Predictors of length of stay following maxillofacial abscess surgery: A 10-year retrospective cohort.

The aim of this study was to identify predictors of length of stay (LOS) after surgical therapy of maxillofacial abscess. Patients diagnosed with a maxillofacial abscess who underwent extraoral incision and drainage under general anesthesia between January 1st, 2012 and January 1st, 2022 were retrospectively reviewed Univariable and multivariable linear regressions were performed to identify the association between pre- and perioperative variables and the LOS. In total, 228 patients were included. In the forward stepwise multivariable analysis, all factors with a p-value <0.2 in the univariable model were included. Ultimately, six independent predictors of increased LOS were identified: female (coef. 0.14, 95% CI 0.03-0.25), immunosuppression (coef. 0.37, 95%CI 0.13-0.61), penicillin allergy (coef. 0.25, 95% CI 0.04-0.46), C-reactive protein (coef. 0.0008, 95% CI 0.0001-0.0014), multiple spaces involvement (coef. 0.36, 95% CI 0.13-0.59), and time to operation (coef. 0.005, 95% CI 0.002-0.008). In conclusion, our study provides new insights into predicting LOS for patients admitted with maxillofacial abscesses. The identification of these markers not only enhances the ability to forecast LOS, but also lays the groundwork for optimizing resource planning and potentially integrating them into a primary prevention algorithm.

Epstein-Barr Virus Infection-Associated Facial Swelling: A Case Report.

Maxillofacial soft tissue swelling is a common clinical symptom with various etiologies. While odontogenic space infection is the most common cause, it is crucial not to overlook maxillofacial swellings caused by specific pathogenic infections and other local factors. This paper reports the case of an adult patient with right-sided swelling of his face, persistent oral mucosal ulcers, and recurrent hyperthermia for 30 days. He had received various antibiotics for the initial diagnosis of "right buccal space infection," but the antibiotics did not have any effect on his symptoms. None of the blood tests, histological examinations, bone marrow biopsies, and immune-related tests produced diagnostic findings. A diagnosis of Epstein-Barr virus (EBV) infection was finally confirmed by biopsy tissue genomics sequencing and quantitative analysis of EBV nucleic acid. In this report, we describe the diagnosis and treatment process for this patient and suggest that facial swelling could be an important clinical symptom of EBV infection.

Inflammatory Markers as Predictors for Prolonged Duration of Hospitalization in Maxillofacial Infections.

Despite the progress made in diagnosing and treating maxillofacial infections, the course of infection can be unpredictable, leading to severe complications, prolonged hospitalization, and substantial financial costs to health care services. It is important to determine whether various serum inflammatory marker levels on admission may predict a prolonged hospital stay in these patients. To analyze the role of CRP, white blood cell count (WBC), and neutrophil-to-lymphocyte ratio (NLR) in predicting the prolonged duration of hospitalization in maxillofacial infections, we performed a retrospective study by collecting paper records data from 108 patients who met our inclusion criteria. The patients were divided into two groups according to the duration of hospitalization (group A < 5 days and group B ≥ 5 days). The predictor variables were CRP, WBC, and NLR, and the outcome variable was the duration of hospitalization. This study confirmed a positive linear correlation (p < 0.001) between the predictors and the outcome variable. The optimal cut-off values for WBC are 11,030 white blood cells/µL and 63 mg/L for CRP. Levels that exceed these optimal values predict a duration of hospitalization of over (≥) 5 days. Serum WBC and CRP on admission may predict the duration of hospitalization in patients with MFI.

Functionalized Prussian Blue Nanozyme as Dual-Responsive Drug Therapeutic Nanoplatform Against Maxillofacial Infection via Macrophage Polarization.

Purpose: Maxillofacial infection is a common disease in stomatology and is difficult to treat owing to its high potential to spread to vital anatomical structures. Excessive levels of reactive oxygen species (ROS) in infected tissues lead to cellular damage and impede tissue regeneration. However, uncontrollable strategies to remove ROS have limited therapeutic efficacy. Nanoparticle systems for scavenging ROS and remodeling the inflammatory microenvironment offer much promise in the treatment of maxillofacial inflammation. Methods: Here, a novel microenvironment-stimuli-responsive drug delivery nanoplatform (HMPB@Cur@PDA) based on a polydopamine (PDA)-functionalized hollow mesoporous Prussian blue (HMPB) nanozyme was developed for the delivery of curcumin (Cur) in the treatment of maxillofacial infection. Low pH and excess ROS in the inflammatory microenvironment cause degradation of the outer PDA layer of the nanocomplex, exposing the HMPB nanozyme and loaded Cur, which synergistically act as a ROS scavenger and anti-inflammatory agent, respectively, and induce macrophage polarization from the pro-inflammatory M1 to the anti-inflammatory M2 phenotype. Results: Experiments in vitro provided strong evidence for the application of novel nanocomplexes in scavenging multiple ROS and inhibiting lipopolysaccharide-induced inflammation. In addition, in vivo results obtained using a mouse maxillofacial infection model demonstrated that HMPB@Cur@PDA had excellent biocompatibility, significantly attenuated the inflammatory response in periodontal tissue, and improved the repair of damaged tissue. Conclusion: Our results indicate that HMPB@Cur@PDA nanocomposites have great potential for ROS regulation as well as having anti-inflammatory effects, providing new insights for the development of dual-response maxillofacial infection treatments.

Epidemiología de la Infección Maxilofacial, tratada quirúrgicamente en el Hospital de Urgencia Asistencia Pública: 5 años de revisión / Epidemiology of Maxillofacial Infection, surgically treated in the Public Assistance Emergency Hospital: 5 years of review

Introducción: Infecciones moderadas, severas y/o profundas del territorio maxilofacial (ITM) constituyen un desafío de gran relevancia en los centros hospitalarios de alta complejidad. Objetivo: Actualizar esta epidemiología de resolución quirúrgica bajo anestesia general, en pabellón central tratado en el Hospital de Urgencia Asistencia Pública (HUAP) durante el período comprendido entre diciembre de 2014 a diciembre de 2019 y compararla con la realidad de otros centros hospitalarios de alta complejidad en Chile y en el extranjero. Materiales y Método: Estudio retrospectivo que analizó los protocolos operatorios de los pacientes intervenidos quirúrgicamente por ITM, en pabellón central, bajo anestesia general, en un período de 60 meses. Las variables analizadas fueron edad, género, espacio anatómico comprometido y presentación clínica. Resultados: Se realizaron 291 procedimientos quirúrgicos, para 452 infecciones. La edad promedio de los pacientes fue 38 años, con predominio del sexo masculino (57,3%); el rango de edad más afectado fue entre los 30-39 años (26,1%); el espacio submandibular fue el más comprometido (29,5%). Discusión: Los resultados expuestos concuerdan con estudios a nivel nacional e internacional. Conclusión: Resulta necesario continuar la investigación epidemiológica para establecer políticas de prevención y tratamiento eficientes en relación a cada servicio y en conjunto a nivel de salud pública.

Introduction: Moderate, severe or deep infections of the maxillofacial territory (IMT) are a relevant problem in hospital centres. Objective: To demonstrate and update the epidemiology of IMT´s with surgical resolution under general Anesthesia in mayor operating rooms at the Public Assistance Emergency Hospital (HUAP) during the period from December 2014 to December 2019, and to compare it with the epidemiological reality of other hospital centres in Chile and abroad. Materials and Method: A retrospective study analyzed the operative protocols of patients for 60 months. Studied variables were age, sex, compromised anatomical space and clinical presentation. Results: 291 surgical procedures were performed to resolve 452 infections. The average age of the operated patients was 38 years, with a slight predominance of the male gender (57.3%); the most affected age range was between 30 and 39 years (26.1%); the submandibular space was the most compromised (29.5%). Discussion: The exposed results agree with studies carried out at national and international level. Conclusion: It is necessary to continue an epidemiological investigation in order to establish efficient prevention and treatment policies for each service and altogether to unify public health statistics.

Unveiling the Pathogenic Bacteria Causing Descending Necrotizing Mediastinitis.

The combination of maxillofacial infections (MI) with descending necrotizing mediastinitis (DNM) is a complex disease characterized by rapid development and high mortality. Here, we performed metagenomic next-generation sequencing (mNGS) using samples from 21 patients with MI and eight patients with DNM. In this study, we found that the species richness of the DNM group was higher than that of the MI group, and the species diversity of the DNM group was higher than that of the MI group, with no statistically significant differences between groups (P > 0.05). LefSE analysis revealed that the main species differing between groups were Bacillus, Lactobacillus, Streptococcaceae, and Streptococcus (S. constellatus and S. anginosus). In addition, the PLS-DA analysis revealed that the dominant groups in the DNM group at the species level were S. constellatus, S. anginosus, Streptococcus intermedius, Prevotella oris, Mogibacterium timidum, and Eubacterium nodatum. Next, we correlated the clinical characteristics of the patients with the relative abundance of the pathogens identified in the LefSe and PLS-DA analyses. The relative abundance of S. anginosus was positively correlated with C-reactive protein (CRP) and calcitoninogen (PCT) but negatively correlated with the percentage of lymphocytes (Lymph%) (P < 0.05). On the other hand, M. timidum was positively correlated with the percentage of neutrophils (Neut%) and glycated hemoglobin (GLU) (P < 0.05), and Parvimonas micra was positively correlated with CRP (P < 0.05).

Analysis of 256 pediatric oral and maxillofacial emergency in-patients during the outbreak of COVID-19.

BACKGROUND/AIMS: Pediatric oral and maxillofacial surgeons have faced severe challenges in ward management due to their high risk of exposure during the COVID-19 epidemic. The aim of this study was to analyze and summarize the treatment methods and infection prevention and control measures applied in emergency cases in the Department of Pediatric Oral and Maxillofacial Surgery, Children's Hospital of Chongqing Medical University, during the COVID-19 epidemic. METHODS: In this retrospective study, information was collected from 256 pediatric emergency patients who were treated from January 23, 2020 to August 9, 2021. The patients' data were statistically analyzed according to age, gender, disease and pathogenesis, operation time, and the main treatment applied in pediatric oral and maxillofacial emergency cases during the COVID-19 epidemic. RESULTS: During the epidemic period, 256 pediatric emergency patients were successfully treated. Among them, there were 170 boys and 86 girls. In all, 182 patients were diagnosed with oral or facial lacerations; 43 had jaw fractures; 26 had maxillofacial infections; and five had dento-alveolar fractures. A total of 246 patients underwent surgery under negative pressure with level 3 protection standards. No doctors or patients infected with COVID-19 were found throughout the stury period. CONCLUSIONS: Pediatric oral and maxillofacial emergency in-patients mainly experienced maxillofacial trauma during the COVID-19 epidemic, followed by infection. Effective diagnosis and treatment, and avoidance of COVID-19 infection can be achieved by strictly following epidemic prevention and treatment procedures.

Efficacy of needle aspiration in patients with oral-maxillofacial abscesses: A retrospective study of 15 consecutive patients.

The aim of this study was to determine the adequacy and safety of needle aspiration (NA) as an alternative to open surgical drainage for oral-maxillofacial abscesses. Fifteen consecutive patients who were diagnosed with oral-maxillofacial abscesses via contrast-enhanced CT from January 2020 to December 2020 were included. All patients were on antibiotics and treated with NA under local anaesthesia using a 20 mL syringe. Data collection included patient characteristics, signs and symptoms, physical examinations, laboratory tests, imaging findings, and outcomes. Next-generation sequencing (NGS) was used to identify the infectious microorganisms from the abscess samples. The study included 15 patients with oral-maxillofacial abscesses. None of our 15 patients required surgical incision and drainage, although repeat aspiration was required. However, after the first NA, the pain was reportedly extremely relieved for all patients. The average duration of antibiotic treatment was 9.20 ± 5.15 days (range 4-23 days). The abscess-affected spaces mainly included the masseter space and submandibular space. Odontogenic infection was the most common aetiology in 15 patients (10/15). The average volume of the abscesses on CT was 5866.26 ± 3627.18 mm3. The main pathogens identified in this study were Prevotella oris (5/15), Peptostreptococcus stomatis (4/15) and Porphyromonas endodontalis (2/15). According to the results of our study, the data support the use of NA as an effective, minimally invasive treatment modality for oral-maxillofacial abscesses. Surgeons should familiarise themselves with this technique, as it can easily be performed in the clinic using local anaesthesia, culture samples may be obtained, and airway obstruction and pain may be relieved.

Ruptured infectious ICA pseudoaneurysm into the sphenoid sinus after maxillofacial infection, successfully treated by selective embolization.

BACKGROUND: Intracranial infectious aneurysms are cerebral aneurysms caused by pathogen-induced inflammation undermining the arterial wall. We present a rare case of inflammatory pseudoaneurysm of cavernous internal carotid artery (ICA). CASE DESCRIPTION: A 51-year-old female with a recent diagnosis of acute lymphoblastic leukemia developed maxillofacial infection with Pseudomonas and Acinetobacter after chemotherapy onset. Initial plain computed tomography (CT) revealed bony dehiscence of the left ICA canal, as well as bilateral protrusion of the vessel within the sphenoid sinus. Following infection spread into the left sphenoid sinus, she presented with episodes of intermittent epistaxis, without any profound vascular abnormalities on postcontrast CT. CT angiography that was performed 15 days later, due to refractory epistaxis, illustrated a large narrow necked irregular shape pseudoaneurysm of the left paraophthalmic ICA, extending into the ipsilateral sphenoid sinus. The aneurysm was completely occluded by selective embolization without parent or adjacent vessel sacrifice, documented on both intraoperative and follow-up angiogram, with no recurrence of epistaxis. CONCLUSION: Conclusively, ruptured internal carotid infectious aneurysms are rare but potentially fatal causes of epistaxis when extended into the sphenoid sinus. Selective coiling is feasible and can provide definitive treatment of these lesions.

Odontogenic Maxillofacial Infections in a High-level Hospital: Orofacial Pain and Related Conditions

ABSTRACT Objective: Odontogenic infection is a common condition in America; the aim of this research was to determine the profile of odontogenic maxillofacial infections and to identify the link between these and the pain felt by patients admitted to the emergency dental service of the Hernân Henriquez Aravena Hospital in Temuco, Chile. Methods: A cross-sectional, double-blind study analysed 49 individuals admitted for emergency dental care. Included were admissions associated with odontogenic infection identified by clinical examination, establishing a relation to pain through a survey. The diagnosis was made clinically using the fascial spaces involved in the infection, presence of self-medication prior to admission, need for surgical treatment and the patient 's systemic conditions. The data were analysed using descriptive statistics, Chi-squared, ANOVA, considering a value of p < 0.05 as significant. Results: The average pain level measured by visual analogue scale (VAS) in emergency admission was 8.1. There was no association between the diagnosis (pulp infection, periodontal infection or pericoronitis) and the VAS (p = 0.078), but there was association between age and the diagnosis (p = 0.022), and the VAS was associated with pain compared to other types of pathologies or traumas (p = 0.011). Conclusion: Odontogenic infection is frequent and linked to age and high-pain values. New public policies should be adopted based on these results. New studies are needed to assess new variables associated with these pathologies.

Computed tomography window blending in maxillofacial imaging.

PURPOSE: The purpose of this study was to demonstrate the ability of a custom window blending algorithm to depict multicompartmental disease processes of the maxillofacial region in a single image, using routine computed tomography (CT) DICOM data. METHODS: Five cases were selected from case files demonstrating trauma, infection, and malignancy of the maxillofacial region on routine CT examinations. Images were processed with a modified Relative Attenuation-Dependent Image Overlay (RADIO) window-blending algorithm in Adobe Photoshop controlled by ExtendScript. RESULTS: The modified RADIO algorithm was able to demonstrate pertinent multicompartmental imaging findings in each of the examinations, allowing simultaneous visualization of clinically relevant bone and soft tissue findings in a single image, without needing to change window and level settings. CONCLUSION: A custom window blending algorithm can demonstrate a range of multicompartmental pathology in the maxillofacial region in a single image.

Epidemiología de la patología quirúrgica que afecta al territorio maxilofacial, tratada bajo anestesia general en el Hospital de Urgencia Asistencia Pública entre 2014 y 2016 / Epidemiology of surgical pathology affecting the maxillofacial area, treated under general anesthesia at the Emergency Hospital Public Assistance between 2014 and 2016

Objetivo: Presentar la experiencia de la especialidad en cirugía y traumatología bucal y maxilofacial en el Hospital de Urgencia Asistencia Pública, a través de la epidemiología de los tratamientos quirúrgicos realizados en pabellón central, bajo anestesia general, durante el período comprendido entre noviembre del 2014 y julio del 2016. Material y métodos: Se realizó un estudio retrospectivo en el que se analizaron los protocolos operatorios de los pacientes intervenidos durante el período. Se recopiló información de la base de datos del pabellón central sobre el diagnóstico, la edad, el sexo y el tipo de procedimiento quirúrgico. Se incluyeron 125 procedimientos quirúrgicos realizados en 109 pacientes. Resultados: La edad promedio de los pacientes intervenidos fue de 38 años, con preponderancia del sexo masculino (70,6%). El 50,4% de los procedimientos quirúrgicos correspondieron a traumatismos en el territorio maxilofacial, de los cuales la fractura mandibular fue la lesión más frecuente (68,3%). El 46,4% de los procedimientos correspondieron a infecciones en el territorio maxilofacial, en los cuales la localización más frecuente fue el espacio anatómico submandibular (25,8%). El resto de los procedimientos se relacionó con otro tipo de diagnósticos (3,2%). Discusión: En general los resultados concuerdan con estudios similares realizados en hospitales de atención de urgencia. Conclusión: Dentro de las patologías de urgencia del territorio maxilofacial, las lesiones traumáticas e infecciones son las que con mayor frecuencia requieren de cirugía mayor bajo anestesia general. Los pacientes intervenidos con cirugía bajo anestesia general en pabellón central son principalmente hombres, siendo las fracturas mandibulares y la infección del espacio submandibular las lesiones más frecuentes en cada tipo de patología.

Objective: To determine the experience of the specialty in Oral and Maxillofacial Surgery and Traumatology at the Hospital Emergency Assistance Publique, through epidemiology of surgical treatments carried out in major operating room, under general anesthesia during the period between November 2014 and July 2016. Material and methods: A retrospective study where the operative protocols of patients operated during the period analyzed was performed. Database information from major operating room for diagnosis, age, sex and type of surgical procedures was collected. 125 surgical procedures performed in 109 patients were included. Results: The average age of the operated patients was 38 years with a preponderance of males (70.6%); 50.4% of surgical procedures were for injuries in the maxillofacial area, where the mandibular fracture was the most common lesion (68.3%); 46.4% of the procedures were for infections in maxillofacial area, where the most common location was the submandibular anatomical space (25.8%). The rest of the procedures related to other diseases (3.2%). Discussion: In general the results are consistent with similar studies in emergency care hospitals. Conclusion: Within the pathologies of urgency of the maxillofacial territory, traumatic injuries and infections are those that most frequently require major surgery under general anesthesia. Patients undergoing surgery under general anesthesia in major operating room are mainly men, with mandibular fractures and submandibular space infections being the most frequent lesions in each type of pathology.

Pathogens and antimicrobial resistance in maxillofacial infection / 中国感染控制杂志

Objective To investigate the distribution and antimicrobial susceptibility of pathogens causing maxillofacial infection in patients,and provide evidence for rational use of antimicrobial agents in clinical practice.Methods Specimens of patients infected with oral and maxillofacial infection in a hospital between January 2012 and December 2016 were performed microbial culture,pathogens were identified and performed antimicrobial susceptibility testing,distribution of pathogens and antimicrobial resistance were analyzed.Results Of 882 patients with maxillofacial infection,male and female accounted for 32.20％ and 67.80％ respectively;35.38％ and 32.65％ of patients aged ～40 years and ～60 years respectively;a total of 145 strains were isolated,88(60.69 ％) of which were gram-negative bacteria,mainly Klebsiella pneumoniae and Pseudomonas aeruginosa;56 (38.62 ％) of which were gram-positive bacteria,mainly Staphylococcus aureus.Resistance rates of Klebsiella pneumoniae to 16 kinds of an timicrobial agents were a11＜50％,resistance rates to imipenem and meropenem were the lowest,both were 3.45％,1 1 strains were extended-spectrum β-lactamases-producing strains;resistance rates of Pseudomonas aeruginosa to 10 kinds of antimicrobial agents were all＜40％.Staphylococcus aureus was susceptible to tigecycline,linezolid,and vancomycin,resistance rate to penicillin was the highest (66.67％),resistance rate to oxacillin was 20.83％.Conclusion The main pathogens causing oral and maxillofacial infection are gram negative bacteria,different pathogens have different antimicrobial resistance,antimicrobial agents should be used rationally during clinical treatment according to antimicrobial susceptibility testing result.

Fever after maxillofacial surgery: a critical review.

PURPOSE: The aim of this paper is to review the pathophysiology of thermoregulation mechanism, various causes of fever after maxillofacial surgery and the different treatment protocols advised in the literature. DISCUSSION: Fever is one of the most common complaints after major surgery and is also considered to be an important clinical sign which indicates developing pathology that may go unnoticed by the clinician during post operative period. Several factors are responsible for fever after the maxillofacial surgery, inflammation and infection being the commonest. However, other rare causes such as drug allergy, dehydration, malignancy and endocrinological disorders, etc. should be ruled out prior to any definite diagnosis and initiate the treatment. Proper history and clinical examination is an essential tool to predict the causative factors for fever. Common cooling methods like tepid sponging are usually effective alone or in conjunction with analgesics to reduce the temperature. CONCLUSION: Fever is a common postoperative complaint and should not be underestimated as it may indicate a more serious underlying pathology. A specific guideline towards the management of such patients is necessary in every hospital setting to ensure optimal care towards the patients during post operative period.

Effect of dexamethasone combined with cefminox perioral injection on serum immunoglobulin in patients with oral and maxillofacial infection / 中国生化药物杂志

Objective To analyse effect of dexamethasone combined with cefminox perioral injection on serum immunoglobulin in patients with oral and maxillofacial infection.Methods 46 patients who were diagnosed with oral and maxillofacial infection in our hospital were collected.All patients were randomly divided into experimental group and control group,23 cases in each group.Control group was treated with cefminox 3.0 g,one time per day perioral injection on the basis of control group treatment, experimental group were given dexamethasone sodium phosphate injection 10 mg, one time per day perioral injection, After the treatment, the serum levels of immunoglobulin IgA,IgG,IgM,CRP and routine blood test were detected in all patients.Results Compared with control group post-treatment, the serum levels of IgA,IgG and IgM were lower in experimental group (P<0.05);the serum level of CRP was lower in experimental group (P<0.05);the serum levels of WBC,NET% were lower in experimental group (P<0.05). Conclusion The dexamethasone combined with cefminox perioral injection can significantly reduce the serum level of immunoglobulin,CRP,WBC and NET% in patients with oral and maxillofacial infection,control the infection and inhibit the development of the disease.

Manejo de Herida Quirúrgica en Infección del Territorio Maxilofacial / Management of Surgical Wound Infection of Maxillofacial Area

El manejo de infecciones maxilofaciales leves o graves tiene como objetivos generales la protección de la vía aérea, eliminación quirúrgica de la fuente de infección, drenajes quirúrgicos de la lesión, antibioterapia adecuada, control de evolución de la lesión y herida facial hasta la resolución completa del proceso infeccioso. El objetivo de este artículo es presentar un caso clínico de una infección del territorio maxilofacial, de difícil manejo local y su respuesta al tratamiento junto a la evolución y manejo de la herida facial resultante. Paciente sexo masculino de 48 años de edad, sin antecedentes mórbidos relevantes se presenta en el servicio de Urgencias del Hospital Base de Valdivia con el diagnóstico de flegmón facial izquierdo. Evoluciona con resistencia al tratamiento convencional y lenta cicatrización de herida quirúrgica posterior al vaciamiento del flegmón abscedado. Se utiliza un hidrogel como coadyudante a la terapia, resultando finalmente en la resolución del cuadro clínico. Se discute evolución del cuadro infeccioso junto a las diferentes terapias coadyuvantes para un proceso infeccioso severo.

The general objective in the management of mild or severe maxillofacial infections, is to protect the airway, realize surgical removal of the source of infection, surgical drainageof the lesion and adequate antibiotic therapy, control during onset of the lesion and facial injury until resolution the infectious process is complete. The aim of this paper is to present a case of an infection of maxillofacial area, difficult to manage locally and its response to treatment with development and management of theresulting facial wound. Patient is a 48 year-old male, without significant morbid history and is treated at the emergency department of the Base Hospital of Valdivia with a subsequent diagnosis of left facial phlegmon. During onset patient presented resistance to conventional treatment and wound healing was slow after emptying abscessed phlegmon. A hydrogel is used as an adjunct to therapy, leading finally to the resolution of clinical case. We discuss evolution of infectious event with various intervention therapies for severe infectious process.

A clinicostatistical study of fascial space infections of the oral and maxillofacial region

Oral and maxillofacial infection is the oldest and most common disease in human history. The infection ranges from the low-grade infection that only requires minimal treatment to the high-grade and life-threatening fascial space infection. In this study, the data on oral and maxillofacial infections were analyzed to aid in the diagnosis and treatment, and to predict the prognosis. This report was based on data from 831 patients with oral and maxillofacial infection (394 males and 437 females) who were hospitalized in the Department of Oral and Maxillofacial surgery of Chosun University Dental Hospital from January 1998 to May 2005. The ratio of males to females was 0.9:1. By age, patients between 60 and 70 years old were the greatest in number (17.1%), while only 5.9% of the patients were between 10 and 20 years old. The most common cause of infection was odontogenic origin (84.4%), followed by post-extraction infection (6.2%), unknown (5.9%), and trauma (3.5%). The most common fascial space involved was the buccal space (39.4%), followed by the canine (20.6%), submandibular (15.9%), pterygomandibular (9.5%), submental (7.6%) and sublingual (2.8%) space. The number of the involved fascial space was one (75.2%), two (19.8%), or more than three (5.0%). In terms of the treatment duration, the hospitalization period of 6 to 10 days was the greatest in number (49.9%). All patients had uneventful recovery without major complication. There are statistically significant correlations between age and treatment period, and the involved space and treatment period, but no correlations between the variables of sex and treatment.

A clinicostastical study of oral and maxillofacial infected patients for the last 5 years

Infections of the oral and maxillofacial region are one of the most common conditions for which a patient presents to a maxillofacial surgeons. Although these infections can arise from a variety of source, dental disease is the most common etiology. So, odontogenic infection are frequently encountered in the practice of oral and maxillofacial surgery. These infections often respond to antimicrobial chemotherapy or surgical intervention, such as extraction of teeth, incision and drainage through clinical features. But, odontogenic infections have the potential to spread via the fascial spaces in the head and neck region, and, they spread to cavernous sinus, deep musculofascial space and other vital structure. We have undertaken clinical studies on infections in the oral and maxillofacial regions by analyzing retrospectively hospitalized patients in the Department of Oral and Maxillofacial Surgery, Chonbuk National University Hospital past 5 years from 2000 to 2004. And, the patients'age, sex, medical history, causes of the infection, surgical intervention, and other clinical parameters were reviewed. The obtained results were as follows: 1. The most frequent cause of oral and maxillofacial infection was odontogenic. And in the odontogenic cause, dental caries was the most common cause (47.2%). 2. The most common fascial space involved was the submandibular space (15.7%), followed by the buccal space (14.8%). 3. 60.4% of all patients required surgical drainage of the abscess, endodontic treatment or tooth extraction or periodontal treatment with drainage. 4. The most causative organism isolated from the pus culture were streptococcus viridans (53.9%). 5. Underlying medical problems were found in 136 patients (41.9%), the most common being hypertension (27.9%) and diabetes (14.7%).

A Clinicostatistical Analysis Of Oral And Maxillofacial Infected Patients