. Given the higher risk of treatment failure with clindamycin, it is necessary to choose the antibiotic treatment for penicillin-allergic patients carefully. A detailed history and allergy testing followed by combination therapy is recommended, especially in severe cases.
Collapse
Affiliation(s)
- R Mahmoud
- Department of Oral and Maxillofacial Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
| | - S Arbel
- Department of Oral and Maxillofacial Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - C Ianculovici
- Department of Oral and Maxillofacial Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - O Peleg
- Department of Oral and Maxillofacial Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - S Kleinman
- Department of Oral and Maxillofacial Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - A Shuster
- Department of Oral and Maxillofacial Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Department of Oral and Maxillofacial Surgery, Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
12
|
Neal TW, Carr BR, Schlieve T. Are higher odontogenic infection severity scores associated with difficult intubations? Oral Maxillofac Surg 2024; 28:435-440. [PMID: 37326786 DOI: 10.1007/s10006-023-01168-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 06/08/2023] [Indexed: 06/17/2023]
Abstract
PURPOSE This study aimed to determine if there is a relation between odontogenic infection severity score (OISS) and difficult intubation at the time of surgical treatment for severe odontogenic infections (SOI). A secondary goal of this study was to determine the utility of OISS as a predictor of difficult intubations. METHODS This retrospective cohort study was composed of consecutive patients admitted and surgically treated in the operating room (OR) for SOIs. Patients with an OISS ≥ 5 were designated as Group 1 and < 5 Group 2. RESULTS There was a statistically significant difference in difficult intubations between the two groups (p = 0.018). Patients with an OISS ≥ 5 were nearly four times more likely to be difficult intubations compared to patients with an OISS < 5 (OR 3.70, 95% CI 1.19-11.45). When OISS ≥ 5 was used to predict difficult intubation, the sensitivity was 69%, the specificity was 63%, the positive predictive value was 23%, and the negative predictive value was 93%. CONCLUSION OISS ≥ 5 was associated with a higher prevalence of difficult intubations compared to an OISS < 5. OISS may provide clinically relevant data that can be used with established risk factors, laboratory values, and clinical judgment.
Collapse
Affiliation(s)
- Timothy W Neal
- Department of Surgery, Division of Oral and Maxillofacial Surgery, UT Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX, USA.
| | - Brian R Carr
- Department of Surgery, Division of Oral and Maxillofacial Surgery, UT Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX, USA
| | - Thomas Schlieve
- Department of Surgery, Division of Oral and Maxillofacial Surgery, UT Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX, USA
| |
Collapse
|
13
|
Ellison I, Callahan N, Moles S. A firm mass at the angle of the mandible. J Am Dent Assoc 2024; 155:252-257. [PMID: 37149795 DOI: 10.1016/j.adaj.2023.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 02/25/2023] [Accepted: 03/05/2023] [Indexed: 05/08/2023]
|
14
|
Nassar AA, Ibrahim HO, Atef A, Hammouda M, Abou-Zeid MA. Intra-oral Drainage of Submandibular Abscess: A Minimally Invasive Technique. A Prospective Study. Indian J Otolaryngol Head Neck Surg 2024; 76:168-175. [PMID: 38440448 PMCID: PMC10908751 DOI: 10.1007/s12070-023-04119-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 07/24/2023] [Indexed: 03/06/2024] Open
Abstract
PURPOSE To evaluate the efficacy of intraoral drainage of isolated submandibular space abscess as a minimally invasive surgical technique compared to the standard trans-cervical approach. PATIENTS AND METHODS This prospective study included 40 subjects with isolated submandibular space abscesses. They were randomly divided into 2 equal groups: trans-cervical surgical drainage (group A) and intra-oral surgical drainage (group B). The included data were demographics, repeated surgery requirement, postsurgical hospitalization duration, formation of scar, and complications. RESULTS Intraoral drainage (Group B) reduced the mean operative time by 15.25 min (P < 0.001) compared with trans-cervical incision (Group A). No considerable difference was found between the 2 groups in regarding hospitalization postoperatively. No weakness in marginal mandibular nerve was found in both groups. Three patients only have a cervical scar in a group (B) who required external drainage due to recollection. No recurrence was detected in a group (A). CONCLUSION The current study demonstrated that isolated submandibular abscesses can be successfully managed with an intraoral drainage modality, and it is a better option than the trans-cervical approach regarding better cosmetic outcome and shorter operative time.
Collapse
Affiliation(s)
- Ahmed Amin Nassar
- Lecturer of Otolaryngology, Faculty of Medicine, Cairo University, Cairo, Arab Republic of Egypt
| | - Hazem Othman Ibrahim
- Clinical Demonstrator of Otolaryngology, Faculty of Medicine, Cairo University, Cairo, Arab Republic of Egypt
| | - Ahmed Atef
- Faculty of Medicine, Cairo University, Cairo, Arab Republic of Egypt
| | - Mostafa Hammouda
- Faculty of Medicine, Cairo University, Cairo, Arab Republic of Egypt
| | - Mohamed Aly Abou-Zeid
- Lecturer of Otolaryngology, Faculty of Medicine, Cairo University, Cairo, Arab Republic of Egypt
| |
Collapse
|
15
|
Albrecht H, Schiegnitz E, Halling F. Facts and trends in dental antibiotic and analgesic prescriptions in Germany, 2012-2021. Clin Oral Investig 2024; 28:100. [PMID: 38231453 PMCID: PMC10794513 DOI: 10.1007/s00784-024-05497-6] [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: 09/25/2023] [Accepted: 01/06/2024] [Indexed: 01/18/2024]
Abstract
OBJECTIVES The study aims to overview German dentists' development of antibiotic and analgesic prescriptions from 2012 to 2021. MATERIALS AND METHODS A longitudinal database analysis was performed based on the annual reports of the "Research Institute for Local Health Care Systems" (WIdO, Berlin). RESULTS From 2012 until 2021, dental antibiotic prescriptions fell by 17.9%. In contrast, the dental proportion of antibiotic prescriptions compared to all antibiotic prescriptions in Germany increased from 9.1 to 13.6%. Aminopenicillins enhanced their share from 35.6 to 49.4%, while clindamycin prescriptions declined from 37.8 to 23.4%. The proportion of ibuprofen prescriptions significantly increased from 60.4% in 2012 to 79.0% in 2021. CONCLUSIONS Since 2013, the most frequently prescribed antibiotic by German dentists has been amoxicillin reaching nearly half of all dental antibiotic prescriptions in 2021. Simultaneously, the proportion of clindamycin has steadily decreased, but the level is still high compared to international data. During the past decade, ibuprofen as a first-line analgesic in German dentistry was continuously gaining in importance. CLINICAL RELEVANCE Aminopenicillins have the best risk-benefit balance in dentistry, but the use of antibiotics generally must be limited only to cases of severe infections or compromised patients. Pre-existing diseases or permanent medications should always be considered when choosing an analgesic.
Collapse
Affiliation(s)
- Helena Albrecht
- Department of Oral and Maxillofacial Surgery, University Medical Center of the Johannes Gutenberg-University of Mainz, Mainz, Germany.
| | - Eik Schiegnitz
- Department of Oral and Maxillofacial Surgery, University Medical Center of the Johannes Gutenberg-University of Mainz, Mainz, Germany
| | - Frank Halling
- Gesundheitszentrum Fulda | Praxis für MKG-Chirurgie/Plast. OP, Fulda, Germany
- Department of Oral and Maxillofacial Surgery, University Hospital Marburg UKGM GmbH, Marburg, Germany
| |
Collapse
|
16
|
Garola F, Cores B, Santalla Claros E, Botta M, Pigazzini P, Piemonte E, Garzón JC. Management of cervicofacial infection: a 7-year retrospective study. Oral Surg Oral Med Oral Pathol Oral Radiol 2024; 137:19-29. [PMID: 37880047 DOI: 10.1016/j.oooo.2023.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 06/28/2023] [Accepted: 07/10/2023] [Indexed: 10/27/2023]
Abstract
OBJECTIVE We aimed to describe and analyze the epidemiologic and clinical variables associated with, treatment for, and development of cervicofacial infection (CFI). STUDY DESIGN We retrospectively examined 201 patients older than 14 years who had met the CFI diagnostic criteria and whose treatment required hospitalization and intervention under general anesthesia at our hospital. We performed chi-square tests to compare proportions in categorical variables and either the Student t test or the Wilcoxon signed-rank test to compare quantitative variables. We performed an analysis of variance to compare 3 or more categories and either Pearson or Spearman correlation coefficient analysis to examine the correlations between quantitative variables. RESULTS The majority (85.07%) of the CFIs were of odontogenic origin. The mean hospitalization length was 4.58 days. Patients with diabetes who used tobacco and/or alcohol had a significantly longer length of hospitalization and several postoperative complications.The most common symptoms were pain, trismus and toothache. Symptoms of fever and nausea were associated with longer hospitalization. The most affected anatomic spaces were submandibular and pterygomandibular. Buccal and infraorbital, temporal, and parotid spaces were associated with longer hospitalization. CONCLUSIONS Most CFIs are of odontogenic origin. Diabetes and tobacco and alcohol use are important risk factors. Treatment should be surgical and target the cause of infection. Timely referrals are important when patients present symptoms compatible with CFI for immediate treatment.
Collapse
Affiliation(s)
- Federico Garola
- Oral and Maxillofacial Surgery Department, Hospital General de Agudos Parmenio Piñero, Ciudad Autónoma de Buenos Aires, Argentina.
| | - Bárbara Cores
- Oral and Maxillofacial Surgery Department, Hospital General de Agudos Parmenio Piñero, Ciudad Autónoma de Buenos Aires, Argentina
| | - Ezequiel Santalla Claros
- Oral and Maxillofacial Surgery Department, Hospital General de Agudos Parmenio Piñero, Ciudad Autónoma de Buenos Aires, Argentina
| | - Mariano Botta
- Oral and Maxillofacial Surgery Department, Hospital General de Agudos Parmenio Piñero, Ciudad Autónoma de Buenos Aires, Argentina
| | - Paola Pigazzini
- Oral and Maxillofacial Surgery Department, Hospital General de Agudos Parmenio Piñero, Ciudad Autónoma de Buenos Aires, Argentina
| | - Eduardo Piemonte
- Oral Medicine Department, Facultad de Odontología, Universidad Nacional de Córdoba, Argentina
| | - Julio César Garzón
- Oral and Maxillofacial Surgery Department, Hospital General de Agudos Parmenio Piñero, Ciudad Autónoma de Buenos Aires, Argentina
| |
Collapse
|
17
|
Dentoalveolar Surgery. J Oral Maxillofac Surg 2023; 81:E51-E74. [PMID: 37833029 DOI: 10.1016/j.joms.2023.06.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2023]
|
18
|
Sajdlowska J, Francois K, Halepas S, Lee KC, Ferneini EM. Does systemic steroid use affect the length of hospital stay for head and neck infections? Oral Surg Oral Med Oral Pathol Oral Radiol 2023; 136:422-426. [PMID: 37316423 DOI: 10.1016/j.oooo.2023.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 03/29/2023] [Accepted: 03/31/2023] [Indexed: 06/16/2023]
Abstract
OBJECTIVE The purpose of this study was to conduct a systematic review to perform a meta-analysis to investigate the outcomes of head and neck infections treated with systemic steroids. STUDY DESIGN The protocol was registered to the International Prospective Register of Systematic Reviews on August 24, 2020. The studies were compiled using PubMed/Medline with a single reviewer from their inception until August 17, 2020. The studies were uploaded onto Convidence.org, and a repeat search was conducted and uploaded on August 17, 2021. Two independent reviewers (J.S. and S.H.) blinded to each other's assessments reviewed the title and/or abstract for inclusion. After a first pass, full-text reviews of the articles were assessed (J.S. and K.F.) for study inclusion. Data were extracted from the steroid (test) and nonsteroid (control) cohorts. RESULTS The initial search of key terms yielded 2,711 studies. Titles and abstracts were reviewed, and only cohort and/or cross-sectional studies with the relevant study groups and the relevant outcomes were retrieved for the filtration system. The 2 reviewers reviewed 188 full-text studies, and 3 studies met the inclusion criteria. Although all 3 studies included the mean length of stay for the treatment and a control group, only 2 studies included the confidence interval, and only 1 included P values. Overall, the studies presented insufficient data to pool outcomes and ran a statistical analysis for meta-analysis. CONCLUSIONS Steroid use reduced the length of stay in 2 studies and increased the length of stay in another larger study. Given the lack of data to perform a meta-analysis, more studies need to be conducted, with a prospective randomized control trial design being essential for guiding evidence-based practice regarding the use of steroids in head and neck infections.
Collapse
Affiliation(s)
- Joanna Sajdlowska
- Department of General Surgery, St. Joseph's University Medical Center, Paterson, NJ, USA
| | - Kevin Francois
- Department of Oral and Maxillofacial Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Steven Halepas
- Division of Oral and Maxillofacial Surgery, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, NY, USA
| | - Kevin C Lee
- Division of Oral and Maxillofacial Surgery, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, NY, USA
| | - Elie M Ferneini
- Beau Visage Med Spa and Greater Waterbury OMS, Cheshire, CT, USA; Division of Oral and Maxillofacial Surgery, School of Dental Medicine, University of Connecticut, Farmington, CT, USA.
| |
Collapse
|
19
|
Valenzuela-Fuenzalida JJ, Baez-Flores B, Sepúlveda RÁ, Medina CM, Pérez R, López E, Sanchis J, Orellana Donoso M, Silva JL, Rodriguez MC, Iwanaga J. Anatomical variations and abnormalities of the maxillary region and clinical implications: A systematic review and metaanalysis. Medicine (Baltimore) 2023; 102:e34510. [PMID: 37747000 PMCID: PMC10519516 DOI: 10.1097/md.0000000000034510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 07/03/2023] [Accepted: 07/05/2023] [Indexed: 09/26/2023] Open
Abstract
OBJECTIVE The objective of this review is to investigate and analyze the anatomical variations present in the maxillary sinus (MS), through the examination of the prevalence of these variations, as well as the corresponding prevalence of clinically significant pathologies and complications associated with them. METHODS The search process was carried out in the following databases; MEDLINE, SCIELO, WOS, CINHAL, SCOPUS, and GOOGLE SCHOLAR, using as search terms; "Maxillary bone," "Maxillary sinus," "Paranasal sinus," "Anatomical variations," "Sinusitis" and "Clinical anatomy." RESULTS A total of 26 articles and 12969 samples were included, from which 12,594 subjects had their sex recorded giving a total of 5802 males and 6792 females. The variants reported by the included were Haller cells, Concha Bullosa, Number of septa, Hypoplastic sinus, Agger Nasi, Thickening of the MS mucosa, Deviation of the nasal septum, Accessory ostium, and Onodi cells. Among the mentioned, the ones that presented the greatest number of studies (between 8 and 10 studies included) were: the Haller Cells, the Concha Bullosa, and the Number of septa, where prevalence was 0.30, 0.36, 0.39 respectively. These variations can lead to sinusitis, cause some types of tumors, or affect neighboring structures that could be compromised by this variation. CONCLUSION As a result, it is certainly complex to distinguish the presence of anatomical variations from pathological abnormalities. Therefore, knowledge of the different variations and their clinical relationships could be a useful asset for clinicians dedicated to this region.
Collapse
Affiliation(s)
- Juan José Valenzuela-Fuenzalida
- Departamento de Morfología, Facultad de Medicina, Universidad Andres Bello, Santiago, Chile
- Departamento de Ciencias Química y Biológicas Facultad de Ciencias de la Salud, Universidad Bernardo O’Higgins, Santiago, Chile
| | - Belén Baez-Flores
- Departamento de Morfología, Facultad de Medicina, Universidad Andres Bello, Santiago, Chile
| | | | - Claudia Moya Medina
- Department of Morphology and Function, Faculty of Health and Social Sciences, Universidad de las Américas, Santiago, Chile
| | - Rubén Pérez
- Department of Morphology and Function, Faculty of Health and Social Sciences, Universidad de las Américas, Santiago, Chile
| | - Esteban López
- Department of Morphology and Function, Faculty of Health and Social Sciences, Universidad de las Américas, Santiago, Chile
| | - Juan Sanchis
- Giaval Research Group, Faculty of Medicine, University of Valencia, Valencia, Spain
| | - Mathias Orellana Donoso
- Departamento de Morfología, Facultad de Medicina, Universidad Andres Bello, Santiago, Chile
- Escuela de Medicina, Universidad Finis Terrae, Santiago, Chile
| | - Javiera Leyton Silva
- Departamento de Morfología, Facultad de Medicina, Universidad Andres Bello, Santiago, Chile
| | | | - Joe Iwanaga
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA
| |
Collapse
|
20
|
D'Arco F, Lee P, Siddiqui A, Nash R, Ugga L. Radiologic diagnosis of non-traumatic paediatric head and neck emergencies. Pediatr Radiol 2023; 53:768-782. [PMID: 36481939 DOI: 10.1007/s00247-022-05556-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 10/18/2022] [Accepted: 11/30/2022] [Indexed: 12/13/2022]
Abstract
Imaging plays a crucial role in evaluating paediatric patients with non-traumatic head and neck lesions in an emergency setting because clinical manifestations of these entities can overlap. For this reason, radiologists must be familiar with the clinical and imaging findings of prevalent paediatric head and neck emergencies. In this review, we present techniques and imaging clues for common complications of pathological processes in the paediatric head and neck, with a focus on the clinical scenario as a starting point for the radiologic approach.
Collapse
Affiliation(s)
- Felice D'Arco
- Department of Radiology, Neuroradiology Unit, Great Ormond Street Hospital, London, UK
| | - Philippa Lee
- Department of Radiology, Imperial College Healthcare NHS Trust, London, UK
| | - Ata Siddiqui
- Radiology Department, Guy's and St. Thomas' NHS Foundation Trust, London, UK
- Department of Neuroradiology, King's College Hospital NHS Foundation Trust, London, UK
| | - Robert Nash
- Ear, Nose and Throat Department, Great Ormond Street Hospital, London, UK
| | - Lorenzo Ugga
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Via Sergio Pansini 5, 80131, Naples, Italy.
| |
Collapse
|
21
|
Jespersen FVB, Hansen SUB, Jensen SS, Omland LH, Helweg-Larsen J, Bjarnsholt T, Nielsen CH, Ziebell M, Bodilsen J, Markvart M. Cerebral abscesses with odontogenic origin: a population-based cohort study. Clin Oral Investig 2023:10.1007/s00784-023-04976-6. [DOI: 10.1007/s00784-023-04976-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 03/21/2023] [Indexed: 04/03/2023]
Abstract
Abstract
Objectives
Recent studies have indicated that cerebral abscess (CA) patients with odontogenic origin are on the rise. However, CA patients are often poorly characterized and with an unknown etiologic background. The purpose of this study is to identify and characterize CA patients that may have an odontogenic origin based on microbiologic, radiographic, and/or clinical findings.
Materials and methods
This is a population-based cohort study analyzing retrospective and prospective data from CA patients. Radiographic examinations of panoramic radiographs (PRs) or computed tomography (CT) scans were conducted. CA patients characterized with odontogenic origin required the fulfilment of the following criteria on admission: (1) Oral pathologic conditions were the only bacterial infections present, (2) oral microorganisms were isolated in the purulent exudate from the brain, and (3) radiographically and/or clinical recordings of oral pathologic conditions.
Results
A total of 44 patients could be included in this study of which 25 (57%) were characterized as having CA with a likely odontogenic origin. Type two diabetes (T2D) (p = 0.014) and microorganisms of the Streptococcus anginosus group (SAG) (p < 0.01) were overrepresented in patients with CAs of odontogenic origin.
Conclusions
Odontogenic infections may cause CAs to a greater extent than previously assumed. T2D was overrepresented among patients with odontogenic CA. When microorganisms of the SAG were isolated from the brain pus, CA patients had a predisposing odontogenic or sinus infection.
Clinical relevance
The identification of patients with a likely odontogenic CA will contribute to understanding the etiology of the infectious disease and highlighting the importance of preserving oral health.
Collapse
|
22
|
Al-Sebaei M, Sindi MA. A Knowledge and Practice Survey Among Dentists in Saudi Arabia Analysing Myths and Misconceptions in Dentistry and Oral Surgery: What Do Dentists Believe? Cureus 2023; 15:e36625. [PMID: 37155434 PMCID: PMC10122836 DOI: 10.7759/cureus.36625] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2023] [Indexed: 05/10/2023] Open
Abstract
Introduction To ensure safe and effective practice, dental practitioners must stay up-to-date with all scientific updates involving their profession. In this regard, many outdated myths and misconceptions may be persistently believed and practiced. This study aimed to examine dental misconceptions circulating among dentists in Saudi Arabia. Methods An electronic survey was administered to Saudi Arabian dental practitioners classified and registered with the Saudi Commission of Health Specialties. It collected their demographics, career and experience details, and responses to 16 questions that targeted different myths. Logistic regression was used to analyze factors associated with their knowledge. Results A total of 519 dentists answered the survey, of which 54% were male with a mean age of 32 ± 9 years and a mean practice of 7 ± 8 years. More than half (57%) practiced general dentistry. In most (69%) of the questions, 40% of the respondents answered incorrectly. The proportion of incorrect answers to some questions reached 62%. Years of teaching, years in practice, and doctor rank had no association with the knowledge score. Conversely, the type of practice and specialty had multiple statistically significant associations (p < 0.05). Conclusion This study shows that many myths, despite being debunked for more than 20 years, are still circulating among Saudi Arabian dentists, including many young dentists. Academic institutions must urgently address these concepts and the science that disproves them; dentists must implement up-to-date, evidence-based knowledge in their practice.
Collapse
Affiliation(s)
- Maisa Al-Sebaei
- Oral and Maxillofacial Surgery, King Abdulaziz University (KAU), Jeddah, SAU
| | | |
Collapse
|
23
|
Neal TW, Schlieve T. Complications of Severe Odontogenic Infections: A Review. BIOLOGY 2022; 11:biology11121784. [PMID: 36552293 PMCID: PMC9775288 DOI: 10.3390/biology11121784] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 12/03/2022] [Accepted: 12/05/2022] [Indexed: 12/13/2022]
Abstract
Severe odontogenic infections are routinely treated with little associated morbidity and mortality. Improvements in surgical techniques, antibiotic treatments, and imaging modalities have made associated complications exceedingly rare. A number of complications have been described in the literature including airway obstruction, descending necrotizing mediastinitis, orbital abscess, septic cavernous sinus thrombosis, cerebral abscess, sepsis, necrotizing fasciitis, and Lemierre's syndrome. The purpose of this article is to discuss the pathophysiology of severe odontogenic infections and the risk factors associated with the development of complications. Given the morbidity and mortality of these conditions, it is important to review the clinical features of each and the diagnostic tools that aid in early recognition.
Collapse
|
24
|
Kang ES, Lee JH. Diagnostic value of presepsin in odontogenic infection: a retrospective study. Maxillofac Plast Reconstr Surg 2022; 44:22. [PMID: 35666350 PMCID: PMC9170860 DOI: 10.1186/s40902-022-00353-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 05/26/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Most head and neck infections originate from odontogenic causes; therefore, it is important to determine the severity of odontogenic infections. Since severe infection can cause sepsis, a systemic examination should be performed when evaluating a patient with odontogenic infection. C-reactive protein (CRP), white blood cell count (WBC), procalcitonin (PCT), and presepsin (PSEP) can be used to evaluate the severity of inflammatory status and sepsis in patients in the early stages of visiting the emergency room. Moreover, sepsis can be diagnosed based on the systemic inflammatory response syndrome (SIRS) classification. In relation to PSEP, significant study results on sepsis have been reported in other organ infections. However, there has been no progress in odontogenic infection; therefore, this study aimed to determine the diagnostic value of sepsis derived from odontogenic infection. METHODS This study was conducted from March 2021 to October 2021 on 43 patients admitted to the Department of Oral and Maxillofacial Surgery, Dankook University Hospital, in the emergency room for odontogenic infection. All patients underwent vital sign assessment and diagnostic tests (CRP, WBC, PCT, PSEP) in the emergency room. Sepsis was classified according to the SIRS criteria, and CRP, WBC, PCT, and PSEP levels were measured. The Statistical Package for the Social Sciences was used for statistical analyses. RESULTS The results of this study showed a moderately positive correlation between CRP and PCT, CRP and PSEP, and CT and PSEP levels. In addition, PCT and PSEP levels showed a positive correlation with sepsis. The odds ratios of sepsis and PCT and sepsis and PSEP were statistically significant. The optimal cut-off values obtained through the receiver operating characteristic curve were 0.24 and 671.5 for PCT and PSEP, respectively. Finally, there were positive correlations between CRP level and length of stay, WBC and Flynn scores, PCT level and Flynn scores, PCT level and length of stay, and PSEP level and length of stay. CONCLUSION WBC and CRP and PCT levels have been used in the past to determine the severity of infection and sepsis in patients with odontogenic infection, but PSEP was also found to have diagnostic value in this study. According to this study, a PSEP level of 671.5 pg/ml or higher for odontogenic infection can be considered an abnormal level.
Collapse
Affiliation(s)
- Eun-Sung Kang
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Dankook University, 119 Dandae-ro, Cheonan, Chungcheongnam-do, 31116, Republic of Korea
| | - Jae-Hoon Lee
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Dankook University, 119 Dandae-ro, Cheonan, Chungcheongnam-do, 31116, Republic of Korea.
| |
Collapse
|
25
|
Valladales-Restrepo LF, Constain-Mosquera CA, Hoyos-Guapacha MA, Hoyos-Guapacha KL, Gaviria-Mendoza A, Machado-Duque ME, Machado-Alba JE. Study of the indications for macrolide prescriptions in a Colombian population. BIOMEDICA : REVISTA DEL INSTITUTO NACIONAL DE SALUD 2022; 42:302-314. [PMID: 35867923 PMCID: PMC9433087 DOI: 10.7705/biomedica.6116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 03/22/2022] [Indexed: 02/07/2023]
Abstract
Introduction The inappropriate use of antibiotics is associated with a greater risk for antimicrobial resistance, high health care costs, adverse events, and worse clinical outcomes. Objective To determine the prescription patterns and approved and nonapproved indications for macrolides in a group of patients from Colombia. Materials and methods This was a cross-sectional study on the indications for the use of macrolides in outpatients registered in a drug-dispensing database of approximately 8.5 million people affiliated with the Colombian health system. Sociodemographic, pharmacological, and clinical variables were considered. Results A total of 9.344 patients had received a macrolide prescription; their median age was 40.1 years (interquartile range: 27.1-53.3 years) and 58.3% were women. The most commonly prescribed macrolide was azithromycin (38.8%) most frequently for Helicobacter pylori infection (15.9%) and pneumonia treatment (15.8%). A total of 31.3% of the prescriptions were used for unapproved indications: common cold (7.8%), COVID-19 (4.0%), and acute bronchitis (3.5%). Residence in the Caribbean region (OR=1.17; 95%CI 1.05-1.31), dental prescriptions (OR=2.75; 95%CI 1.91-3.96), presence of chronic respiratory comorbidities (OR=1.30; 95%CI 1.08-1.56), and prescription of erythromycin (OR=3.66; 95%CI 3.24-4.14) or azithromycin (OR=2.15; 95%CI 1,92-2.41) were associated with a higher probability of macrolide use for unapproved indications while being 18-64 years old (OR=0.81; 95%CI 0.71-0.93) or 65 years or older (OR=0.77; 95%CI 0.63-0.94) and residing in Bogotá-Cundinamarca (OR=0.74; 95%CI 0.65-0.85) were associated with reduced risk. Conclusions Most patients received macrolides for respiratory tract infections; erythromycin and azithromycin were used for unapproved indications in people under 18 years of age and those with chronic respiratory diseases.
Collapse
Affiliation(s)
- Luis Fernando Valladales-Restrepo
- Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma S.A., Pereira, Colombia; Grupo de Investigación en Biomedicina, Facultad de Medicina, Fundación Universitaria Autónoma de las Américas, Pereira, Colombia; Semillero de Investigación en Farmacología Geriátrica, Facultad de Medicina, Fundación Universitaria Autónoma de las Américas, Pereira, Colombia.
| | - Camilo Alexander Constain-Mosquera
- Semillero de Investigación en Farmacología Geriátrica, Facultad de Medicina, Fundación Universitaria Autónoma de las Américas, Pereira, Colo.
| | - María Alejandra Hoyos-Guapacha
- Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma S.A., Pereira, Colombia.
| | - Karol Liceth Hoyos-Guapacha
- Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma S.A., Pereira, Colombia.
| | - Andrés Gaviria-Mendoza
- Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma S.A., Pereira, Colombia; Grupo de Investigación en Biomedicina, Facultad de Medicina, Fundación Universitaria Autónoma de las Américas, Pereira, Colombia.
| | - Manuel Enrique Machado-Duque
- Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma S.A., Pereira, Colombia; Grupo de Investigación en Biomedicina, Facultad de Medicina, Fundación Universitaria Autónoma de las Américas, Pereira, Colombia.
| | - Jorge Enrique Machado-Alba
- Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma S.A., Pereira, Colombia.
| |
Collapse
|
26
|
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; 11:jcm11102731. [PMID: 35628858 PMCID: PMC9145374 DOI: 10.3390/jcm11102731] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/08/2022] [Accepted: 05/10/2022] [Indexed: 02/01/2023] Open
Abstract
The treatment of oral and maxillofacial infections is based on a recognized algorithm that may require modification under the influence of various local and systemic factors. The aim of this study was to present a comprehensive and microbiological profile of oral and maxillofacial infections, and explore possible correlations between the course of an infection and selected systemic factors based on the medical records of 329 patients affected by the disease. We identified most common clinical, demographic, bacterial, and laboratory parameters specific for these infections. There were statistically significant differences in Erythrocyte Sedimentation Rate, number of accompanying diseases, otalgia, dyspnea, and speech difficulties occurrence and neck space involvement between diabetic and non-diabetic patients. The duration of hospitalization and accompanying diseases correlated positively with the patient age and white blood cell count, and C-reactive protein value negatively correlated with age. The primary cause of infections, age, and comorbid diseases can modify the infection course and increase the risk of developing serious complications. It confirms the need for effective and targeted bacterial treatment in the early stages of infections. Age and general diseases are the most important systemic factors determining the infection symptoms and laboratory parameters assessing the severity of the inflammatory process.
Collapse
Affiliation(s)
- Bartłomiej Kamiński
- Department of Otolaryngology, Maria Skłodowska-Curie District Hospital, 26-110 Skarżysko-Kamienna, Poland;
| | - Katarzyna Błochowiak
- Department of Oral Surgery and Periodontology, Poznan University of Medical Sciences, 61-701 Poznan, Poland;
| | - Konrad Kołomański
- Department of Maxillofacial Surgery, Hospital of the Ministry of Interior, 25-375 Kielce, Poland; (K.K.); (M.S.)
| | - Maciej Sikora
- Department of Maxillofacial Surgery, Hospital of the Ministry of Interior, 25-375 Kielce, Poland; (K.K.); (M.S.)
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, 70-111 Szczecin, Poland
| | - Sławomir Karwan
- Department of Maxillofacial Surgery, Regional Specialized Children’s Hospital, 10-561 Olsztyn, Poland;
| | - Dariusz Chlubek
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, 70-111 Szczecin, Poland
- Correspondence:
| |
Collapse
|
27
|
Kamil W, Kruger E, Turlach B, Tennant M. Hospitalization for Oral Health-Related Conditions of the Australian Ageing Population: Two Decades of Analysis. Geriatrics (Basel) 2021; 7:geriatrics7010002. [PMID: 35076481 PMCID: PMC8788296 DOI: 10.3390/geriatrics7010002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 12/14/2021] [Accepted: 12/17/2021] [Indexed: 11/16/2022] Open
Abstract
The burden of oral health care increases among older people, with a profound challenge in utilising dental services in primary dental care settings. This study aimed to analyse two decades of nationwide hospital separation patterns due to oral health-related conditions among older people. Ageing population data were obtained from the Australian Bureau of Statistics, including people aged 65 years and older. All principal diagnoses of oral health conditions (ICD-10-AM) were analysed in this study. The hospitalisation data included all separations of older people for the financial years 1998–1999 to 2018–2019. A total of 205,461 hospital separations were recorded for older people over a period of twenty-one years. More than 60% of these separations were collectively attributed to dental caries, disorders of teeth and supporting structures, diseases of the jaws, diseases of the pulp and periapical tissues. However, the average rate of separations per 10,000 people due to dental caries was the highest among the dental conditions (8.68). Furthermore, the remaining oral health-related conditions predict an annual percentage increase in the rate that would compromise their oral health quality of life. Dental caries and its sequela seem to be the leading cause for oral health-related hospital admissions in Australia for people aged 65 and older. This could be an indicator of the inadequacy of disease management in the primary dental care setting.
Collapse
Affiliation(s)
- Wisam Kamil
- Department of Anatomy, Physiology and Human Biology, School of Human Sciences, The University of Western Australia, Perth, WA 6009, Australia; (E.K.); (M.T.)
- Correspondence:
| | - Estie Kruger
- Department of Anatomy, Physiology and Human Biology, School of Human Sciences, The University of Western Australia, Perth, WA 6009, Australia; (E.K.); (M.T.)
| | - Berwin Turlach
- Department of Mathematics and Statistics, School of Physics, Math and Computing, The University of Western Australia, Perth, WA 6009, Australia;
| | - Marc Tennant
- Department of Anatomy, Physiology and Human Biology, School of Human Sciences, The University of Western Australia, Perth, WA 6009, Australia; (E.K.); (M.T.)
| |
Collapse
|
28
|
Kingren MS, Starr ME, Saito H. Divergent Sepsis Pathophysiology in Older Adults. Antioxid Redox Signal 2021; 35:1358-1375. [PMID: 34210173 PMCID: PMC8905233 DOI: 10.1089/ars.2021.0056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 06/25/2021] [Accepted: 06/27/2021] [Indexed: 12/12/2022]
Abstract
Significance: Both incidence and mortality rates of sepsis significantly increase with advanced age, and the majority of sepsis patients are late middle-aged or older. With the proportion of older adults rapidly increasing in developed countries, age-dependent sepsis vulnerability is an urgent medical issue. Due to an increasing life expectancy, postsepsis complications and health care costs are expected to increase as well. Recent Advances: Older patients suffer from higher sepsis incidence and mortality rates, likely resulting from frequent comorbidities, increased coagulation, dysgylcemia, and altered immune responses. Critical Issues: Despite a large number of ongoing clinical and basic research studies, there is currently no effective therapeutic strategy targeting older patients with severe sepsis. The disparity between clinical and basic studies is a problem, and this is largely due to the use of animal models lacking clinical relevance. Although the majority of sepsis cases occur in older adults, most laboratory animals used for sepsis research are very young. Further, despite the wide use of combination fluid and antibiotic treatment in intensive care unit (ICU) patients, most animal research does not include such treatment. Future Directions: Because sepsis is a systemic disease with multiple organ dysfunction, combined therapy approaches, not those targeting single pathways or single organs, are essential. As for preclinical research, it is critical to confirm new findings using aged animal models with clinically relevant ICU-like medical treatments. Antioxid. Redox Signal. 35, 1358-1375.
Collapse
Affiliation(s)
- Meagan S. Kingren
- Aging and Critical Care Research Laboratory, Departments of University of Kentucky, Lexington, Kentucky, USA
- Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, Kentucky, USA
| | - Marlene E. Starr
- Aging and Critical Care Research Laboratory, Departments of University of Kentucky, Lexington, Kentucky, USA
- Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, Kentucky, USA
- Surgery, University of Kentucky, Lexington, Kentucky, USA
| | - Hiroshi Saito
- Aging and Critical Care Research Laboratory, Departments of University of Kentucky, Lexington, Kentucky, USA
- Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, Kentucky, USA
- Surgery, University of Kentucky, Lexington, Kentucky, USA
- Physiology, University of Kentucky, Lexington, Kentucky, USA
| |
Collapse
|
29
|
D'Amore S, Kumar N, Ramaswami U. Jaw involvement in Gaucher disease: a not-so-uncommon feature of a rare disease. BMJ Case Rep 2021; 14:e244298. [PMID: 34785512 PMCID: PMC8596049 DOI: 10.1136/bcr-2021-244298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2021] [Indexed: 11/04/2022] Open
Abstract
Gaucher disease is an inborn error of metabolism resulting from the deficiency of the enzyme glucocerebrosidase and consequent accumulation of glucocerebroside within the lysosomes of macrophages. The clinical presentation is very diverse, depending on the age of onset and the severity of the disease, and results from the progressive infiltration of lipid-laden cells in various organs. Common manifestations of Gaucher disease include enlarged liver and/or spleen (hepatosplenomegaly), bone marrow disease (pancytopenia) and bone abnormalities, which are extremely variable and can affect multiple skeletal sites. While bone involvement of long bones and vertebrae is a well-recognised feature of Gaucher disease, jawbone involvement is less commonly noted. Here, we describe a case of a 63-year-old patient with type 1 Gaucher disease with a history of long-term use of bisphosphonates and who had presented with dental pain, with subsequent investigations confirming the radiological features of jaw involvement in Gaucher disease, including periodontal disease.
Collapse
Affiliation(s)
- Simona D'Amore
- Lysosomal Storage Disorders Unit, Royal Free London NHS Foundation Trust, London, UK
| | - Navdeep Kumar
- Special Care Dentistry, University College London Hospitals NHS Foundation Trust, London, UK
| | - Uma Ramaswami
- Lysosomal Storage Disorders Unit, Royal Free London NHS Foundation Trust, London, UK
| |
Collapse
|
30
|
Akhiwu BI, Akhiwu HO, Mudashiru TO, Ijehon B, Aderemi AA, Bwala LZ, Ambrose E, Sani MI, Dauda AM, Okafor EU, Chimbueze E, Ladeinde AL. Quackery as a Cause of Maxillofacial Infections and Its Implications. JOURNAL OF THE WEST AFRICAN COLLEGE OF SURGEONS 2021; 11:24-28. [PMID: 36132970 PMCID: PMC9484503 DOI: 10.4103/jwas.jwas_47_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 03/30/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND In recent times, the prevalence of quackery in oral and maxillofacial practice has become rampant with complications, one of which is odontogenic infections. This study was aimed to identify how common quackery is among our patients with odontogenic infections and the outcome of the patients. MATERIALS AND METHODS The study was a descriptive cross-sectional study of all patients presenting with odontogenic infections seen at the accident and emergency unit and the oral and maxillofacial surgery clinics of a tertiary hospital in North Central Nigeria from January 2017 to December 2021. Information obtained included sociodemographic characteristics, presenting complaints, duration of illness, prehospital care, diagnosis, duration of hospital stay, where the patient was first managed, what is the "doctor/dentist" status, and outcome. RESULTS A total of 237 patients were recruited with a male to female ratio of 1:1.3. The commonest presenting complaints were toothache and jaw swelling with patients been ill for up to 2 weeks before presenting. About 41.8% of the patients have a co-existing health condition, and 46.4% of the patients had tooth extraction by a quack, with 82.7% taking antibiotics prescribed by a chemist before presentation. About 11.0% of the patients died; 96.2% of those that died had their tooth extracted by quacks. Patients with preexisting health conditions and preadmission tooth extraction were more likely to die with odds ratio (OR) = 2.230; 95% confidence interval (CI) = 1.06-4.71 and OR = 28.9; 95% CI = 3.97-209.6, respectively. CONCLUSION Quackery is very common in our society. The odds of death are increased in patients with odontogenic infection if the patient has a preexisting health condition and even more significant if they had their tooth extracted by quacks.
Collapse
Affiliation(s)
- BI Akhiwu
- Oral and Maxillofacial Surgery Department, Faculty of Dental Sciences, University of Jos/Jos University Teaching Hospital, Jos, Plateau State, Nigeria
| | - HO Akhiwu
- Department of Paediatrics, Jos University Teaching Hospital, Jos, Plateau State, Nigeria
| | - TO Mudashiru
- Dental and Maxillofacial Surgery Department, Jos University Teaching Hospital, Jos, Plateau State, Nigeria
| | - B Ijehon
- Dental and Maxillofacial Surgery Department, Jos University Teaching Hospital, Jos, Plateau State, Nigeria
| | - AA Aderemi
- Dental and Maxillofacial Surgery Department, Jos University Teaching Hospital, Jos, Plateau State, Nigeria
| | - LZ Bwala
- Dental and Maxillofacial Surgery Department, Jos University Teaching Hospital, Jos, Plateau State, Nigeria
| | - E Ambrose
- Dental and Maxillofacial Surgery Department, Jos University Teaching Hospital, Jos, Plateau State, Nigeria
| | - MI Sani
- Dental and Maxillofacial Surgery Department, Jos University Teaching Hospital, Jos, Plateau State, Nigeria
| | - AM Dauda
- Dental and Maxillofacial Surgery Department, Jos University Teaching Hospital, Jos, Plateau State, Nigeria
| | - EU Okafor
- Dental and Maxillofacial Surgery Department, Jos University Teaching Hospital, Jos, Plateau State, Nigeria
| | - E Chimbueze
- Dental and Maxillofacial Surgery Department, Jos University Teaching Hospital, Jos, Plateau State, Nigeria
| | - AL Ladeinde
- Oral and Maxillofacial Surgery Department, College of Medicine, University of Lagos/University of Jos, Jos, Plateau State, Nigeria
| |
Collapse
|
31
|
Multiple Brain Abscesses of Odontogenic Origin. May Oral Microbiota Affect Their Development? A Review of the Current Literature. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11083316] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
In the last few years, the role of oral microbiota in the setting of oral diseases such as caries, periodontal disease, oral cancer and systemic infections, including rheumatoid arthritis, cardiovascular disease and brain abscess (BA), has attracted the attention of physicians and researchers. Approximately 5–7% of all BAs have an odontogenic origin, representing an important pathological systemic condition with a high morbidity and mortality. A systematic search of two databases (Pubmed and Ovid EMBASE) was performed for studies published up to 5 January 2021, reporting multiple BAs attributed to an odontogenic origin. According to PRISMA guidelines, we included a total of 16 papers reporting multiple BAs due to odontogenic infections. The aim of this review is to investigate the treatment modality and the clinical outcome of patients with multiple BAs due to odontogenic infections, as well as to identify the most common pathogens involved in this pathological status and their role, in the oral microbiota, in the onset of oral infections. A multidisciplinary approach is essential in the management of multiple BAs. Further studies are required to understand better the role of microbiota in the development of multiple BAs.
Collapse
|
32
|
Three things. Br Dent J 2020; 229:701. [DOI: 10.1038/s41415-020-2464-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
33
|
Tips for odontogenic infections. Br Dent J 2020; 229:760-761. [DOI: 10.1038/s41415-020-2516-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
34
|
Cousin GC, Yousaf I. Ludwig's angina: infected teeth must be extracted. BMJ 2020; 371:m4466. [PMID: 33208308 DOI: 10.1136/bmj.m4466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Gary C Cousin
- Royal Blackburn Teaching Hospital, Blackburn BB2 3LR, UK
| | - Imran Yousaf
- Royal Blackburn Teaching Hospital, Blackburn BB2 3LR, UK
| |
Collapse
|