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At least 199 records · Page 11Linked to original sources
PubMed1990

Uncontrolled bleeding during endodontic treatment as the first symptoms for diagnosing von Willebrand's disease. A case report.

Von Willebrand's disease has been established as the most common hereditary hemorrhagic disease. Endodontic treatment, when possible, rather than extraction is the treatment of choice in patients suffering from such a disease. A case is presented in which, during regular endodontic treatment, uncontrollable bleeding occurred, suggestive of a generalized bleeding disorder. A thorough hematologic examination revealed von Willebrand's disease, which the patient was not aware of. The dental surgeon can play an important role in the diagnosis and treatment of such patients.

Adult↗
PubMed1991

Oral mucosal soft tissue necrosis caused by superinfection. Report of three cases.

Three patients in whom flap necrosis developed after oral surgeries and antibiotic therapies were studied microbiologically by routine aerobic and anaerobic methods. In all cases the bacteria Enterobacter cloacae, Klebsiella oxytoca, Escherichia coli, and coagulase-negative penicillinase-producing staphylococci were resistant to the antibiotics used. These bacteria are frequent microorganisms of superinfection and were not found after the necrotic tissues had repaired.

Adult↗
PubMed1978

Metastatic Peptostreptococcus intermedius endophthalmitis after a dental procedure.

A 46-year-old man developed symptoms of a chronic progressive uveitis in his right eye approximately one week after a dental procedure. The patient's intraocular inflammation was not diminished by massive treatment with topical and systemic corticosteroid therapy or intravenously administered adrenocorticotropic hormone. The inflammatory process progressed to an overt endophthalmitis during a period of three weeks and the eye eventually required evisceration. A pure culture of Peptostreptococcus intermedius was isolated from the eye. The most likely source of this organism was hematologic transport following a dental procedure.

Bacterial Infections↗
PubMed1980

Cutaneous odontogenic sinus.

A case report and discussion of cutaneous odontogenic sinus tracts, frequently encountered but often misdiagnosed and mistreated, are presented. Awareness that periapical dental abscesses are the most common etiologic factor of cutaneous sinus tracts involving the face and neck will facilitate their early diagnosis and prevent needless treatment or anxiety for the patient. These lesions are often misinterpreted as chronic, resistant to therapy, pyogenic nodules, or granulomas. A high degree of suspicion is required for making the correct diagnosis, and dental roentgenographic studies should routinely be obtained in all such lesions. Permanent healing cannot be achieved unless the original site of infection is located and eradicated.

Dental Fistula↗
PubMed2000

The swollen face. Severe odontogenic infections.

Owing to the widespread availability of preventive dental care and the development of effective antibiotics for the treatment of orofacial infection, the incidence of serious odontogenic infections has decreased dramatically over the past 50 years. Serious dental infections still occur, however, and their occasionally severe complications or even mortality warrant serious study of the clinical presentation, anatomy, and pathophysiology of orofacial infections. The goal of this review is to provide the emergency practitioner with a concise description of the clinical presentation, relevant anatomy, and treatment principles of odontogenic infection in the patient who presents to the ED with a swollen face or difficulty in opening the mouth widely. Prompt institution of surgical therapy for the infection, aided by appropriate antibiotic therapy enables the healthcare professions to continue their remarkable progress in treating these once-dreaded infections.

Anti-Bacterial Agents↗
PubMed2001

Different treatment outcomes of two intruded permanent incisors--a case report.

Intrusive luxation involves the displacement of the tooth apically into the alveolar socket. This type of injury represents a very complex wound, involving disruption of the marginal gingival seal, alveolar bone, periodontal ligament fibers, cementum and the neuro-vascular supply to the pulp, which results in severely compromised healing and possible complications. The case presented is a report of a 60-year-old lady who fell and intruded her two maxillary central incisors. The healing outcomes of the two central incisors were markedly different from each other even though they sustained similar injuries.

Alveolar Process↗
PubMed2001

Are antibiotics being used appropriately for emergency dental treatment?

AIM: To investigate the therapeutic prescribing of antibiotics to patients presenting for emergency dental treatment. DESIGN: A prospective clinical study. METHOD: Information was collected via a questionnaire concerning the patient's reason for attendance and treatment undertaken at emergency dental clinics in North and South Cheshire. RESULTS: Over an 11-week period 1,069 patients attended the five clinics, 1,011 questionnaires were analyzed. The majority of the attendees had pain (879/1011). 35% (311/879) of these patient had pulpitis and 74% (230/311) had been issued a prescription for antibiotics, without any active surgical intervention. Th principal antibiotic prescribed for both adult and child patients was amoxicillin. CONCLUSION: The majority of patients attending the emergency dental clinics had pain, with a large proportion having localised infections either as pulpitis or localised dental abscess. Three quarters of these patients had no surgical intervention and were inappropriately prescribed antibiotics.

Adolescent↗
PubMed1998

Thrombotic thrombocytopenic purpura that is refractory to therapeutic plasma exchange in two patients with occult infection.

BACKGROUND: The etiology of thrombotic thrombocytopenic purpura (TTP) remains undetermined. TTP has been associated with a number of secondary causes including infections, drugs, menses, pregnancy, autoimmune diseases, and bone marrow transplantation. Regardless of the inciting factors, it is widely accepted that endothelial injury and platelet aggregation are integral components. The morbidity and mortality have been significantly reduced with the use of plasmapheresis. However, refractory forms of TTP remain a clinical management challenge. Refractory TTP has not previously been associated with occult bacterial infection. CASE REPORT: Two patients had classic TTP that was refractory to daily plasma exchange with fresh-frozen plasma. Multiple attempts over a period of months to wean these patients off plasma exchange resulted in exacerbations of disease activity, as indicated by increased schistocytosis, decreased hematocrit, increased serum lactate dehydrogenase, and decreased platelet counts. Both patients were empirically treated for infections during hospitalization, although microbial cultures failed to isolate an organism. Discontinuation of antimicrobial therapy on multiple occasions in one patient was associated with recurrence of disease. In the other patient, dental extraction with drainage of an occult periodontal abscess resulted in sustained remission of disease. CONCLUSION: Occult bacterial infection may play a role in triggering and sustaining TTP that is refractory to conventional treatment. A careful search for such an infection and appropriate antimicrobial therapy should be considered in the management of these patients.

Anti-Bacterial Agents↗
PubMed2001

Necrotizing fasciitis of odontogenic origin in Ibadan, Nigeria.

We reviewed eight patients with necrotizing fasciitis of odontogenic origin. There were three women and five men, mean age 58 (range 46-72), and none had any associated medical condition such as diabetes. All cases had symptoms of toothache for a mean duration of 34 days (range 26-42) before they sought treatment. Infection originated in the molar teeth region, and initially presented as an odontogenic or periodontal abscess. The clinical features of necrotizing fasciitis became apparent only after the superficial fascia had been invaded. The transient unusually reddish hue for a dark skin might be explained by the fact the deep fascia and muscles were affected before the superficial fascia and skin. Necrosis of the skin began in the submandibular region and progressed downwards. The necrotic area was less than the extent of infection. Antimicrobial treatment, debridement, and fasciotomy improved healing. Delay before appropriate treatment had an adverse affect on outcome, and one patient died.

Aged↗
PubMed2003

[Quantitative analysis of contrast enhanced MRI of the inferior alveolar nerve in inflammatory changes of the mandible].

PURPOSE: To evaluate the role of contrast enhanced MRI in quantifying signal changes of the inferior alveolar nerve following inflammatory changes of the mandible. MATERIAL AND METHODS: 30 patients with inflammatory changes of the mandible underwent MRI of the face. Both sides of the mandible, the affected as well as the unaffected healthy side were evaluated retrospectively. Regions of interest were placed at 5 defined places on both sides to assess signal intensity before and after intravenous application of paramagnetic contrast agent. The results of the measurements were compared between the healthy and the affected side (t-test, p < 0.05) and correlated with clinical findings (t-test, p < 0.05). RESULTS: All patients with hypesthesia of the inferior alveolar nerve in areas of the lips or chin (n = 4) showed a marked increase in signal intensity from 35 % to 83 % distal to the inflammatory process. Patients without sensitivity disorders showed less increase in signal intensity with a maximum of 51 % distal to the inflammatory process. In nearly all patients no contrast enhancement was observed distal to the first molar on the unaffected side. CONCLUSIONS: Quantitative analysis of contrast enhanced MRI of the neurovascular bundle is able to show pathologic mandibular lesions. In case of inflammatory changes of the mandible the neurovascular bundle is able to show pathologic mandibular lesions. In case of inflammatory changes of the mandible, the neurovascular bundle shows a significant increase in signal intensity distal to the lesion compared to the unaffected healthy side of the mandible.

Adolescent↗
PubMedDate not supplied

Anaerobic osteomyelitis in children.

Twenty-six pediatric patients with osteomyelitis caused by anaerobic bacteria are presented. The etiologic factors were chronic mastoiditis (7 patients), decubitus ulcers (5), chronic sinusitis (4), periodontal abscesses (3), bites (3), paronychia (2), trauma (1) and scalp infection after fetal monitoring (1). Seventy-four organisms (2.8 isolates/specimen), including 63 anaerobes (2.4/specimen), and 11 facultative and aerobic bacteria (0.4/specimen) were recovered. The predominant organisms were anaerobic cocci (29 isolates), Bacteroides sp. (21), Fusobacterium sp. (8), Streptococcus sp. (5) and Clostridium sp. (4). The organisms generally reflected the microbial flora of the mucous surface adjacent to the infected site. Ten beta-lactamase-producing organisms were recovered from 7 (27%) patients. These included all isolates of the Bacteroides fragilis (4) and of Staphylococcus aureus (3), 2 of the 12 Bacteroides melaninogenicus group and 1 of 3 Bacteroides oralis. The clinical, diagnostic and therapeutic aspects of anaerobic osteomyelitis in children are discussed.

Adolescent↗
PubMed1990

Cytomegalovirus-induced osteomyelitis in a patient with the acquired immunodeficiency syndrome.

A 43-year-old man with AIDS had a periodontal abscess, no fever, and normal findings on funduscopic examination. Three months later, the abscess area was debrided, and histologic examination of the tissue revealed osteomyelitis of the mandible. Within the area of osteomyelitis were numerous cells with inclusions typical of cytomegalovirus (CMV) infected cells. Funduscopic examination at that time revealed extensive CMV retinitis. Osteomyelitis should be added to the list of infections caused by CMV in patients with AIDS.

Acquired Immunodeficiency Syndrome↗