Clinical Management of Orofacial Odontogenic Infection: A Four Year Retrospective Study

Abstract

Orofacial odontogenic infection, although arises from dental origin, can extend into the facial spaces and lead to debilitating complications. This study analysed the clinical pattern and management of orofacial odontogenic infection in a tertiary hospital namely Hospital Raja Permaisuri Bainun in Perak, Malaysia. We investigated any associations between socio-demographic factors, diabetic, comorbidities, smoking, pregnancy, antibiotic resistance, number and type of space infected towards prolonged hospital stay. All adult patients with orofacial odontogenic infections treated by Department of Oral and Maxillofacial Surgery from 2014 to 2018 were included. Clinical patterns were evaluated. Statistical analysis was performed to measure various variables towards prolonged hospital stay. A total of 154 patients (78 male, 76 female) were included in this study with mean age of 37.95 ± 14.9 years. Key factors of orofacial odontogenic infection requiring admissions were swelling, pain, trismus, odynophagia, reduced oral intake, raised floor of mouth and dyspnea. Among inpatients, three factors were significantly associated with prolonged hospital stay, namely antibiotic resistance, multiple space and secondary space infection. Local prevalence data was reported. Pus culture and sensitivity tests were recommended for all inpatients with multiple space and secondary space involvement, in order to rule out antibiotic resistance and to improve recovery rate.

Etiology and Demographic Distribution of Odontogenic Abscesses in the Maxillofacial Area in Patients Over 18 Years of Age: A Five-Year Retrospective Study

“…The course of abscesses and the outcome of the disease, not only of the head and neck but also in general, depend on the immune status of the patient, the type and virulence of the microorganisms and the treatment performed [8]. Treatment of purulent odontogenic infections aims at evacuation of the purulent focus by incision and drainage of the abscess cavity, possibly removal of the source of infection, which in this case is the diseased tooth; other treatment options include oral or parenteral antibacterial therapy [9]. In our routine surgical practice, we do not always remove the source of infection during the incision of the abscess itself.…”