Odontogenic infection is a common cause of sepsis in the head and neck. Infection frequently spreads in a predictable pattern within the fascial spaces of the neck and can result in airway compromise. Often the condition results in significant morbidity and a prolonged hospital stay. In this study, we assessed the incidence of sepsis syndrome in patients presenting to a regional maxillofacial unit with odontogenic infection. Six months of prospective data were collected, with sixty-seven patients included. The focus of infection was mandibular in 70.1% and maxillary in 29.9%. The mean length of stay was four days and 61.2% of patients were diagnosed with sepsis syndrome on admission. This group remained in hospital significantly longer than non-sepsis syndrome patients (sepsis=4.7 days, non-sepsis=2.9 days. p=0.0145.) The site of infection was not a significant factor in the development of the systemic inflammatory response syndrome (SIRS).
Orofacial infections following dental extractions are a common referral to an oral and maxillofacial department as an emergency, especially when combined with swelling and limited mouth opening. The case presented demonstrates a rare complication of chronic suppurative osteomyelitis with bilateral pathological fractures of the mandible, which occurred following a staged dental clearance. CPD/Clinical Relevance: Dental extractions are one of the most common treatments carried out by oral surgeons and general dental practitioners. This case highlights a rare but encountered complication of routine oral surgery and demonstrates when it is necessary to make an immediate referral to the local oral and maxillofacial surgery unit.
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