Study of Anaerobic Bacteria in Dental Abscess in a Tertiary Care Hospital

Majority of anaerobes involved in dental infections are thought to be endogenous in origin. Due to breech of continuity of pulp chamber bacterial colonization occurs. Responsible pathogens are polymicrobial. If left untreated in early stages, it can act as foci of disseminated infections and spread rapidly to adjacent structures leading to life threatening conditions. Aims: The present study was undertaken to identify different anaerobic organisms and their association with risk factors. Methods: 40 pus samples were collected after mouth wash from patients presented with dental abscess. Samples were processed immediately for aerobic and anaerobic culture. After comparing with the aerobic culture, obligate anaerobes were checked for aero tolerance. Subculture done for identification of species by Gram stain, colony morphology and conventional biochemical tests. Final identification was done by Vitek 2 system. Results: 40 (100%) samples were culture positive. Total 60 bacterial isolates recovered from this 40 samples. Out of which aerobes 36 (60%) and anaerobes 24 (40%) isolated. Aerobes present in 18 (45%), anaerobes present in 12 (30%) cases and mixed aerobic and anaerobic flora in 10 (25 %) cases. Predominant isolates were anaerobic cocci, Peptostreptococcus micros (41.6%) followed by Peptostreptococcus anaerobios (25%).Diabetes mellitus, bad chewing habits, poor oral hygiene found as significant risk factors. Conclusion: This study highlights polymicrobial nature of infections and role of anaerobes play as pathogens. Early diagnosis and interventions are extremely important to prevent systemic complications. One should have a high index of suspicion of anaerobes while dealing with dental infections.

Cerebral abscess as a complication of a dental abscess

A dental abscess, most often caused by inadequate oral hygiene, can be easily treated if timely diagnosed. However, delay in treatment can lead to bacterial dissemination and serious complications, such as development of a cerebral abscess. Authors retrospectively analyzed a case of a 15-year-old boy admitted to our pediatrics department with a cerebral abscess due to a dental abscess. A 15-year-old patient presented with supra-orbital swelling which due to previous delay in dental treatment had caused dental, orbital and cerebral abscess formation. After extraction of the affected tooth and six weeks of IV antibiotics the size of the cerebral abscess was practically unchanged. An epidural drainage and further treatment with IV antibiotics were needed to eliminate the cerebral abscess. The urgency of dental treatment to inhibit further microbial spread is of great importance and delay can have serious consequences.

Characterization of consultations for odontogenic abscesses in a major Chilean hospital

OBJECTIVES: To characterize consultations for odontogenic abscesses at the dental and maxillofacial unit of the public emergency hospital in Santiago, Chile. METHODOLOGY: descriptive study, involving consecutive sampling of patients with diagnosis of odontogenic abscess, conducted between august and september 2016. descriptive statistics were performed to determine the frequency of diagnosis, affected tooth, sex and need for hospitalization. RESULTS: odontogenic abscesses accounted for 6.3 percent (n=414) of a total of 6,535 consultations. males represented 59 percent; 42 percent of odontogenic abscesses presented in molars and maxillary premolars. the vestibular space was the most frequently affected anatomical space (50 percent), associated in 53 percent of the cases to submucosal abscesses. ninety-eight per cent of patients were successfully treated on an outpatient basis, 2 percent required hospitalization, mainly associated to abscesses involving the deep submandibular space. CONCLUSION: odontogenic abscesses account for a low percentage of dental emergencies at the public emergency hospital in Santiago, Chile. most cases receive outpatient treatment.

Non Hodgkin lymphoma in the maxillary sinus mimicking dental abscess: a case report

Malignant lymphomas are neoplasms with diffuse proliferation of neoplastic lymphocytes and their precursor cells. Diffuse large B-cell lymphoma, which is a subtype of non-Hodgkin's lymphomas, rarely occurs in the head and neck area and is especially rare in the maxillary sinus. We report a case of a 76-year-old female patient who was referred to the oral and maxillofacial surgery office for evaluation of a dental abscess as a clinical diagnosis. Laboratory tests revealed no signs of inflammation or infection; therefore, incisional biopsy was performed. The final diagnosis was diffuse large B-cell lymphoma in the maxillary sinus. Here we describe this case with a review of relevant literature.

Características dentales del raquitismo hipofosfatémico: Reporte de un caso / Dental characteristics of hypophosphatemic rickets: Case report

El raquitismo hipofosfatémico resistente a la vitamina D está caracterizado por una hipofosfatemia persistente e hiperfosfaturia. Este disturbio metabólico causa una calcificación deficiente de las estructuras mineralizadas tales como en los huesos y dientes. Una de las alteraciones bucales más importantes de esta enfermedad es la recurrente formación de abscesos ''espontáneos'' afectando a múltiples dientes primarios, así como permanentes sin caries o trauma, relacionado con una mineralización deficiente de la dentina. Nosotros reportamos un caso de raquitismo hipofosfatémico resistente a la vitamina D en un paciente que reportó múltiples abscesos dentales y requirió tratamiento con pulpectomías, pulpotomías y coronas de acero cromo en molares y resinas en dientes anteriores. El objetivo del presente artículo es dar a conocer las características de este trastorno, el tratamiento y las consideraciones dentales.

Hypophosphatemic vitamin-D resistant rickets is characterized by persistent hypophosphatemia and hyperphosphaturia. This metabolic disorder causes deficient calcification of mineralized structures such as bones and teeth. One of the most important oral alterations elicited by this condition is the recurrent formation of ''spontaneous'' abscesses. These affect multiple caries or trauma to free primary o permanent teeth and are related to a deficient dentin mineralization. We report a case of hypophosphatemic vitamin-D resistant rickets in a patient who reported multiple dental abscesses and who required treatment consisting in pulpectomies, pulpotomies and chrome-steel crowns in molars and composite resin in anterior teeth. The aim of the present article was to raise awareness on the characteristics of this disorder, as well as its treatment and dental considerations.

Dental abnormalities and oral health in patients with Hypophosphatemic rickets

INTRODUCTION: Hypophosphatemic rickets represents a group of heritable renal disorders of phosphate characterized by hypophosphatemia, normal or low serum 1,25 (OH)2 vitamin D and calcium levels. Hypophosphatemia is associated to interglobular dentine and an enlarged pulp chambers. AIM: Our goal was to verify the dental abnormalities and the oral health condition in these patients. MATERIAL AND METHODS: Prospective study of oral conditions in patients with Hypophosphatemic rickets. This report employed a simple method to be easily reproducible: oral clinical exam and radiographic evaluation. RESULTS: Fourteen patients were studied, 5 males, median age of 11years (4 to 26). Occlusion defects (85,7 percent) and enamel hypoplasia (57,1 percent) were significant more frequently than dental abscesses (one patient). We observed enlarged pulp chambers in 43 percent of the patients and hypoplasia and dentin abnormalities in 14,3 percent. We could not detect a significant correlation between dental abnormalities and delayed treatment (p>0,05). DMFT index for 6 to 12 years patients (n = 12) showed that the oral health is unsatisfactory (mean DMFT = 5). CONCLUSIONS: Patients with Hypophosphatemic Rickets frequently present dental alterations and these are not completely recovered with the treatment, unless dental abscess and they need a periodical oral examination.