Odontogenic infection

牙源性感染
  • 文章类型: Case Reports
    由牙齿问题引起的牙源性和口面部感染并不常见,但会引起严重的并发症。早期干预对于防止严重后果至关重要,包括颈深间隙感染和可能危及生命的并发症。怀孕会导致荷尔蒙的变化,引起生理和口腔改变。这些变化影响牙龈血管系统,免疫反应,化学成分,pH值,和牙龈下的植物群。由于母亲和胎儿的潜在风险,在怀孕期间管理严重的颈部感染具有挑战性。及时治疗对于避免诸如气道阻塞和相关的紧急气管造口术的需要至关重要。怀孕也会导致早产等并发症,低出生体重,孕产妇或胎儿死亡率。
    方法:一名28岁孕妇到大学教学医院口腔颌面外科门诊就诊,主诉面部右下侧肿胀,张口减少。经临床检查,诊断为下颌下及翼状体间隙感染,主要原因是47。考虑到患者的严重程度,建议在全身麻醉下进行切口和引流。
    孕妇未经治疗的蛀牙会发展为面部空间感染,并危及生命。在紧急情况下,在全身麻醉下可能需要切开和引流,以防止严重的并发症。
    结论:这种综合方法不仅有效地解决了牙源性感染,而且确保了母亲和发育中胎儿的健康。体现了定制护理在管理有牙科问题的孕妇中的重要性。
    UNASSIGNED: Odontogenic and orofacial infections resulting from dental issues are uncommon but cause significant complications. Early intervention is crucial to prevent severe consequences, including deep neck space infections and potentially life-threatening complications. Pregnancy leads to hormonal changes, causing physiological and oral cavity alterations. These changes affect in gingival vascular system, immune response, chemical composition, pH levels, and sub-gingival flora. Managing severe neck infections during pregnancy is challenging due to potential risks for both the mother and fetus. Prompt treatment is essential to avoid complications such as airway obstruction and the associated need for emergency tracheostomy. Pregnancy can also lead to complications like preterm delivery, low birth weight, and maternal or fetal mortality.
    METHODS: A 28 year old pregnant female reported to university teaching hospital to outpatient department of oral and maxillofacial surgery, with complaint of swelling over lower right side of face and reduced mouth opening. On clinical examination it was diagnosed as sub mandibular and pterygoid space infection, primary cause being 47. Looking at the severity patient was advised for incision and drainage under general anesthesia after getting a fitness.
    UNASSIGNED: Untreated dental decay in pregnant women can progress to facial space infections with life-threatening consequences. In emergencies, incision and drainage may be necessary under general anesthesia to prevent severe complications.
    CONCLUSIONS: This comprehensive approach not only addressed the odontogenic infection effectively but also ensured the well-being of both the mother and the developing foetus, exemplifying the importance of tailored care in managing pregnant individuals with dental concerns.
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  • 文章类型: Case Reports
    Lemierre综合征是咽炎的一种罕见且严重的并发症,估计全球每年发病率为100,000人中的1人。其特征是颈内静脉化脓性血栓性静脉炎伴转移性感染,通常在口咽感染后。据报道,罕见的Lemierre综合征病例是由牙源性感染引起的。
    一名33岁的男性因发烧和咽喉痛的症状来我院就诊16天。其他症状包括左颈部和肩部疼痛。此外,代谢综合征是根据腰围诊断的,糖尿病,和高脂血症。使用宏基因组下一代测序(mNGS)技术检测坏死梭杆菌。增强的计算机断层扫描(CT)扫描显示左近端颈静脉和头臂静脉血栓形成。基于这些观察,诊断为Lemierre综合征。病因是在发病前约2周,根管牙齿中的填充物丢失,没有血液或疼痛。患者在抗生素和血液净化治疗后恢复。
    应评估发烧患者的Lemierre综合征,喉咙痛,颈部疼痛。如果根管治疗的填充物丢失,尤其是那些患有代谢综合征的人,我们应该意识到这种疾病的可能性。此外,mNGS检测可作为发热不确定患者的重要辅助诊断工具.
    UNASSIGNED: Lemierre\'s syndrome is a rare and serious complication of pharyngitis with an estimated annual incidence of 1 in 100,000 people worldwide. It is characterized by septic thrombophlebitis of the internal jugular vein with metastatic infection, usually after oropharyngeal infection. Rare cases of Lemierre\'s syndrome have been reported to be caused by odontogenic infection.
    UNASSIGNED: A 33-year-old male visited our hospital with symptoms of fever and sore throat for 16 days. The other symptoms included pain in his left neck and shoulder. In addition, metabolic syndrome was diagnosed based on waist circumference, diabetes, and hyperlipidemia. Fusobacterium necrophorum bacteria was detected using the metagenomic next-generation sequencing (mNGS) technique. The enhanced computerized tomography (CT) scan showed thrombosis of the left proximal jugular vein and brachiocephalic vein. Based on these observations, Lemierre\'s syndrome was diagnosed. The etiology was that the fillings in the root canal tooth were lost with no blood or pain about 2 weeks before the onset. The patient recovered after treatment with antibiotics and blood purification.
    UNASSIGNED: Lemierre\'s syndrome should be evaluated for patients with fever, sore throat, and neck pain. If the loss of fillings from root canal therapy occurs, especially for those with metabolic syndrome, we should be aware of the possibility of this disease. Furthermore, the mNGS test can be used as a crucial supplementary diagnostic tool for patients with undetermined fever.
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  • 文章类型: Case Reports
    结核病(TB),也被称为科赫病,是一种通常由结核分枝杆菌引起的慢性肉芽肿病(M.结核病)。1882年3月24日,罗伯特·科赫博士发现了引起结核病的结核分枝杆菌。在人类中,牛分枝杆菌和非典型分枝杆菌也可能引起这种疾病。根据2022年10月27日发布的世界卫生组织(WHO)《2022年全球报告》,印度2022年的结核病发病率为210/100,000人口。首先,结核病影响人类的肺部区域,而其次,它可能通过淋巴结影响肺外部位,如骨骼和肠道。在这篇文章中,我们报道了一例罕见的下颌骨结核性骨髓炎,患者报告脸颊肿胀,模仿导致下颌骨骨髓炎的牙源性感染。当在下颌骨的手术清创术和刮除术中发现俗气的材料时,通过基于盒式的核酸扩增测试(CB-NAAT)对结核性骨髓炎进行了明确的诊断。在这个诊断之后,患者立即开始抗结核治疗(ATT),这导致了疾病的完全解决。在过去的六个月中,患者一直在定期随访,没有疾病复发的证据。下颌骨的原发性结核病非常罕见,文献中只有少数报道的病例。
    汗马,RahmanSA,丹麦语M,etal.一例5岁儿童下颌骨结核性骨髓炎的罕见病例。IntJClinPediatrDent2024;17(2):202-205。
    Tuberculosis (TB), also known as Koch\'s disease, is a chronic granulomatous disease typically caused by Mycobacterium tuberculosis (M. tuberculosis). On 24th March 1882, Dr Robert Koch discovered M. tuberculosis that caused TB. In humans, M. bovis and atypical mycobacterium may also cause this disease. According to the World Health Organization (WHO) Global Report 2022, published on 27th October 2022, the incidence of TB in India for the year 2022 is 210/100,000 population. Primarily, TB affects the pulmonary region in humans, whereas secondarily, it may affect extrapulmonary sites such as the bones and intestines via lymph nodes. In this article, we are reporting a rare case of tubercular osteomyelitis of the mandible, in which the patient reported swelling of the cheek, mimicking an odontogenic infection that led to mandibular osteomyelitis. The definitive diagnosis of tubercular osteomyelitis was made by cartridge-based nucleic acid amplification test (CB-NAAT) when the cheesy material was found during surgical debridement and curettage of the mandible. Following that diagnosis, antitubercular treatment (ATT) was started immediately for the patient, which led to the complete resolution of the disease. The patient has been on regular follow-up for the last six months with no evidence of relapse of disease. Primary TB of the mandible is very rare, with only a few reported cases in the literature.
    UNASSIGNED: Khan MA, Rahman SA, Danish M, et al. A Rare Case of Tubercular Osteomyelitis of Mandible in a 5-year-old Child. Int J Clin Pediatr Dent 2024;17(2):202-205.
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  • 文章类型: Case Reports
    嗜麦芽窄食单胞菌可在免疫功能正常的患者中引起罕见的牙源性脑脓肿,强调在中枢神经系统感染中考虑罕见病原体的重要性。仅报告了三例由这种微生物引起的脑脓肿和一例垂体脓肿,量身定制的诊断方法和个体化治疗方案对于准确管理至关重要.
    脑脓肿提出了诊断和治疗挑战,嗜麦芽窄食单胞菌感染在中枢神经系统中非常罕见。我们介绍了一个有免疫能力的患者中由嗜麦芽嗜血杆菌引起的牙源性脑脓肿的病例,强调这种感染的稀有性和复杂性。一名66岁的男性表现为时空定向障碍和左侧无力。放射学检查显示右后额区有扩张性病变。进行了开颅手术和引流,鉴定脓性物质中的嗜麦芽链球菌。患者对定制的抗生素治疗反应良好。嗜麦芽窄食链球菌相关的中枢神经系统感染很少见,强调在非典型病例中需要加强临床怀疑。这个案例有助于文献,强调多学科方法对成功诊断和管理的重要性。
    UNASSIGNED: Stenotrophomonas maltophilia can cause rare odontogenic brain abscesses in immunocompetent patients, highlighting the importance of considering uncommon pathogens in central nervous system infections. With only three reported cases of cerebral abscesses and one pituitary abscess caused by this microorganism, tailored diagnostic methods and individualized treatment regimens are crucial for accurate management.
    UNASSIGNED: Brain abscesses present diagnostic and therapeutic challenges, with Stenotrophomonas maltophilia infections being exceptionally rare in the central nervous system. We present a case of odontogenic brain abscesses caused by S. maltophilia in an immunocompetent patient, highlighting the rarity and complexity of such infections. A 66-year-old male presented with spatial-temporal disorientation and left-sided weakness. Radiological investigations revealed an expansive lesion in the right posterior frontal region. A craniotomy and drainage were performed, identifying S. maltophilia in the purulent material. The patient responded well to tailored antibiotic therapy. S. maltophilia-related central nervous system infections are infrequent, emphasizing the need for a heightened clinical suspicion in atypical cases. This case contributes to the literature, emphasizing the importance of a multidisciplinary approach for successful diagnosis and management.
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  • 文章类型: Journal Article
    本次临床审计的目的是评估需要住院治疗的牙科感染的特征,这可能有助于改善预防和管理政策。这项研究回顾性评估了Nepean医院收治的患者的记录,Kingswood,新南威尔士州,澳大利亚,由于2018年至2019年之间的牙科感染。共有102名患者,大多在30多岁,性别分布平等,因牙齿感染入院,出现疼痛(100%),肿胀(99%),三联子(40.2%),吞咽困难(27.4%),发烧(21%)[>37°C],心动过速(24.8%)和呼吸急促(9.3%)。大多数患者(68%)在周末就诊,在正常工作时间之外,和公众假期。共有52.5%的患者曾服用过抗生素。龋齿,吸烟,心理健康问题,非法药物使用的特征强烈。大多数患者(56.4%)在局部麻醉下接受治疗。住院总时间为271天(平均2.7,SD1.6)。Augmentin是处方最多的抗生素。8.8%的患者报告有并发症,主要是由于气道受损。导致住院治疗的牙科感染仍然是医疗保健系统的负担。一个值得注意的发现是演讲主要是在周末,在正常工作时间之外,和公众假期,大多数人需要在局部麻醉下进行牙科干预。提供随叫随到的紧急牙科服务可以减少潜在的可预防的住院治疗和住院时间。
    The aim of this clinical audit is to evaluate the characteristics of dental infections requiring hospitalisations, which may help improve preventative and management policies. This study retrospectively evaluated the records of patients admitted to the Nepean hospital, Kingswood, New South Wales, Australia, due to dental infections between 2018 and 2019. A total of 102 patients, mostly in their thirties with equal gender distribution, were admitted with dental infections, presenting with pain (100%), swelling (99%), trismus (40.2%), dysphagia (27.4%), fever (21%) [>37 °C], tachycardia (24.8%) and tachypnoea (9.3%). Most patients (68%) presented on weekends, outside regular working hours, and public holidays. A total of 52.5% of patients had taken prior antibiotics. Dental caries, smoking, mental health issues, and illicit drug use were featured strongly. The majority of patients (56.4%) underwent treatment under local anaesthesia. The total length of hospital stay was 271 days (mean 2.7, SD 1.6). Augmentin was the most prescribed antibiotic. Complications were reported in 8.8% of the patients, primarily due to airway compromise. Dental infections leading to hospitalisations continue to be a burden on the healthcare system. A notable finding was that the presentations were primarily on weekends, outside regular working hours, and public holidays, and the majority required dental interventions under local anaesthesia. The provision of on-call emergency dental services may reduce potentially preventable hospitalisations and the length of hospital stay.
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  • 文章类型: Journal Article
    上颌窦病理,特别是它与牙源性感染的关系,是牙科的一个重要问题。这项回顾性研究探讨了沙特阿拉伯上颌窦病变的患病率及其与牙源性感染的关系。
    这项回顾性研究包括411名年龄在20-80岁的患者。进行锥形束计算机断层扫描以识别存在,location,以及牙源性感染和上颌窦病理的特征。同时记录患者的年龄和性别。
    鼻窦炎在50.6%的病例中普遍存在,病理分布无明显性别或年龄差异。发现牙源性病变和鼻窦病变之间存在显着关联,尤其是在左边。
    鼻窦病变的患病率很高,尤其是鼻窦炎,被观察到,牙源性和鼻窦病变之间的联系,尤其是在左边。在承认这项研究的局限性的同时,这些发现强调了牙齿和鼻窦健康综合评估的必要性.
    UNASSIGNED: Maxillary sinus pathology, particularly its association with odontogenic infections, is a significant concern in dentistry. This retrospective study explored the prevalence of maxillary sinus pathologies and their association with odontogenic infections in Saudi Arabia.
    UNASSIGNED: This retrospective study included 411 patients aged 20-80 years. Cone-beam computed tomography was performed to identify the presence, location, and characteristics of odontogenic infections and maxillary sinus pathologies. Patients\' age and sex were also recorded.
    UNASSIGNED: Sinusitis was prevalent in 50.6 % of the cases, with no significant sex or age differences in the pathology distribution. A notable association was found between odontogenic and sinus pathologies, particularly on the left side.
    UNASSIGNED: A significant prevalence of sinus pathologies, particularly sinusitis, was observed, with an association between odontogenic and sinus pathologies, notably on the left side. While acknowledging the limitations of the study, these findings underscore the need for integrated dental and sinus health assessments.
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    文章类型: Journal Article
    关于CRP水平与牙源性感染之间关系的研究似乎是有限的。这项研究的目的是确定不同类型的牙源性感染之间的CPR水平差异。
    研究了所有连续诊断和治疗符合纳入标准的牙源性牙槽和筋膜间隙感染的患者。收集的数据是年龄,性别,烟草使用,酒精摄入量,和药物滥用。其他收集的数据是疼痛,刺耳,吞咽困难,滥用抗生素,预先存在的医疗状况,脉搏率,血压,呼吸频率,体温,白细胞,牙源性感染的类型,治疗类型,住院时间和C反应蛋白。所有分析均使用IBMSPSS21.0版(IBMCorp,纽约,美国)。P-值小于5%被认为是统计学上显著的。
    本研究共纳入44例患者,平均年龄为45.3±1.39岁,范围为10至60岁。与无疼痛史患者相比,有疼痛史阳性患者的C反应蛋白明显更高(P=0.01)。筋膜间隙感染患者的C反应蛋白水平高于牙槽炎患者,差异有统计学意义(P=0.02)。同样,与住院时间少于同日的患者相比,住院时间超过5天的患者的C反应蛋白为17.5mg/dl(P=0.03)。
    C反应蛋白的总平均值75.4±3.53mg/dl大于临界水平,而白细胞计数的9.62X109/L低于参考值。有疼痛的病人,牙源性感染后,筋膜间隙感染和在医院停留超过五天的C反应蛋白水平较高。
    UNASSIGNED: It appears that studies on the association between CRP levels and odontogenic infections are limited. The aim of this study is to determine the difference in CPR levels between the different types of odontogenic infections.
    UNASSIGNED: All consecutive patients that were diagnosed and treated for dentoalveolar and fascial space infections of odontogenic origin that met the inclusion criteria were studied. The data collected were age, gender, tobacco use, alcohol intake, and drug abuse. Other collected data were pain, trismus, dysphagia, antibiotics abuse, pre-existing medical condition, pulse rate, blood pressure, respiratory rate, body temperature, white blood cell, type of odontogenic infection, type of treatment, length of hospital stay and C-reactive protein. All analysis were done using IBM SPSS version 21.0 (IBM Corp, New York, USA). P- Value less than 5% was considered statistically significant.
    UNASSIGNED: A total of 44 patients with a mean age of 45.3±1.39 years ranging from 10 to 60 years were enrolled in this study. The C-reactive protein was significantly higher among patients with positive history of pain compared to those without pain (P = 0.01). The patients with fascial space infection had C-reactive protein levels higher than those with dentoalveolar infection and the difference in their means was statistically significant (P = 0.02). Likewise, the C-reactive protein was 17.5mg/dl significantly higher in the patients that stayed more than 5days in the hospital compared to those that stayed less than the same days(P = 0.03).
    UNASSIGNED: The total mean of C-reactive protein of 75.4±3.53 mg/dl was greater than the critical level while the 9.62 X 109/L of WBC counts was lower than that of the reference value. Patients that had pain, fascial space infection and stayed more than five days in the hospital had higher levels of C-reactive protein following odontogenic infections.
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  • 文章类型: Journal Article
    背景:牙源性上颌窦炎(OMS)在牙科和耳鼻咽喉科领域都得到了广泛认可。最近,医源性牙源性上颌窦炎可以经常遇到。这项研究的目的是通过比较CBCT和症状的术前和术后体积测量,评估使用小侧窗入路对牙源性上颌窦炎患者进行口内冲洗的效果。我们调查了2016年至2022年在PNUDH口腔颌面外科就诊的21例患者。所有患者的信息都是从电子数据库中提取的。包括随访时间为2个月或更长时间的患者。使用ImageJ程序(美国国立卫生研究院,威斯康星大学)。
    结果:在21例患者中,16人(76.1%)为男性,5名(23%)为女性。最常见的手术类型是全身麻醉(16例),其中7例有口窦瘘。在上颌窦炎的原因中,有七名植入物相关患者,五名拔牙患者,7名植骨患者,和其他组的两名患者。鼻窦冲洗后,射线照相不透明度降低了40.15%,尤其是在植骨和拔牙病例中。临床上,17例(80.9%)患者症状得到改善。
    结论:通过这项研究,可以得出结论,小侧窗入路上颌窦冲洗是临床和放射学上有效的治疗牙源性上颌窦炎的方法。
    BACKGROUND: Odontogenic maxillary sinusitis (OMS) is widely acknowledged in both the dentistry and otolaryngology fields. Recently, iatrogenic odontogenic maxillary sinusitis cases can be encountered frequently. The purpose of this study was to evaluate the effect of intraoral sinus irrigation using the small lateral window approach in patients with odontogenic maxillary sinusitis by comparing pre- and postoperative volumetric measurement of CBCT and symptoms. We surveyed 21 patients who visited the Oral and Maxillofacial Surgery Department at PNUDH from 2016 to 2022. All the patients\' information was extracted from an electronic database. The patients with a follow-up period of 2 months or more were included. The three-dimensional volumetric measurement was performed using the ImageJ program (National Institute of Health, University of Wisconsin).
    RESULTS: Among 21 patients, 16 (76.1%) were male, and 5 (23%) were female. The most common type of surgery was general anesthesia (16 cases) in which oroantral fistula was present in 7 cases. In the causes of maxillary sinusitis, there were seven implant-related patients, five patients of tooth extraction, seven patients of bone grafting, and two patients in other groups. Radiographic opacity decreased by 40.15% after sinus irrigation especially in bone graft and tooth extraction cases. Clinically, symptoms improved in 17 patients (80.9%).
    CONCLUSIONS: By this study, it can be concluded that maxillary sinus irrigation using the small lateral window approach is a clinically and radiologically effective treatment method for odontogenic maxillary sinusitis.
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  • 文章类型: Journal Article
    牙源性感染是由牙齿和周围牙周组织引起的广泛的头颈部疾病。这些基本上可以预防的感染不成比例地影响了少数民族和种族少数群体以及低收入/无保险群体的成员,并给我们的医疗保健系统带来巨大的成本。未经治疗,牙源性感染可以扩散到头颈部的深间隙,并可能导致危及生命的并发症。治疗的主要方法包括及时治疗受影响的牙齿。这些感染是全球公共卫生问题,随着获得常规牙科护理的机会增加,这种感染可能会减少。
    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.
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  • 文章类型: Journal Article
    牙齿发育和解剖结构的异常可能提示存在先天性或获得性异常。异常的检测,因此,是放射科医师要达到的一项重要技能。需要了解牙齿胚胎学知识和对成熟各个阶段牙齿的放射学表现的理解,才能了解异常的牙齿发育。虽然许多牙齿异常在专用牙科X光片上有很好的描述,例如,第一次遇到牙齿异常可能是放射科医师出于其他原因而进行的计算机断层扫描(CT)或磁共振(MR)检查。这篇文章描述了正常的牙齿解剖和发展,在CT和MRI上描述新生儿牙列的外观,临床放射科医生最常遇到的模式。回顾了放射学和牙科文献,我们机构的补充案例说明了关键概念。使用连续MR脑部检查的分析来研究牙齿发育知识的价值。最后,将解剖学原理应用于CT诊断牙源性感染。通过对文献和案例数据的分析,牙齿病理学与正常解剖和发育的对比有助于先天性和获得性牙齿疾病的检测和表征。
    Abnormalities of dental development and anatomy may suggest the presence of congenital or acquired anomalies. The detection of abnormalities, therefore, is an important skill for radiologists to achieve. Knowledge of dental embryology and an understanding of the radiologic appearances of teeth at various stages of maturation are required for the appreciation of abnormal dental development. While many tooth abnormalities are well-depicted on dedicated dental radiographs, the first encounter with a dental anomaly may be by a radiologist on a computed tomographic (CT) or magnetic resonance (MR) exam performed for other reasons. This article depicts normal dental anatomy and development, describing the appearance of the neonatal dentition on CT and MRI, the modalities most often encountered by clinical radiologists. The radiology and dental literature are reviewed, and key concepts are illustrated with supplemental cases from our institution. The value of knowledge of dental development is investigated using the analysis of consecutive MR brain examinations. Finally, the anatomical principles are applied to the diagnosis of odontogenic infection on CT. Through analysis of the literature and case data, the contrast of dental pathology with normal anatomy and development facilitates the detection and characterization of both congenital and acquired dental disease.
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