BACKGROUND: Whether in neurology or dentistry, odontogenic brain abscess stands as an ailment demanding undivided attention. The onset of this disease is insidious, with a relatively low incidence rate but a markedly high fatality rate. Moreover, its symptoms lack specificity, easily leading to misdiagnosis, oversight, and treatment delays. Hence, clinicians should maintain heightened vigilance when faced with pathogenic bacteria of dental origin in patients.
METHODS: This paper encapsulates the latest research findings on the clinical manifestations and essential treatment points of odontogenic brain abscess. It may offer a crucial reference for prompt diagnosis and improved therapeutic approaches.
CONCLUSIONS: Odontogenic brain abscess, an infection of the cerebral parenchyma, usually appears in immunocompromised patients with dental ailments or postdental surgeries. The main pathogenic microorganisms include Streptococcus intermedius, Fusobacterium nucleatum, Streptococcus anginosus, and Millerella. Given the undetectable and nonspecific symptoms in patients, the diagnostic process relies on microbiological methods. Therefore, clinicians should actively investigate and identify the pathogenic microorganisms of odontogenic brain abscess for early detection and selection of appropriate treatment regimens to avoid disease management delays.

OBJECTIVE: Primordial odontogenic tumor is a rare odontogenic tumor reported for the first time in 2014. It was included in the latest edition of World Health Organization classification of Head and Neck Tumors as a new benign mixed epithelial-mesenchymal neoplasm. To date, 26 cases has been reported in literature. The aim of this study was to determine the possible presence of primordial odontogenic tumor in the previously diagnosed cases with myxoid stroma.
METHODS: This study was a retrospective descriptive study that was concluded in Oral and Maxillofacial Pathology Department, School of Dentistry, Tehran University of Medical Sciences. We reviewed all 19,380 cases from 19,66 to find the lesions with myxoid stroma which were in differential diagnosis with primordial odontogenic tumor. These cases should be associated with an impacted or unerupted tooth and belong to the patients under 20 years old.
RESULTS: We find 503 pericoronal lesions with myxoid stroma. Three cases were isolated after recut and reevaluation for finding fulfill histologic features. After immunohistochemical analysis, we find a new case of developing primordial odontogenic tumor associated with odontoma.
CONCLUSIONS: Primordial odontogenic tumor a recently described odontogenic tumor has a well-defined clinicopathological and immunohistochemical profile and should be differentiated from the others pericoronal lesions. It is the first time that this archival review has been done to find probable cases of primordial odontogenic tumor.

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.

Tetanus is an acute and vaccine-preventable disease caused by anaerobic bacteria, Clostridium tetani. This bacterium can enter the human body via a deep wound, burn injury or medical procedure; however, certain cases also originate from odontogenic infection. In the present study, a tetanus infection associated with dental origin in a 44-year-old man is reported. The case was complicated by lockjaw and difficulty swallowing that worsened over a few days, followed by a generalized spasm. Furthermore, a literature review was performed, in which six reported cases of tetanus, presumed to be of dental or oral origin, were identified between 2011and 2021. General practitioners, especially dentists, should be aware of tetanus associated with odontogenic origin even without a history of an external penetrating wound or other medical procedures:.

Ameloblastic carcinoma is a rare malignant neoplasm arising from the odontogenic epithelium. Ameloblastic carcinoma commonly occurs de novo affecting the posterior segments of the mandible. Presently, only less than 100 cases have been reported arising from the maxilla. We report a unique case of maxillary ameloblastic carcinoma in a 68-year-old male with a 5.6 cm positron emission tomography (PET) avid left maxillary sinus mass. The patient underwent a left maxillectomy which revealed hyperchromatic and pleomorphic tumor cells arranged in a nested and trabecular architecture. The tumor cells showed distinct peripheral palisading with reverse polarization. Areas of bone destruction, necrosis, lymphovascular and perineural invasions, as well as atypical mitoses, were identified. Immunohistochemically, the tumor cells were positive for keratin cocktail (AE1/AE3 and CAM 5.2), keratin 19, p40, and weakly positive for MDM2, while negative for calretinin. Molecular analysis revealed wild-type BRAF; however, alterations in CDKN2A/B, MTAP, RB1, SMARCA4, STK11, FGF12, SETD2, and TP53 were present. This histopathologic and molecular profile supported the diagnosis of ameloblastic carcinoma. There has been no evidence of disease recurrence or metastasis eleven months after the initial diagnosis.

Ameloblastoma is a benign epithelial odontogenic tumor with the capacity to aggressively invade the surrounding bone. Surgical removal of the tumor can result in extended disease-free interval (cure). However, controversy surrounds the most appropriate surgical margin required to prevent local recurrence while simultaneously minimizing morbidity. En bloc excisional surgery carries the risk of major complications such as mandibular drift, hemorrhage, and oronasal fistula formation. Conservative therapy without a safety margin reduces potential morbidity but is likely to result in local recurrence. No reliable rate, nor time to recurrence, is documented but may be as high as 91% with conservative therapy. Conversely, surgery with a 10- to 20-mm margin is associated with a 0-4.6% recurrence rate. There is no documented difference in the recurrence rate with a 10- vs. 20-mm margin. The correlation of the histologic margin with the recurrence rate following excisional surgery has not determined a required histologic safety margin. Rather, no local recurrence occurs despite narrow or incomplete margins. Thus, pathologic margins > 0 mm may be sufficient to prevent local recurrence or recurrence may be protracted. Accordingly, a narrow (5-10 mm) gross surgical margin may be the most appropriate. Additional research is required for confirmation, and only level 4 evidence on safety margins has been achieved thus far. Future work should focus on defining the extension of neoplastic cells past the demarcation of ameloblastoma on variable diagnostic imaging modalities as well as determining the recurrence rate with various surgical and histologic safety margins.

UNASSIGNED: The AOT is an atypical tumor of odontogenic origin that comprises about 0.1% of jaw tumors and cysts as well as up to 3% of odontogenic tumors (OTs).
UNASSIGNED: This review describes the clinical, radiographical, histopathological, and immunohistochemical properties of adenomatoid odontogenic tumor (AOT) and reports an occurrence of an AOT in a boy, 13 years of age.
UNASSIGNED: A male, 13 years of age, presented with a swelling with respect to the left maxilla, painless, and with obvious facial asymmetry. The orthopantomogram and computed tomography scan revealed a large unilocular radiolucency in the left maxilla with permanent lateral incisor embedded within the lesion and permanent canine pushed away from its normal position. After complete enucleation of the cyst under local anesthesia and extraction of associated impacted permanent teeth and retained deciduous teeth related to the lesion, the defect was filled with a bone graft and closed. Postoperative follow-up was uneventful.
UNASSIGNED: An accurate diagnosis should be established through clinical, radiographical, and pathological correlations in order to be able to differentiate AOT from other conditions for early diagnosis.
UNASSIGNED: This report highlights the salient features of the AOT to be able to correctly diagnose and manage the lesion.
UNASSIGNED: Kamble A, Shimpi MR, Dash JK, et al. Adenomatoid Odontogenic Tumor of the Maxilla in a 13-year-old Patient: A Rare Case Report with a Review of Literature. Int J Clin Pediatr Dent 2021;14(4):596-600.

Concerns regarding increasing antibiotic resistance raise the question of the most appropriate oral antibiotic for empirical therapy in dentistry. The aim of this systematic review was to investigate the antibiotic choices and regimens used to manage acute dentoalveolar infections and their clinical outcomes. A systematic review was undertaken across three databases. Two authors independently screened and quality-assessed the included studies and extracted the antibiotic regimens used and the clinical outcomes. Searches identified 2994 studies, and after screening and quality assessment, 8 studies were included. In addition to incision and drainage, the antibiotics used to manage dentoalveolar infections included amoxicillin, amoxicillin/clavulanic acid, cefalexin, clindamycin, erythromycin, metronidazole, moxifloxacin, ornidazole and phenoxymethylpenicillin. Regimens varied in dose, frequency and duration. The vast majority of regimens showed clinical success. One study showed that patients who did not receive any antibiotics had the same clinical outcomes as patients who received broad-spectrum antibiotics. The ideal choice, regimen and spectrum of empirical oral antibiotics as adjunctive management of acute dentoalveolar infections are unclear. Given that all regimens showed clinical success, broad-spectrum antibiotics as first-line empirical therapy are unnecessary. Narrow-spectrum agents appear to be as effective in an otherwise healthy individual. This review highlights the effectiveness of dental treatment to address the source of infection as being the primary factor in the successful management of dentoalveolar abscesses. Furthermore, the role of antibiotics is questioned in primary space odontogenic infections, if drainage can be established.

UNASSIGNED: Oro-facial fascial space infection is known to be a clinical presentation of neglected dental care. The proportion of children with dental sepsis has also been known to increase markedly with caries experience. Such fascial space infection in the paediatric age group is known to progress rapidly within a short period and is thus potentially more fatal than in the adult population.
UNASSIGNED: This study aimed to document and evaluate the pattern of oro-facial fascial space infection amongst paediatric Gambian population.
UNASSIGNED: The study was a 4-year descriptive retrospective survey of all patients with oro-facial fascial space infection seen and managed at the dental unit of the polyclinic attached to the Edward Francis Small Teaching Hospital in Banjul, The Gambia from May 2015 to April 2019. The information collated were patients\' sociodemographic data as well as clinical features related to their medical and dental condition. The extracted data were analyzed using Statistical Package for Social Sciences (SPSS) version 15.0 (SPSS Inc, Chicago, IL). Absolute numbers and simple percentages were used to describe categorical variables. Quantitative variables were described using mean (with standard deviation), median and range. Categorical variables were compared using chi square test and numeric variables compared using student t-test. Differences were considered significant if p<0.05.
UNASSIGNED: A total of 322 patients with oro-facial fascial space infection were managed within the period of the study out of whom 93 patients that met the inclusion criteria were studied. Their ages ranged from 3 months to 16 years, with a mean age of 8.5(SD2.1) years. There were 54 males and 39 females with a gender (M: F) ratio of 1.4: 1. All the patients presented with painful facial swelling and fever. Eighty-one (87.1%) had a history of toothache. The median number of fascial space involvement was 1 space; the submandibular space was involved unilaterally in 43 (46.2%) and bilaterally in 8 patients (8.6%). Eighty-one (87.1%) were odontogenic in origin and 12 (12.9%) were non-odontogenic. Seventy-two (88.89%) of odontogenic cases involved posterior teeth and 45 (62.5%) of these were the first permanent molars. Incision and decompression and teeth extraction were done for all the odontogenic cases. Staphylococci and/or streptococci were cultured from six patients. All the patients had inpatient treatment with a combination of intravenous amoxicillin, metronidazole and gentamicin treatment. Mortality rate was 5.4% (5 out of 93) and the mean age of patients who died, 3.0 (SD0.3) years, was significantly lower than that of those who survived, 8.3 (SD1.4) years, (p<0.0001).
UNASSIGNED: The commonest symptoms of oro-facial fascial space infection in the Gambian paediatric population were fever, facial swelling and toothache. Most of the infections were odontogenic and affected most commonly the submandibular space. Posterior teeth were more commonly involved than the anterior, with the first permanent molar being the most commonly affected tooth. Incision and decompression were performed in all odontogenic cases, with extraction of all culprit teeth. All patients had in-patient treatment with intravenous amoxicillin, metronidazole and gentamicin. The mortality rate was 5.4%. The burden of dental caries with its complications is huge in the paediatric population of the Gambia. Training of dental surgeons and specialists and their auxiliaries with advocacy on the need for regular dental checkup for children, as well as prompt attention to dental diseases will help to reduce this scourge.

Primordial odontogenic tumor (POT) is a recently designated benign mixed epithelial and mesenchymal odontogenic tumor and only sixteen cases have been reported worldwide till now. Here we report an another case of POT in a 14-year old boy who presented with an asymptomatic buccal enlargement in the right maxillary region for past 4-5 months. A well-defined, unilocular, radiolucent lesion with impacted teeth was observed radiographically. A detailed account of clinico-radiographical and histolological differential diagnoses along with an updated literature review has been presented.