• Journal of the korean academy of Pediatric Dentistry
• /
• v.26 no.4
• /
• pp.623-629
• /
• 1999

The definition of fascial spaces are latent spaces between fascial planes. If infections which spread from dental origin to soft tissue are mild, they are restricted by fascial planes. But, when infections are severe, fascial spaces are often used as a natural pathway which spread to the deep cervical region. If they are not treated at early stage, they may result in the fatal complications as followings; airway obstruction, septicemia, cerebral abscess, and thrombophlebitis etc. The early treatment of fascial space abscess is very important for young children. These case reports present the successful result of fascial space abscess treatment through intracanal drainage without surgical excision. It is proven that the treatment through intracanal drainage has some benefits to the surgical excision, which are as follows: 1) It is economic to the patients or their parents avoiding admission. 2) The treatment procedure is more simple. 3) Childrens can avoid the fearful environment.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.30 no.6
• /
• pp.497-503
• /
• 2004

One of the most difficult problems to damage in dentistry is an odontogenic infection. These infections may range from low-grade, well-localized infections that require only minimal treatment to a severe, life-threatenig fascial space infection. Although the overwhelming majority of odontogenic infections are easily managed by minor surgical procedures and supportive medical therapy that includes antibiotic administration, the practitioner must constantly bear in mind that these infections may become severe in a very short time. We made an investigation was targeting on 78 male and 47 female patients (125 patients in total) who had been hospitalized because of the fascial space abscess on the oral and maxillofacial area and gained a complete recovery in Daegu Catholic University Hospital, Oral & Maxillofacial Surgery from January 1999 to December 2003. By tracing their charts, we could grasp the characteristics such as age, gender, the time of breakout and specific areas of the attacks, making a conclusive study of the statistical analysis and finally, we could reach conclusions. Now, we report the conclusion from the investigation with the literature. The proportion of males and females was approximately 3 to 2, and in age group, patients under 10 years old marked the highest, 22.4%. The patients between the age of 10 and 40 were only 14.4%, yet those who were between 40 and 80 marked 53.6% in contrast. In the monthly distribution, the order was Dec.(13.6%)-Sep.(12%)-Jan.(10.4%) and in seasonal distribution, it was winter(30.4%)-fall(28%)- summer(24.4%)- spring(19.2%). Considering the medical history, D.M. was the highest which was 30.3%, hypertension marked 24.4%, and the patients with both D.M. and hypertension were 9.0%. The major cause of infection of oral and maxillofacial areas was odontogenic infection, which marked about 96%, and especially the cases related to dental caries occurred most frequently, which was 51.2%. In the number of relaxed fascial space, single fascial space was 81.6%, and in the degree of relaxation of fascial space, the buccal space abscess marked 40.8%, following submandibular space abscess, which was 30.4%.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.35 no.1
• /
• pp.136-143
• /
• 2008

Infections involved with the oral and maxillofacial area are associated with various anatomical structures. If the proper treatment is not done in an immediate period, the infections will be quite fatal. The causes of the infections are numerous, but the most common cause of odontogenic infections in children is a dental caries. It is known to lead to some kinds of diseases such as periapical abscess, cellulitis, osteomyelitis, Ludwig's angina, toxic shock syndrome and so on. The common pathogenic sequence of fascial abscess is a necrotic pulpal inflammation in the form of dentoalvelor abscess which spreads over and gradually penetrates into the fascial membranes through the cortical bones and finally contracts the potential fascial spaces. If the infections of oral maxillofacial area were penetrated into the surrounding soft tissues, then they would diffuse into the directions of the least tissue resistance along with the connective tissues and the fascial spaces. These infections can be properly cured by tooth extraction, endodontic therapy, surgical treatment including Incision & drainage and antibiotics. The purpose of the cases is to report the satisfactory treatment results in the patients derived from the canine fascial space abscesss or buccal fascial space ones of the odontogenic origin.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.36 no.4
• /
• pp.314-319
• /
• 2010

Odontogenic infections are a normally locally confined, self-limiting process that is easily treated by antibiotic therapy and local surgical treatment. However, it may spread into the surrounding tissues through a perforation of the bone, and into contiguous fascial spaces or planes like the primary or secondary fascial spaces. If the infection extends widely, it may spread into the lateral pharyngeal and retropharyngeal space. The retropharyngeal space is located posterior to the pharynx. If an odontogenic infection spreads into this space, severe life-threatening complications will occur, such as airway obstruction, mediastinitis, pericarditis, pleurisy, pulmonary abscess, aspiration pneumonia and hematogenous dissemination to the distant organs. The mortality rate of mediastinitis ranges from 35% to 50%. Therefore, a rapid evaluation and treatment are essential for treating retropharyngeal space abscesses and preventing severe complications. Recently, we encountered two cases of a retropharyngeal space abscess due to the spread of an odontogenic infection. In all patients, early diagnosis was performed by computed tomography scanning and a physical examination. All patients were treated successfully by extensive surgical and antibiotic therapy.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.24 no.4
• /
• pp.813-822
• /
• 1997

Odontogenic maxillofacial space abscess in childeren was treated by the surgcal intervention combined with antiboitic therapy. Followings are the results after monitoring its progression. 1. Maxillofascial space abscess is mainly from the odontogenic infection and it may result in the severe states with the various fascial spaces and their relatives. So their early detection and treatment are needed. 2. The most common symptom in patients was the pain under palpation with painful swelling and the mouth floor elevation was observed in the sublingual space abscess. 3. In most cases, for its treatment, symptomatic therapy, antibiotic therapy, surgical incision and drainage were executed. If the infected tooth is possibly conserved, endodontic treatment is preferred, otherwise, it will be extracted as soon as possible.

• Journal of Korean Dental Science
• /
• v.8 no.2
• /
• pp.89-94
• /
• 2015

As popularity of dental implantation is increasing, the number of cases associated with complications also increase. Evaluation on diabetes mellitus is often neglected due to the disease's irrelevance to implantability. However, patients with diabetes mellitus are susceptible to infection due to impaired bactericidal ability of neutrophils, cellular immunity and activity of complements. Due to this established connection between diabetes mellitus and infection, a couple of cases were selected to present patients with diabetes mellitus with glycemic incontrollability, suffering from post-implantation dentigerous inter-fascial space abscess.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.26 no.5
• /
• pp.490-496
• /
• 2000

We have conducted a retrospective study of 224 patients with the diagnosis of oral and maxillofacial infection who had been treated between 1988 and 1999 at Gyeong-Sang National University Hospital. This study was aimed to furnish the data of oral and maxillofacial infection and to aid diagnosis and treatment. The most common fascial space involved, as determined by clinical, radiologic, and operative findings, were the submandibular space(39.4%). The most frequent cause of oral and maxillofacial infection was odontogenic 68.8%. In the odontogenic cause, dental caries was the most common cause. Two-hundred three patients required surgical drainage of the abscess. Seventeen patients needed tracheostomy for airway control. The overall mortality was 0.9% despite aggressive anti-microbial therapy and early surgical intervention. All other patients had an uneventful recovery without major complication except osteomyelitis case(6.0%). The combination of early radiologic diagnosis, effective antimicrobial therapy, and intensive surgical management contributed to the good prognosis.

• Journal of Oral Medicine and Pain
• /
• v.41 no.3
• /
• pp.133-136
• /
• 2016

Facial abscess is a suppurative condition that is caused by infection and that its infected materials built up within the loose connective tissues or a fascial space of the head and neck. Facial abscess should be treated with a caution since it can make threat to patient's life. When pus collects near masticatory muscles, it may lead to masticatory muscle disorder reducing the range of mouth opening and the mobility of jaw. The authors review an uncommon case of facial abscess which occurred in temporal muscle and induced mouth opening limitation.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.49 no.4
• /
• pp.198-207
• /
• 2023

Objectives: This study investigated causative strains and their antibiotic sensitivity in patients who were hospitalized for maxillofacial odontogenic infections at a tertiary center in South Korea over the past 10 years with the aim of providing guidelines for the selection of appropriate empirical antibiotics. Materials and Methods: Patients with head and neck fascial space abscesses due to odontogenic infections who underwent incision and drainage surgery with pus culture tests between 2013 and 2022 at the Department of Oral and Maxillofacial Surgery, Dankook University Hospital were included. The bacterial isolates and antibiotic sensitivity of each strain were analyzed for 2013-2022, 2013-2017, and 2018-2022. The affected fascial spaces were classified into primary, secondary, and deep neck spaces. Results: In the 192 patients included in this study, 302 strains were detected. Viridans streptococcus had the highest frequency (51.7%), followed by Prevotella spp. (16.9%), Staphylococcus spp. (5.6%), and Klebsiella pneumoniae (4.6%). The identification rate of viridans streptococcus significantly increased from 41.8% in 2013-2017 to 60.9% in 2018-2022. Viridans streptococcus showed an antibiotic sensitivity of 80.5% to ampicillin; the sensitivity to penicillin antibiotics decreased over the study period. Antibiotic susceptibility was approximately 94% for third-generation cephalosporins. K. pneumoniae, which was identified at a high percentage in patients with deep neck space infection, showed increasing antibiotic resistance to most antibiotics over the study period. Conclusion: Viridans streptococcus was identified in head and neck fascial space abscesses with the highest frequency. Empirical antibiotics should be effective against this strain; penicillin antibiotics are considered inappropriate. For effective treatment of deep neck space abscesses, bacterial culture and antibiotic sensitivity tests performed as soon as possible are essential.

• Korean Journal of Bronchoesophagology
• /
• v.12 no.2
• /
• pp.42-46
• /
• 2006

Descending necrotizing mediastinitis (DNM) is defined as mediastinal infection that begins at the cervical region and spread through deep fascial planes into the mediastinum. This is a rare and life-threatening complication of deep neck space infection. As infection reaches the mediastinum, widespread cellulitis, necrosis, abscess formation and sepsis may occur. So, early diagnosis and immediate antibiotics and surgical treatment are required to improve the poor prognosis of DNM. We present four cases of deep neck infection causing a virulent mediastinitis with a literature review.