• Imaging Science in Dentistry
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• v.41 no.4
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• pp.189-193
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• 2011

The advent and wide use of antibiotics have decreased the incidence of deep neck infection. When a deep neck infection does occur, however, it can be the cause of significant morbidity and death, resulting in airway obstruction, mediastinitis, pericarditis, epidural abscesses, and major vessel erosion. In our clinic, a patient with diffuse chronic osteomyelitis of mandible and fascial space abscess and necrotic fasciitis due to odontogenic infection at the time of first visit came. We successfully treated the patient by early diagnosis using contrast-enhanced CT and follow up dressing through the appropriate use of radiographic images.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.39
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• pp.18.1-18.4
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• 2017

Background: Postoperative infection occurs when bone graft material is dislodged into the maxillary sinus cavity and most of the patients are often uncomfortable with the drainage and irrigation procedures to eradicate the infection. In this case report, we share a technique in treating patients with such condition. Material and methods: A 47-year-old patient was referred after sinus elevation using the crestal socket osteotome, bone graft, and implant insertion at a local clinic. Clinical and radiographic findings confirmed the diagnosis of right maxillary sinusitis. A surgical and medical treatment regimen was applied. Results: By using this technique for irrigation, we were able to achieve successful results, and the patient was satisfied due to less discomfort during the irrigation process. Conclusion: This method is a patient-friendly technique for sinus irrigation. It is not only limited to sinus grafted patients, but also maxillary sinusitis patients in any other type of odontogenic infection.

• Archives of Craniofacial Surgery
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• v.16 no.1
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• pp.39-42
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• 2015

Actinomycosis is a subacute or chronic suppurative infection caused by Actinomyces species, which are anaerobic Gram-positive bacteria that normally colonize the human mouth and digestive and urogenital tracts. Cervicofacial actinomycosis is the most frequent clinical form of actinomycosis, and is associated with odontogenic infection. Characterized by an abscess and mandibular involvement with or without fistula, but the cervicofacial form of actinomycosis is often misdiagnosed because the presentation is not specific and because it can mimic numerous infectious and non-infectious diseases, including malignant tumors. We report a rare case of actinomycosis infection with coexisting submandibular sialolithiasis. The patient presented with a $1{\times}1cm$ abscess-like lesion below the lower lip. Punch biopsy of the lesion revealed atypical squamous cell proliferation with infiltrative growth, suggestive of squamous cell carcinoma. The patient underwent wide excision of this lesion, where the lesion was found to be an abscess formation with multiple submandibular sialolithiases. The surgical specimen was found to contain Actinomyces without any evidence of a malignant process. We assumed that associated predisposing factors such as poor oral hygiene may have caused a dehydrated condition of the oral cavity, leading to coexistence of actinomycosis and sialolithiasis.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.1
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• pp.34-42
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• 2004

The appropriate care to the dental emergency patients is much important in the aspect of community dental service. To attain such a purpose, the sacred duty of the training of oral and maxillofacial surgeons is required. So, a retrospective study on the characteristics of dental injuries and diseases in emergency care unit will be very meaningful. This study was carried by reviewing the charts and radiographic films of 3,394 patients, treated for dental emergency at Wonju Christian Hospital, Republic of Korea, from January 1, 1993 to December 31, 2002. All patients were classified to 6 groups including trauma, toothache, infection, hemorrhage, TMJ disorder and the others. The clinical characteristics of diseases and treatment modalities according to each group were analyzed. The trauma (73.9%) was the most frequent cause in dental emergency patients, and acute toothache, odontogenic infection, oral hemorrhage, and TMJ disorder were next in order. Gender prediction was male (68%), there were many patients on May and December in the monthly frequency, and the most frequent age group was from 0 to 9 years. In the trauma group, male (68.6%) was predominant, and soft tissue injuries and primary closures were the most frequent type of injury and treatment. In jaw fractures, traffic accidents were the most cause and the weakest site was mandibular symphysis area, and mandibular angle, condyle, and body area were next in order. In the acute toothache group, the cause was dental pulpitis mostly and treatment for that was drug administration mainly. Buccal space abscess in infection group had the largest incidence (24.5%), and common treatments were incision and drainage and medications. In the hemorrhage group, a major cause was postoperative bleeding (60.3%) and hemostasis was obtained by pressure dressing, curettage and suture. For the TMJ disorder group, the peak incidence (63.8%) was shown in the post-traumatic myofascial pain dysfunction syndrome and its primary care was medication such as analgesics and sedatives. In the other group, the various specific symptoms were complained due to acute sialadenitis, trigeminal neuralgia, acute stomatitis, chemical burn, terminal stage neuritis of head and neck cancer, and foreign body aspiration. In conclusion, for the rapid and proper care of the emergency dental diseases, well-trained education should be presented to the intern and resident course of oral and maxillofacial surgery. And it is demanded that oral and maxillofacial surgeons must be prepared in knowledge and skill for such emergency care.

• Journal of Dental Anesthesia and Pain Medicine
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• v.20 no.4
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• pp.251-259
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• 2020

Oral and maxillofacial infection is a common complication in patients undergoing chemotherapy. The treatment of oral diseases in such patients differs from that administered to healthy patients. This paper reports a case of acute osteomyelitis of odontogenic origin following a recent chemotherapy session. The patient's condition was life-threatening because of neutropenic fever and sepsis that developed during the inpatient supportive care. However, the patient showed prompt recovery within 40 days following the use of appropriate antibiotics and routine dressing, without the requirement for surgical treatment, except tooth extraction. As seen in this case, patients undergoing chemotherapy are more susceptible to rapid progression of infections in the oral and maxillofacial areas. Therefore, accurate diagnosis through prompt clinical and radiological examination, identification of the extent of infection, and assessment of the patient's immune system are crucial for favorable outcomes. It is also necessary to eliminate the source of infection through appropriate administration of antibiotics. In particular, a broad-spectrum antibiotic with anti-pneumococcal activity is essential. Proper antibiotic administration and wound dressing are essential for infection control. Furthermore, close consultation with a hemato-oncologist is necessary for effective infection management based on the professional evaluation of patients' immune mechanisms.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.41 no.6
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• pp.293-298
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• 2015

Objectives: Infection involving the orbit, zygomatic space, lateral pharyngeal space, or hemifacial and oral floor phlegmon is referred to as cervicofacial infection (CFI). When diagnosis and/or adequate treatment are delayed, these infections can be life-threatening. Most cases are the result of odontogenic infections. We highlight our experiences in the management of this life-threatening condition. Materials and Methods: This was a retrospective study of patients who presented with CFI from December 2005 to June 2012 at the Oral and Maxillofacial Surgery Clinic or the Accident and Emergency Unit of Ahmadu Bello University Teaching Hospital (Zaria, Nigeria). The medical records of all patients who presented with either localized or diffuse infection of the maxillofacial soft tissue spaces were retrospectively collected. Data collected was analyzed using SPSS version 13.0 and are expressed as descriptive and inferential statistics. Results: Of the 77 patients, 49 patients (63.6%) were males, a male to female ratio of 1:7.5. The ages ranged from two years to 75 years with a mean of $35.0{\pm}19.3$ years, although most patients were older than 40 years. The duration of symptoms prior to presentation ranged from 6 to 60 days, with a mean of $11.0{\pm}9.4$ days. More than 90% of the patients presented to the clinic within the first 10 days. The most commonly involved anatomical space was the submandibular space (n=29, 37.7%), followed by hemifacial space (n=22, 28.6%) and buccal space (n=7, 9.1%). Ludwig angina accounted for about 7.8% of the cases. Conclusion: CFI most commonly involves the submandibular space, typically affects individuals with a low level of education, and is influenced by traditional medical practices. Despite improved health care delivery, CFI remains a significant problem in developing countries.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.41
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• pp.49.1-49.8
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• 2019

Background: The purpose of this study was to review the clinical features of oromaxillofacial infections in patients presenting to a hospital emergency ward, to identify the key factors affecting the requirement for hospitalization, and the potential risk factors predisposing to a prolonged length of hospital stay. Methods: A retrospective medical record review of the 598 patients treated for oromaxillofacial infection from 2013 to 2017 at the oral and maxillofacial surgery department, Yangsan Pusan National University Hospital, was conducted. The following information was collected from each patient: sex, age, past medical history, site of infection, etiology, admission or outpatient care, level of C-reactive protein (mg/dL), fascial spaces involved, treatment method, and duration of hospitalization. Chi-squared tests were used to identify risk factors, which were further analyzed using multivariable logistic regression. Results: A total of 606 patients were eligible for inclusion in the study, of which eight were excluded due to having incomplete charts; thus, 598 patients were included: 55% were male, mean patient age was 47.1 ± 19.9 years, and 12.9% of patients were diabetic. Furthermore, 71.2% of patients had infection originating in the mandible; the most common tooth of origin was lower posterior, and 29.8% of patients were hospitalized. Risk factors for hospital admission were elderly patients with concurrent disease, elevated C-reactive protein level, and multiple-space infection in the oromaxillofacial area. The duration of hospitalization was correlated with both diabetes and age. Conclusions: The requirement for hospital admission is determined by the severity of the infection; even severe infections, once treated with appropriate surgery, have no relation to the length of hospital stay. The important risk factors for increased duration of hospitalization are diabetes mellitus and older age. The understanding of risk factors associated with a prolonged hospital stay during the treatment of oromaxillofacial infection will aid in treatment planning as well as highlight the importance of adequate diabetes control in patients at risk of such infection.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.31 no.4
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• pp.322-328
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• 2005

Oral and maxillofacial infections are most commonly odontogenic in origin. The present study was implemented for patients with oral and maxillofacial infections in order to determine what differences were present in cultured bacteria, depending upon the different types of infection. For the present study, the epidemiological characteristics, the state of infection, and the results of the pus culture and antibiotic susceptibility tests were analyzed for the 159 cases where pus culture tests were performed. The patients were treated at the Oral and Maxillofacial Surgical Department of Chonnam National University Hospital during an 18-months period from March 2003 to August 2004. Among the total 159 pus culture specimens, bacteria were cultured in 111 cases (69.8%). In the 111 pus culture specimens, Streptococcus species, Neisseria species, and Staphylococcus species were cultured from 69 cases (51.1%), 21 cases (15.6%), and 15 cases (11.1%), respectively and were determined to be bacterial strains the predominant bacteria responsible for oral and maxillofacial infectious diseases. Twenty four cases (15.1%) among the 159 specimens showed mixed infections. The mostly isolated bacteria from each of the space abscess, dentoalveolar abscess, inflammatory cyst, and pericoronitis cases were the Viridans streptococci. There was little relevance between the type of infection and the type of cultured bacteria. Antibiotic susceptibility tests showed a high level of susceptibility to teicoplanin(100%), vancomycin(100%), chloramphenicol(96.4%), ofloxacin(88.3%), imipenem(83.3%), erythromycin(82.5%) and a low susceptibility to cefazolin(40.0%), oxacillin(44.7%), ampicillin(49.4%), penicillin(51.1%). These results indicate that there was no significant difference among the cultured bacteria depending on the type of infections and their susceptibility to cephalosporin and penicillin G was low.

• Proceedings of the KACD Conference
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• 2001.05a
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• pp.252-252
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• 2001

;The Varicella zoster virus can cause two infectious diseases. The primary infection of this virus leads to Chicken pox and it goes into a latent period until it reveals itself again. When secondarily shown. it is called Herpes Zoster. Herpes Zoster can usually be seen between T-3 and L-2 of immunodepressant patients but in 13%. it is seen in the trigeminal nerve branch. During the predrominal stage. burning sensation, itching. and sharp pain can be experienced unilaterally where the nerve branch is distributed. Patients can also express tooth pain in this stage. After 2-4 days the acute stage begins with its characteristic unilateral macule showing vesicle formation. In this stage fever and fatigue can be experienced. Continuous pain even after the acute stage is called postherpetic neuralgia; deep pain and burning sensation can be expressed by the patient. The sequelae of this disease consists of rare osteomyelitis. necrosis of the jaws. or loss of teeth.teeth.

• Korean Journal of Bronchoesophagology
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• v.8 no.1
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• pp.71-74
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• 2002

A 44-year-old man was admitted to our hospital because of high fever, neck swelling, and dyspnea. He was diagnosed as descending necrotizing mediastinitis (DNM) extended from oropharyngeal infection. Descending necrotizing mediastinitis(DNM) is a lethal process originating from odontogenic. oropharyngeal, or cervical infections that descends along the fascial planes into the mediastinum. DNM is relatively rare, but it is lethal disease with high mortality. Immediate and sufficient mediastinal drainage is indispensable for the disease. The principles of the surgical approach for DNM are discussed, with a brief review of the literature following these case reports.