Management of upper odontogenic infections and the role of multidisciplinary treatment

  • matteo trimarchi | trimarchi.matteo@hsr.it Department of Surgical Sciences, Division of Otolaryngology, IRCCS San Raffaele Hospital, Vita-Salute University, Milano, Italy, Italy.
  • Alessandro Vinciguerra Department of Surgical Sciences, Division of Otolaryngology, IRCCS San Raffaele Hospital, Vita-Salute University, Milano, Italy, Italy. https://orcid.org/0000-0003-4805-4908
  • Andrea Galli Department of Surgical Sciences, Division of Otolaryngology, IRCCS San Raffaele Hospital, Vita-Salute University, Milano, Italy, Italy.
  • Paolo Capparè Dentistry Department, IRCCS San Raffaele Hospital, Vita-Salute University, Milano, Italy, Italy.
  • Raffaele Vinci Dentistry Department, IRCCS San Raffaele Hospital, Vita-Salute University, Milano, Italy, Italy.
  • Mario Bussi Department of Surgical Sciences, Division of Otolaryngology, IRCCS San Raffaele Hospital, Vita-Salute University, Milano, Italy, Italy.

Abstract

Aim Odontogenic sinusitis is a group of infections related to dental conditions. It may involve the paranasal sinuses (upper odontogenic infections, UOs) and cervical-fascial spaces. Proper diagnosis and treatment of dental complications can be challenging due to  unspecific clinical presentation.

Materials and methods A retrospective study of 37 patients with acute UOs treated between January 2008 and December 2018 is presented. A clear etiological and chronological relationship between the odontogenic focus and sinonasal infection was required for inclusion in the study.

Results The causes of UOs were mainly dental implantation (29.8%) and tooth extraction (18.9%). In all cases, UOs were treated with transnasal endoscopic surgery, associated with transoral procedures in 24 out of 37 patients (64.9%). Empirical antibiotic therapy was used in all cases, whereas antibiogram-driven therapy was adopted secondarily in 22 out of 37 cases (59.4%). Surgical success was achieved in 97.3% of patients.

Conclusions Multidisciplinary agreement of an otorhinolaryngologist and dental surgeon is a crucial step in proper diagnosis and treatment of UOs. A correct surgical approach and antibiogram-driven therapy are key elements of correct resolution of infection.

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Published
2019-09-12
Section
Articles
Keywords
odontogenic infections, odontogenic sinusitis, maxillary sinusitis, dental implant, caries
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Received 2019-06-16
Published 2019-09-12

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How to Cite
trimarchi, matteo, Vinciguerra, A., Galli, A., Capparè, P., Vinci, R., & Bussi, M. (2019). Management of upper odontogenic infections and the role of multidisciplinary treatment. Journal of Osseointegration. https://doi.org/10.23805/JO.2019.11.03.15