Odontojenik Enfeksiyonlar

Odontojenik enfeksiyonlar oral ve maksillofasiyal bölgede en çok görülen hastalıklardan biridir. Bu enfeksiyonlar genellikle kendi kendini sınırlayan enfeksiyonlar olmakla birlikte, zaman zaman virülans organizmalarla ciddi veya potansiyel olarak ölümcül koşullara yol açabilen, oldukça tehlikeli durumlar meydana gelebilmektedir. Bu enfeksiyonların mortalite oranı % 10-40’dır. Günümüzde antibiyotiklerin kullanımıyla birlikte mortalite oranları önemli ölçüde azalmıştır. Bununla birlikte, ciddi morbidite ve fatalite görülmeye devam etmektedir. Enfeksiyon sebebiyle hava yolu açıklığının tehlikeye girdiği durumlarda, hava yolunu oluşturmak öncelikli tedavidir. Gerekirse uygun aerobik ve anaerobik duyarlılık için örnek alınabilir. Uygun antibiyotik kullanımı ve cerrahi drenaj tedavi için gereklidir. Derin fasiyal boşluklara yayılabilen odontojenik enfeksiyonların doğru ve etkili tedavisi için bölgenin anatomisine hakim olmak önemlidir. Bu derlemede odontojenik enfeksiyon türleri, mikrobiyolojisi, patolojisi, klinik özellikleri, yönetimi ve spesifik fasiyal alan enfeksiyonlarının sunulması amaçlanmıştır.

Anahtar Kelimeler:

Odontojenik enfeksiyon, apse, fasiyal alan

Odontogenic Infections

Odontogenic infections are one of the most common diseases in the oral and maxillofacial regions. These infections are usually self-limiting infections, sometimes dangerous situations can occur with virulent organisms that can lead to serious or potentially fatal conditions. These infections are associated with a 10-40 % mortality rate. Today, mortality rates have decreased significantly with the use of antibiotics. However, serious morbidity and fatality continues to occur. In cases where the airway clearance is compromised due to infection, creating an airway is the primary treatment. If necessary, specimen can be taken for appropriate aerobic and anaerobic sensitivity. Appropriate antibiotics and surgical drainage are required for treatment. It is important to be master the anatomy of the region for the correct and effective treatment of odontogenic infections that can spread into the deep facial spaces. In this review, it is aimed to present odontogenic infection types, microbiology, pathology, clinical features, management and specific facial spaces infections.

Keywords:

Odontogenic infection, abscess, fascial space,

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1. Zamiri B, Hashemi S B, Hashemi S H, Rafiee Z, Ehsani S. Prevalence of odontogenic deep head and neck spaces infection and its correlation with length of hospital stay. J Dent. 2012;13(1):29-35.
2. Ryan P, McMahon G. Severe dental infections in the emergency department. Eur J Emerg Med. 2012;19(4):208-213.
3. Seppänen L, Lauhio A, Lindqvist C, Suuronen R, Rautemaa R. Analysis of systemic and local odontogenic infection complications requiring hospital care. J Infect. 2008;57(2):116-122.
4. Reynolds SC, Chow AW. Life-threatening infections of the peripharyngeal and deep fascial spaces of the head and neck. Infect Dis Clin North Am. 2007;21:557-576.
5. Arias-Chamorro B, Contreras-Morillo M, Acosta-Moyano A, Ruiz-Delgado F, BermudoAñino L, Valiente-Álvarez A. Multiple odontogenic abscesses. Thoracic and abdomino-perineal extensión in an immuno competent patient. Med Oral Patol Oral Cir Bucal. 2011;16(6):772-775.
6. Jiménez Y, Bagán JV, Murillo J, Poveda R. Odontogenic infections. Complications. systemic manifestations. Med Oral Patol Oral Cir Bucal. 2004;9 Suppl:139-147.
7. Jundt JS, Gutta R. Characteristics and cost impact of severe odontogenic infections. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012;114(5):558-566.
8. Kumar Verma D, Rajan R. A case of thrombocytopenia due to odontogenic infection. J Dent Res Dent Clin Dent Prospect. 2011;5(4):144-147.
9. Barsamian JG, Scheffer RB. Spontaneous pneumothorax: an unusual occurrence in a patient with Ludwig’s angina. J Oral Maxillofac Surg. 1987;45(2):161-168.
10. Bahl R, Sandhu S, Singh K, Sahai N, Gupta M. Odontogenic infections: microbiology and management. Contemp Clin Dent. 2014;5(3):307-311.
11. Andersson L, Kahnberg KE, Pogrel M. Oral and maxillofacial surgery. West Sussex United Kingdom: Blackwell Publishing; 2010.
12. Rubin E FJ. Pathology. 3rd edition. Philadelphia PA: Lippincott-Raven Publishers; 1999.
13. Grossi SG, Zambon JJ, Ho AW, Koch G, Dunford RG, Machtei EE. Assessment of risk for periodontal disease risk indicators for attachment loss. J Periodontol. 1994;65(3):260-267.
14. Kornman KS. Diagnostic and prognostic tests for oral diseases: practical applications. J Dent Educ. 2005;69(5):498-508.
15. Kuo LC, Polson AM, Kang T. Associations between periodontal diseases and systemic diseases: a review of the inter-relationships and interactions with diabetes, respiratory diseases, cardiovascular diseases and osteoporosis. Pub Heal. 2008;122(4):417-433.
16. Kinane D, Bouchard P. Periodontal diseases and health: consensus report of the sixth European workshop on periodontology. J Clin Periodontol. 2008;15(8):333-337.
17. Moloney J, Stassen LFA. Pericoronitis: treatment and a clinical dilemma. J Ir Dent Assoc. 2009;55(4):190-192.
18. Schütz-Fransson U, Bjerklin K, Lindsten R. Long-term follow-up of orthodontically treated deep bite patients. European J Orthod. 2006;28(5):503-512.
19. Harrison JE, Ashby D. Orthodontic treatment for posterior crossbites. In: Cochrane Database of Systematic Reviews. 2001.
20. Kurol J, Bjerklin K. Ectopic eruption of maxillary first permanent molars: a review. J Dent Child . 1986;53(3):209-214.
21. Huber KL, Suri L, Taneja P. Eruption disturbances of the maxillary incisors: a literature review. J Clin Pediatr Dent. 2008;32(3):221-230.
22. Melsen B, Terp S. The influence of extractions caries cause on the development of malocclusion and need for orthodontic treatment. Swed Dent J. 1982;15:163-169.
23. O’Brien K, McComb JL, Fox N, Bearn D, Wright J. Do dentists refer orthodontic patients inappropriately. Br Dent J. 1996;181(4):132- 136.
24. Kuriyama T, Karasawa T, Nakagawa K, Saiki Y, Yamamoto E, Nakamura S. Bacteriologic features and antimicrobial susceptibility in isolates from orofacial odontogenic infections. Oral Surg Oral Med Oral Pathol Oral Radiol. 2000;90(5):600-608.
25. Dahlén G. Microbiology and treatment of dental abscesses and periodontal-endodontic lesions. Periodontol 2000. 2002;28(1):206- 239.
26. Stefanopoulos PK, Kolokotronis AE. The clinical significance of anaerobic bacteria in acute orofacial odontogenic infections. Oral Surg Oral Med Oral Pathol Oral Radiol. 2004;98(4):398-408.
27. Siqueira JF, Rôças IN. Treponema species associated with abscesses of endodontic origin. Oral Microbiol Immunol. 2004;19(5):336-309.
28. Robertson D, Smith AJ. The microbiology of the acute dental abscess. J Med Microbiol. 2009;58(2):155-162.
29. Sobottka I, Cachovan G, Stürenburg E, Ahlers MO, Laufs R, Platzer U. In vitro activity of moxifloxacin against bacteria isolated from odontogenic abscesses. Antimicrob Agents Chemoter. 2002;46(12):4019-4021.
30. Lewis MAO, Parkhurst CL, Douglas CWI, Martin M V, Absi EG, Bishop PA. Prevalence of penicillin resistant bacteria in acute suppurative oral infection. Antimicrob Agents Chemoter.1995;35(6):785-791.
31. Ogle OE. Odontogenic infections. Dent Clin North Am. 2017;61:235-252.
32. Sabiston CB, Gold WA. Anaerobic bacteria in oral infections. Oral Surg Oral Med Oral Pathol Oral Radiol. 1974;38(2):187-192.
33. Gilbert DN, Moellering RC Jr, Eliopoulos GM. Sanford guide to antimicrobial therapy. 39th Edition.
34. Haggerty CJ, Laughlin RM. Atlas of operative oral and maxillofacial surgery. Oxford United Kingdom: John Wiley & Sons; 2015.
35. Huang TT, Liu TC, Chen PR, Tseng FY, Yeh TH, Chen YS. Deep neck infection: analysis of 185 cases. Head Neck. 2004;26:854-860.
36. Boscolo-Rizzo P, Marchiori C, Montolli F, Vaglia A. Deep neck infections: a constant challenge. ORL J Otorhinolaryngol Relat Spec. 2006;68(5):259-265.
37. Srirompotong S, Art-Smart T. Ludwig’s angina: a clinical review. Eur Arch Otorhinolaryngol. 2003;260(7):401-403.
38. Harwood-Nuss A, Linden C, Luten R. Dental, oral and salivary gland infections. The Clinical Practice of Emergency Medicine. 2nd edition. Philadelphia: Lippincott Williams & Wilkins Publishers; 1996.
39. Kim MK, Allareddy V, Nalliah RP, Kim JE, Allareddy V. Burden of facial cellulitis: estimates from the nationwide emergency department sample. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012;114(3):312-317.
40. Ferrera PC, Busino LJ, Snyder HS. Uncommon complications of odontogenic infections. Am J Emerg Med. 1996;14(3):317- 322.
41. Barakate MS, Jensen MJ, Hemli JM, et al. Ludwig’s angina: report of a case and review of management issues. Ann Otol Rhinol Laryngol. 2001;110:453-456.
42. Richardson MA, Flint PW, Haughey BH. Cummings Otolaryngology – Head and Neck Surgery. St. Louis: Mosby; 2010.
43. Vieira F, Allen SM, Stocks RM, Thompson JW. Deep neck infection. Otolaryngol Clin North Am. 2008;41:459-483.