Epidemiologic evaluation of maxillofacial infections and their risk factors and associated complications in a one year period in Shariati hospital in 2013-2014
Abstract
Purpose: Maxillofacial infections (MIs) commonly occur in patients of all ages, representing a life-threatening challenge when reaching deep facial spaces. The epidemiologic studies of MIs and their characteristics are very important and beneficial for both patients and clinicians. Therefore, the aim of this prospective study was to determine the annual incidence, etiology, risk factors an surgery of the Shariati hospital during a 1-year period. Material and Methods: The demographic data, levels of some serum markers on day of admission, such as erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), bandemia, serum albumin, predisposing factors for each patient referred for treatment of MI were recorded by one researcher in November 2013 to November 2014. The linear regression test was used to evaluate whether there was a relationship between the amount of changes in ESR, CRP and albumin levels and age of the patients, pregnancy, gender and severity of infection. Panoramic radiography as well as axial and coronal CT scans with soft tissue window were performed for all cases, except pregnant participants. The origin of MIs, including odontogenic, pathologic and foreign body, was identified for each patient.Results: During the study period, a total of 157 patients (87 female, 70 male), with an age range of 3 to 74 years (mean, 23.5±13.2 years), were admitted to the department of maxillofacial surgery. Regardless of the gender, the most frequent cause of MIs was odontogenic sources (128 cases, 81.5%). The most common affected area was the buccal space with 106 positive cases (67.5%). The most common teeth responsible for maxillofacial fascial space infection were mandibular third molars. A positive association was found between CRP and ESR levels and the severity of infections. Serum albumin and ESR levels were significantly reduced and increased in the patients with severe infection and pregnant patients, respectively. Conclusion: The results of this study indicated that odontogenic origins were the main cause of MIs and the most common involved space was the buccal space. Diabetes mellitus was the most commonly found systemic disease among the participants of this study. The findings of this study suggest that dentists should consider that the most appropriate treatment of odontogenic infections involves surgical intervention and selection of a suitable antibiotic as an adjunct.
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2. Yuvara V. Maxillofacial Infections of Odontogenic Origin: Epidemiological, Microbiological and Therapeutic Factors in an Indian Population. Indian J Otolaryngol Head Neck Surg 2016; 68(4): 396–9.
3. Lee JK, Kim HD, Lim SC. Predisposing factors of complicated deep neck infection: an analysis of 158 cases. Yonsei Med J 2007 28; 48(1):55-62.
4. Huang TT, Tseng FY, Yeh TH, Hsu CJ, Chen YS. Factors affecting the bacteriology of deep neck infection: a retrospective study of 128 patients. Acta Otolaryngol. 2006 Apr; 126(4):396-401.
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7. Seppänen L, Rautemaa R, Lindqvist C et al (2010) Changing clinical features of odontogenic maxillofacial infections. Clin Oral Invest 14:459–65
8. Rajendra Santosh AB, Ogle OE, Williams D, Woodbine EF. Epidemiology of Oral and Maxillofacial Infections. Dent Clin North Am 2017;61(2):217-33
9. Kitamura S. Anatomy of the fasciae and fascial spaces of the maxillofacial and the anterior neck regions. Anat Sci Int 2018;93(1):1-13.
10. Mabrouk A, Helal H, Mohamed AR, Mahmoud N. Incidence, etiology, and patterns of maxillofacial fractures in ain-shams university, cairo, egypt: a 4-year retrospective study. Craniomaxillofac Trauma Reconstr. 2014;7(3):224-32.
11. Storoe W, Haug RH, Lillich TT. The changing face of odontogenic infections. J Oral Maxillofac Surg. 2001 Jul;59(7):739-48
12. Wang J, Ahani A, Pogrel MA. A five-year retrospective study of odontogenic maxillofacial infections in a large urban public hospital. Int J Oral Maxillofac Surg. 2005;34(6):646-9.
13. Nadig K, Taylor NG.Management of odontogenic infection at a district general hospital. Br Dent J. 2018 22;224(12):962-966.
14. Bross-Soriano D, Arrieta-Gomez JR, Prado-Calleros H, et al. Management of Ludwig’s angina with small neck incisions: 18 years experience. Otolaryngol Head Neck Surg 2004;130:712–717.
15. Sanchez R, Mirada E, Arias J, et al. Severe odontogenic infections: Epidemiological, microbiological and therapeutic factors. Med Oral Patol Oral Cir Bucal 2011;16:e670–676.
16. Mathew GC, Ranganathan LK, Gandhi S, Jacob ME, Singh I, Solanki M, Bither S. Odontogenic maxillofacial space infections at a tertiary care center in North India: a five-year retrospective study.Int J Infect Dis. 2012;16(4):e296-302.
17. Zaleckas L, Rasteniene R, Rimkuviene J, et al. Retrospective analysis of cellulitis of the floor of the mouth. Stomatologija 2010;12:23–7
18. Saito CT, Gulinelli JL, Marão HF, Garcia IR Jr, Filho OM, Sonoda CK, Poi WR, Panzarini SR. Occurrence of odontogenic infections in patients treated in a postgraduation program on maxillofacial surgery and traumatology. J Craniofac Surg. 2011;22(5):1689-94
19. Zhang C, Tang Y, Zheng M, Yang J, Zhu G, Zhou H, Zhang Z, Liang X. Maxillofacial space infection experience in West China: a retrospective study of 212 cases. Int J Infect Dis. 2010;14:e414-417.
20. Rastenienė R, Pūrienė A, Aleksejūnienė J, Pečiulienė V, Zaleckas L. Odontogenic Maxillofacial Infections: A Ten-Year Retrospective Analysis. Surg Infect (Larchmt). 2015;16(3):305-12.
21. Ariji Y, Gotoh M, Kimura Y, Naitoh M, Kurita K, Natsume N, Ariji E. Odontogenic infection pathway to the submandibular space: imaging assessment. Int J Oral Maxillofac Surg. 2002;31(2):165-9.
22. Shakya N, Sharma D, Newaskar V, Agrawal D, Shrivastava S, Yadav R. Epidemiology, Microbiology and Antibiotic Sensitivity of Odontogenic Space Infections in Central India. J Maxillofac Oral Surg. 2018;17(3):324-331.
23. Stathopoulos P, Igoumenakis D, Shuttleworth J, Smith W, Ameerally P. Predictive factors of hospital stay in patients with odontogenic maxillofacial infections: the role of C-reactive protein. Br J Oral Maxillofac Surg. 2017;55(4):367-370.
24. Robinson DP, Klein SL. Pregnancy and pregnancy-associated hormones alter immune responses and disease pathogenesis. Horm Behav. 2012;62(3):263-71.
25. Fujiwara N, Tsuruda K, Iwamoto Y, Kato F, Odaki T, Yamane N, Hori Y, Harashima Y, Sakoda A, Tagaya A, Komatsuzawa H, Sugai M, Noguchi M.Significant increase of oral bacteria in the early pregnancy period in Japanese women. J Investig Clin Dent. 2017;8(1).
26. Sharma A, Gokkulakrishnan S, Shahi AK, Kumar V. Efficacy of serum CRP levels as monitoring tools for patients with fascial space infections of odontogenic origin: A clinicobiochemical study. Natl J Maxillofac Surg. 2012;3(2):148-51.
27. Sufrin S, Nessa A, Islam MT, Das RK, Rahman MH. Study on Serum Albumin in Third Trimester of Pregnancy. Mymensingh Med J. 2015;24(3):464-6.
28. Mirochnik R, Araida S, Yaffe V, Abu El-Naaj I. C-reactive protein concentration as a prognostic factor for inflammation in the management of odontogenic infections. Br J Oral Maxillofac Surg. 2017;55(10):1013-1017.
29. Ren YF, Malmstrom HS. Rapid quantitative determination of C-reactive protein at chair side in dental emergency patients. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007;104(1):49-55.
30. Basarigidad TV, Bajentri AL, Baljoshi VS. Change in erythrocyte sedimentation rate (ESR) in pregnancy and puerperium in the same woman. NJBMS. 2013;4: 111-113
31. Bhagania M, Youseff W, Mehra P, Figueroa R. Treatment of odontogenic infections: An analysis of two antibiotic regimens. J Oral Biol Craniofac Res. 2018;8(2):78-81.
2. Yuvara V. Maxillofacial Infections of Odontogenic Origin: Epidemiological, Microbiological and Therapeutic Factors in an Indian Population. Indian J Otolaryngol Head Neck Surg 2016; 68(4): 396–9.
3. Lee JK, Kim HD, Lim SC. Predisposing factors of complicated deep neck infection: an analysis of 158 cases. Yonsei Med J 2007 28; 48(1):55-62.
4. Huang TT, Tseng FY, Yeh TH, Hsu CJ, Chen YS. Factors affecting the bacteriology of deep neck infection: a retrospective study of 128 patients. Acta Otolaryngol. 2006 Apr; 126(4):396-401.
5. Statkievicz C, Faverani LP, Gomes-Ferreira PH, Ramalho-Ferreira G, Garcia-Junior IR. Misdiagnosis of Extensive Maxillofacial Infection and Its Relationship with Periodontal Problems and Hyperglycemia. Case Rep Dent 2016;2016:5960546.
6. Kamat RD, Dhupar V, Akkara F, Shetye O.A comparative analysis of odontogenic maxillofacial infections in diabetic and nondiabetic patients: an institutional study. J Korean Assoc Oral Maxillofac Surg. 2015;41(4):176-80.
7. Seppänen L, Rautemaa R, Lindqvist C et al (2010) Changing clinical features of odontogenic maxillofacial infections. Clin Oral Invest 14:459–65
8. Rajendra Santosh AB, Ogle OE, Williams D, Woodbine EF. Epidemiology of Oral and Maxillofacial Infections. Dent Clin North Am 2017;61(2):217-33
9. Kitamura S. Anatomy of the fasciae and fascial spaces of the maxillofacial and the anterior neck regions. Anat Sci Int 2018;93(1):1-13.
10. Mabrouk A, Helal H, Mohamed AR, Mahmoud N. Incidence, etiology, and patterns of maxillofacial fractures in ain-shams university, cairo, egypt: a 4-year retrospective study. Craniomaxillofac Trauma Reconstr. 2014;7(3):224-32.
11. Storoe W, Haug RH, Lillich TT. The changing face of odontogenic infections. J Oral Maxillofac Surg. 2001 Jul;59(7):739-48
12. Wang J, Ahani A, Pogrel MA. A five-year retrospective study of odontogenic maxillofacial infections in a large urban public hospital. Int J Oral Maxillofac Surg. 2005;34(6):646-9.
13. Nadig K, Taylor NG.Management of odontogenic infection at a district general hospital. Br Dent J. 2018 22;224(12):962-966.
14. Bross-Soriano D, Arrieta-Gomez JR, Prado-Calleros H, et al. Management of Ludwig’s angina with small neck incisions: 18 years experience. Otolaryngol Head Neck Surg 2004;130:712–717.
15. Sanchez R, Mirada E, Arias J, et al. Severe odontogenic infections: Epidemiological, microbiological and therapeutic factors. Med Oral Patol Oral Cir Bucal 2011;16:e670–676.
16. Mathew GC, Ranganathan LK, Gandhi S, Jacob ME, Singh I, Solanki M, Bither S. Odontogenic maxillofacial space infections at a tertiary care center in North India: a five-year retrospective study.Int J Infect Dis. 2012;16(4):e296-302.
17. Zaleckas L, Rasteniene R, Rimkuviene J, et al. Retrospective analysis of cellulitis of the floor of the mouth. Stomatologija 2010;12:23–7
18. Saito CT, Gulinelli JL, Marão HF, Garcia IR Jr, Filho OM, Sonoda CK, Poi WR, Panzarini SR. Occurrence of odontogenic infections in patients treated in a postgraduation program on maxillofacial surgery and traumatology. J Craniofac Surg. 2011;22(5):1689-94
19. Zhang C, Tang Y, Zheng M, Yang J, Zhu G, Zhou H, Zhang Z, Liang X. Maxillofacial space infection experience in West China: a retrospective study of 212 cases. Int J Infect Dis. 2010;14:e414-417.
20. Rastenienė R, Pūrienė A, Aleksejūnienė J, Pečiulienė V, Zaleckas L. Odontogenic Maxillofacial Infections: A Ten-Year Retrospective Analysis. Surg Infect (Larchmt). 2015;16(3):305-12.
21. Ariji Y, Gotoh M, Kimura Y, Naitoh M, Kurita K, Natsume N, Ariji E. Odontogenic infection pathway to the submandibular space: imaging assessment. Int J Oral Maxillofac Surg. 2002;31(2):165-9.
22. Shakya N, Sharma D, Newaskar V, Agrawal D, Shrivastava S, Yadav R. Epidemiology, Microbiology and Antibiotic Sensitivity of Odontogenic Space Infections in Central India. J Maxillofac Oral Surg. 2018;17(3):324-331.
23. Stathopoulos P, Igoumenakis D, Shuttleworth J, Smith W, Ameerally P. Predictive factors of hospital stay in patients with odontogenic maxillofacial infections: the role of C-reactive protein. Br J Oral Maxillofac Surg. 2017;55(4):367-370.
24. Robinson DP, Klein SL. Pregnancy and pregnancy-associated hormones alter immune responses and disease pathogenesis. Horm Behav. 2012;62(3):263-71.
25. Fujiwara N, Tsuruda K, Iwamoto Y, Kato F, Odaki T, Yamane N, Hori Y, Harashima Y, Sakoda A, Tagaya A, Komatsuzawa H, Sugai M, Noguchi M.Significant increase of oral bacteria in the early pregnancy period in Japanese women. J Investig Clin Dent. 2017;8(1).
26. Sharma A, Gokkulakrishnan S, Shahi AK, Kumar V. Efficacy of serum CRP levels as monitoring tools for patients with fascial space infections of odontogenic origin: A clinicobiochemical study. Natl J Maxillofac Surg. 2012;3(2):148-51.
27. Sufrin S, Nessa A, Islam MT, Das RK, Rahman MH. Study on Serum Albumin in Third Trimester of Pregnancy. Mymensingh Med J. 2015;24(3):464-6.
28. Mirochnik R, Araida S, Yaffe V, Abu El-Naaj I. C-reactive protein concentration as a prognostic factor for inflammation in the management of odontogenic infections. Br J Oral Maxillofac Surg. 2017;55(10):1013-1017.
29. Ren YF, Malmstrom HS. Rapid quantitative determination of C-reactive protein at chair side in dental emergency patients. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007;104(1):49-55.
30. Basarigidad TV, Bajentri AL, Baljoshi VS. Change in erythrocyte sedimentation rate (ESR) in pregnancy and puerperium in the same woman. NJBMS. 2013;4: 111-113
31. Bhagania M, Youseff W, Mehra P, Figueroa R. Treatment of odontogenic infections: An analysis of two antibiotic regimens. J Oral Biol Craniofac Res. 2018;8(2):78-81.
| Files | ||
| Issue | Vol 6, No 1 (Winter 2019) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/jcr.v6i1.1625 | |
| Keywords | ||
| Maxillofacial infection Risk factors Complications | ||
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How to Cite
1.
Mahmood Hashemi H, Sharifi R, Hasheminasab M, Mortazavi M. Epidemiologic evaluation of maxillofacial infections and their risk factors and associated complications in a one year period in Shariati hospital in 2013-2014. J Craniomaxillofac Res. 2019;6(1):11-19.
