Evaluation of Efficacy of Ultrasonography as an Additional Diagnostic Tool for Deciding Management Protocol of Odontogenic Superficial Fascial Space Infections: A Prospective Clinical Study

Abstract

Objective To explore the efficacy of ultrasonography as an additional diagnostic tool in superficial odontogenic fascial space infections of maxillofacial region and modifying the treatment plan when needed. Materials and Methods Forty patients with superficial fascial space infections underwent a detailed clinical, plain radiological and ultrasonographic examination. Based on the ultrasonographic findings, final diagnosis was made and compared with clinical findings. Patients diagnosed with cellulitis were given medical line of treatment, and those with abscess were subjected to incision and drainage along with standard general supportive care and removal of etiologic agent.Results In this study, out of 40 patients (male = 22, female = 18), clinical diagnosis of cellulitis was made in 26 cases (65%) and abscess in 14 (35.0%). On USG examination, cellulitis was present in 21 cases (52.5%), while abscess in 19 (47.5%). Final diagnosis of cellulitis was made in 13 (59.1%) males and 12(66.7%) females, while abscess was confirmed in 9 (40.9%) male and 6 (33.3%) female patients. The results showed that sensitivity of the clinical examination alone was 64% with 33% specificity, and for USG, sensitivity was 84% with specificity of 100%. Conclusion The adjuvant role of ultrasonography in the diagnosis and timely management of superficial fascial space infections is promising owing to its accessibility, relative safety, repeatability and cost-effectiveness.

Ultrasonography (USG) as an adjuvant diagnostic aid in fascial space infections

“…Pulp necrosis caused by caries, trauma, periodontal infections, pericoronitis or any of these may lead to most odontogenic infections in healthy patients. [14] In this study, the most frequently involved space was buccal space followed by submandibular space, that is in accordance with some studies [15].…”

“…The most affected tooth was mandibular first molar both in males (10) and in females (15). In a total of 60 cases, clinical diagnosis of cellulitis was made in 18 cases (30 %) and that of abscess in 42 patients (70.0 %).…”

Maxillofacial infections of dental origin

“…The vast majority of studies showed a male prevalence in maxillofacial infections of odontogenic origin [7][8][9] . However, in the present study, a slight prevalence of females was observed in 52% of the sample.…”