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Severe odontogenic infections, part 2: prospective outcomes study
Thomas R Flynn1, Rabie M Shanti, Catherine Hayes
1Harvard School of Dental Medicine, Boston, MA 02115, USA. thomas_flynn@hsdm.harvard.edu
Summary
Severe odontogenic infections can lead to abscesses, longer hospital stays, and reoperations. Peptostreptococci may prevent abscesses, while infection extent and complications predict longer hospital stays.
Area of Science:
- Oral and Maxillofacial Surgery
- Infectious Diseases
- Clinical Microbiology
Background:
- Severe odontogenic infections pose significant clinical challenges.
- Predicting outcomes like abscess formation, treatment failure, and hospital stay is crucial for patient management.
Purpose of the Study:
- To identify predictors for four key outcomes in severe odontogenic infections: abscess formation, penicillin therapeutic failure (PTF), length of hospital stay (LOS), and reoperation.
- To understand the factors influencing patient recovery and treatment effectiveness.
Main Methods:
- Prospective case series of 37 patients with severe odontogenic infections.
- Multivariate linear and logistic regression analyses were employed to assess associations between variables and outcomes.
- Key variables included demographics, infection characteristics, treatment details, and microbiological findings.
Main Results:
- Culture of Peptostreptococci was a negative predictor of abscess formation.
- Length of hospital stay (LOS) was predicted by the number of infected spaces and duration of operation.
- No significant predictors for PTF or reoperation were found in multivariate analysis, though penicillin-resistant organisms were noted in PTF cases.
Conclusions:
- The anatomic extent and severity of infection, along with complications like PTF and reoperation, predict increased LOS.
- Penicillin-resistant organisms are significantly associated with PTF.
- The role of Peptostreptococci in abscess formation requires further research.
