• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제33권6호
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• pp.669-676
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• 2007

본 교실에서는 당뇨와 지방간의 전신 질환이 있는 환자에서 구강 내 외상으로 안검의 안와 격막을 통한 안와 연조직염, 상악 제1대구치 치근단 농양이 측두와를 통한 안와 외측 골막하 농양, 상악 제2유구치 치료 후 상악동염 및 사골미로염을 통한 안와 내측 골막하 농양, 하악 제1대구치 치근단 농양이 저작간극과 측두와를 거쳐 관골의 안와부 골수염 및 안와 외측 하방에 골막하 농양, 상악 제2,3대구치 치근단 농양이 익돌구개와, 측두하와 및 하안와열을 거쳐 안구 후방에 안와농양을 형성한 후 기존의 농양 전상방부에 새로운 농양을 형성하며 상안와열증후군으로 까지 진행된 증례를 비롯하여 다양한 안와연조직 감염의 증례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제18권1호
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• pp.47-54
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• 1996

저자등은 경희대학교 치과대학 부속병원 구강악안면외과에 상악 우측 제1대구치를 원인치로 하는 우측 저작극의 감염으로 인하여 개구장애와 두통을 호소하여 입원치료중 입원 16일째 동측의 중뇌동맥경색의 진단하에 사망한 증례를 경험하여 치성감염의 두 개내 합병증에 관한 문헌고찰과 함께 보고하는 바이다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제30권6호
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• pp.540-544
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• 2004

The oral lesion of acquired syphilis - primary, secondary, and tertiary - is comparatively rare. Most of the time secondary syphilis manifests itself as a systemic disease with maculopapular eruptions of the skin, generalized lymphadenopathy, fever, and occasional eruptions on the mucous membranes. The lesions of the tertiary stage may occur anywhere in the body, including the oral cavity. Necrotizing faciitis of the head and neck is an uncommon, rapidly spreading soft tissue infection of polymicrobial origin characterized by extensive necrosis and gas formation in the subcutaneous tissue and superficial fascia. This is characterized by its fulminating, devastating, and rapid-progressing course. The mortality rate is high if it is not treated promptly and vigorously. Patients with an impaired immune system and those with small-vessel disease such as diabetes mellitus are more prone to develop this infection.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제41권4호
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• pp.176-180
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• 2015

Objectives: The increased prevalence of antibiotic resistance is an outcome of evolution. Most patients presenting with odontogenic space infections also have associated systemic co-morbidities such as diabetes mellitus resulting in impaired host defense. The present study aims to compare the odontogenic spaces involved, antibiotic susceptibility of microorganisms, length of hospital stay, and the influence of systemic comorbidities on treatment outcome in diabetic patients. Materials and Methods: A 2-year prospective study from January 2012 to January 2014 was conducted on patients with odontogenic maxillofacial space infections. The patients were divided into two groups based on their glycemic levels. The data were compiled and statistically analyzed. Results: A total of 188 patients were included in the study that underwent surgical incision and drainage, removal of infection source, specimen collection for culture-sensitivity, and evaluation of diabetic status. Sixty-one out of 188 patients were found to be diabetic. The submandibular space was the most commonly involved space, and the most prevalent microorganism was Klebsiella pneumoniae in diabetics and group D Streptococcus in the nondiabetic group. Conclusion: The submandibular space was found to be the most commonly involved space, irrespective of glycemic control. Empiric antibiotic therapy with amoxicillin plus clavulanic acid combined with metronidazole with optimal glycemic control and surgical drainage of infection led to resolution of infection in diabetic as well as nondiabetic patients. The average length of hospital stay was found to be relatively longer in diabetic individuals.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제29권1호
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• pp.42-49
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• 2007

Infections in oral and maxillofacial region are relativley common and self-limiting, but in some cases, infections spread to adjacent hard and soft tissue and to cause any complication, even threaten life. So we made retrospective study of patients with interfascial infection who had been hospitalized and been treated by surgical treatment in Dankook university about 10 years. We reviewed the charts of patient with interfascial infection from 1995 to 2005. The result were as follows: 1. In gender & age distribution, male(54.2%) & fouth decade were most frequently. 2. The most common cause of infection was dental caries(55.2%) and the most of involving teeth was lower posterior teeth(44.1%). 3. Submandibular space is most frequently involving space and most infection involved mainly one space. 4. The patients with systemic disease were 38.2%. Diabetic mellitus was 87.2% of systemic diease. The admission period was 19.5 days in systemic disease. 5. The most microorganism in culture was Streptococcus Viridans(36.2%) in all patient. Klebsiella Pneumoniae was found most in Diabetic Mellitus. 6. The patient were mainly treated I&D on admission day. Of them 5(1.1%) patients were received tracheostomy. 7. Serum albumin, CRP and body weight are associated with Nutritional Risk Index(NRI). High risk patient group according to NRI classification showed higher rate of complications & mortality. 8. The patients with complication were 28(6.7%) persons. 4(0.9%) patients were expired. Nutritional Risk Index was helpful to predict the prognosis. When interfascial infection starts to spread, we must pay attention to airway management. Fluid therapy with nutritional may support to healing of wound.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제48권2호
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• pp.117-121
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• 2022

Infantile osteomyelitis is a rare disease that is infective in nature and may rapidly turn fatal, as the disease is often misdiagnosed due to its varied presenting signs. Early diagnosis may help in avoiding systemic involvement and permanent deformity. The disease presents with signs of orbital involvement, nasal congestion, and emesis, as well as other standard hallmarks of infection. Furthermore, the maxilla is a highly vascular and porous bone and the occurrence of osteomyelitis in an infant maxilla is highly uncommon. In addition, routine blood work is not suggestive of the presence of this disease. Thus, prompt diagnosis of this condition poses a challenge to surgeons due to the confusing array of symptoms combined with the rarity of the disease. One such case of osteomyelitis of the maxilla in a young child is presented. The dilemma encountered by the surgeon during the diagnosis and treatment of the disease is discussed.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제36권4호
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• pp.314-319
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• 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.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제18권4호
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• pp.712-717
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• 1996

The term osteomyelitis literally means inflammation of bone marrow. It is described as an inflammatory condition of bone primarily engaging the medullary cavity extending to the periosteum. Following circulatory collapse and ischemia, the involved portions of the bone become necrotic. Cellulitis and osteomyelitis are the most frequent complications of fractures of the mandible and maxilla, because there is an abscessed tooth in the line of fracture. Since most fractures are compound fractures, infection may develop because of contact with oral secretions or outside air. The treatment of chronic osteomyelitis is still under debate. Some authors rely on antibiotics alone, while others advocate combination with surgery. But when infection occurs, establish proper drainage and administer antibiotics. Author treated a case of infected mandibular fracture with mandibular osteotomy, sequestrectomy, iliac bone graft and hyperbaric oxygen therapy, who had suffered suppurative osteomyelitis and mandibular nonunion following the open reduction of the mandibular fracture.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제30권6호
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• pp.497-503
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• 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 Association of Oral and Maxillofacial Surgeons
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• 제39권4호
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• pp.175-181
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• 2013

Objectives: This retrospective study was performed to evaluate the clinical impact of diabetes mellitus on the prognosis in secondary space infection. Materials and Methods: Medical records, radiographic images, computed tomography, and microbial studies of 51 patients (25 diabetic patients and 26 non-diabetic patients) were reviewed. Patients were diagnosed as secondary fascial space infections with odontogenic origin and underwent treatment at Chonnam National University Hospital, in Department of Oral and Maxillofacial Surgery, from January 2007 to February 2009. Results: Compared to patients without diabetes, patients with diabetes were presented with the following characteristics: older age (diabetic patients: 62.9 years, non-diabetic patients, 47.8 years), more spaces involved (diabetic patients, 60%; non-diabetic patients, 27.3%), more intense treatment, longer hospitalization (diabetic patients, 28.9 days; non-diabetic patients, 15.4 days), higher white blood cell and C-reactive protein values, higher incidence of complication (diabetic patients, 40%; non-diabetic patients, 7.7%), and distinctive main causative microorganisms. Conclusion: These results suggest that the prognosis of diabetic patients is poorer than that of non-diabetic patients in secondary space infections since they had greater incidence rates of involved spaces, abnormal hematologic findings, more complications, and additional procedures, such as tracheostomy.