Abstract：
Dentoalveolar abscesses are localized infections within the tooth or the surrounding alveolar bone, often resulting from untreated dental caries or dental trauma causing alveolar bone resorption or even loss. Serious consequences arising from the spread of a dental abscess can often lead to significant morbidity and mortality. The acute dentoalveolar abscess is a polymicro-bial infection comprising strict anaerobes, such as anaerobic cocci i.e., Prevotella fusobacterium species, and facultative anaerobes i.e., Streptococci viridians and Streptococcus anginosus. Moreover, inappropriately managed dental infections can progress to severe submandibular space infections with associated serious complications, such as sepsis and airway obstruction. An audit of the Hull Royal Infirmary between 1999 and 2004 showed an increase in the number of patients presenting to oral and maxillofacial surgery services with dental sepsis. Thus, the scientific com-munity is forced to focus on treatment strategies for the management of dentoalveolar abscess (DAA) and other related dental problems. The current treatment includes antibiotic therapy, including β-lactams and non-β- lactams drugs, but it leads to the development of resistant micro-organisms due to improper and wide usage. Furthermore, the currently used β-lactam therapeutics is non-specific and easily hydrolyzed by the β-lactamase enzymes. Thus, the research focused on the non-β-lactams that can be the potential pharmacophore and helpful in the management of DAA, as the appropriate use and choice of antibiotics in dentistry plays an important role in antibiotic stewardship. The newer target for the choice is NLRP inflammasome, which is the major chemical mediator involved in dental problems. This review focused on pathogenesis and current therapeutics for the treatment of dentoalveolar abscesses.
摘要：
牙槽脓肿是牙齿或周围牙槽骨内的局部感染，通常是由于未经治疗的龋齿或牙齿创伤导致牙槽骨吸收甚至损失。由牙脓肿的传播引起的严重后果通常会导致显著的发病率和死亡率。急性牙槽脓肿是一种多微生物感染，包括严格的厌氧菌，如厌氧球菌，普氏梭菌物种，和兼性厌氧菌，即，弧菌链球菌和强肌链球菌。此外，不适当管理的牙齿感染可发展为严重的颌下间隙感染，并伴有严重的并发症。如败血症和气道阻塞。1999年至2004年对赫尔皇家医院的审计显示，接受口腔颌面外科服务的败血症患者人数有所增加。因此，科学界被迫将重点放在治疗牙槽骨脓肿(DAA)和其他相关牙科问题的治疗策略上.目前的治疗包括抗生素治疗，包括β-内酰胺类药物和非β-内酰胺类药物，但由于不适当和广泛的使用，它导致了抗性微生物的发展。此外，目前使用的β-内酰胺治疗剂是非特异性的并且容易被β-内酰胺酶水解。因此，该研究集中在非β-内酰胺类，它们可能是潜在的药效团，有助于DAA的管理，因为在牙科中适当使用和选择抗生素在抗生素管理中起着重要作用。选择的新目标是NLRP炎性体，这是涉及牙齿问题的主要化学介质。本文就牙槽炎的发病机制及治疗方法作一综述。
