Odontogenic cervical necrotizing fasciitis, etiological aspects

Introduction: Cervical necrotizing fasciitis is a rare but very severe infection that affects the soft‑tissues of the cephalic extremity. Cervical necrotizing fasciitis most frequently occurs secondarily to inflammatory odontogenic disorders and represents the most severe infection of maxillofacial spaces, with a high lethal potential.Materials and Methods: In this study, we selected 55 patients with confirmed cervical necrotizing fasciitis of odontogenic origin, treated in the Clinic of Oral and Maxillofacial Surgery in Cluj‑Napoca during January 1996-December 2012.Results: In the majority of cases, the disease evolved without the presence of associated systemic disorders (60% [45.49- 72.69]), the rest of the patients having 1-4 types of systemic disorders; type 2 diabetes mellitus was the most frequent type of underlying systemic disorder. From the appearance of the first symptoms until the presentation for treatment, a time interval of 2-30 days elapsed. During this time period, 78.18% (95% confidence interval [CI] [65.49 89.06]) of the patients received antibiotic treatment, but without results. Mandibular molars were the most frequent starting point of the disease, and the submandibular space was the first affected by the disease, 47.27% (95% CI [32.76-61.79]). Bacteriological exams showed that facultatively aerobic/anaerobic G + bacteria were the most frequently identified (72.22% [58.21-83.60]).Conclusion: The odontogenic lesions of the lower molars, complicated by submandibular space infections, are the most frequent starting point of odontogenic cervicofacial necrotizing fasciitis. Delayed surgical treatment and strict antibiotic therapy play an important role in favoring the development of odontogenic necrotizing fasciitis.Keywords: Head and neck infections, necrotizing fasciitis, odontogenic infectio

The Prevalence Of Hypodontia In Children With Cleft And Nonrelated Controls

The aim of this study was to compare the occurrence of hypodontia, dental age, and asymmetric dental development in children with cleft with a non- sibling control group. The study sample consisted of 30 children with cleft (aged 7.2 to 17.1 years) and 60 controls without cleft (aged between 7 and 18.8 years). Hypodontia, dental age, and asymmetric dental development were assessed on panoramic radiographs of the children with cleft and the control children without cleft. The cleft (p.001) group showed a significantly higher frequency of hypodontia and a significantly higher occurrence (cleft p.01) of asymmetric dental development, compared with the control group. Only a small, but insignificant delay in dental development could be found in the cleft group. The cleft subjects showed a significantly higher occurrence of hypodontia and asymmetric dental development than the non-cleft control group. This may suggest a genetic component for the occurrence of hypodontia and asymmetric dental development

Pre-surgical treatment planning of maxillary canine impactions using panoramic vs cone beam CT imaging

Objectives: The aim of this prospective study was to compare the impact of using two-dimensional (2D) panoramic radiographs and three-dimensional (3D) cone beam CT for the surgical treatment planning of impacted maxillary canines. Methods: This study consisted of 32 subjects (19 females, 13 males) with a mean age of 25 years, referred for surgical intervention of 39 maxillary impacted canines. Initial 2D panoramic radiography was available, and 3D cone beam CT imaging was obtained upon clinical indication. Both 2D and 3D pre-operative radiographic diagnostic sets were subsequently analysed by six observers. Perioperative evaluations were conducted by the treating surgeon. McNemar tests, hierarchical logistic regression and linear mixed models were used to explore the differences in evaluations between imaging modalities. Results: Significantly higher confidence levels were observed for 3D image-based treatment plans than for 2D image-based plans (p < 0.001). The evaluations of canine crown position, contact relationship and lateral incisor root resorption were significantly different between the 2D and 3D images. By contrast, pre- and perioperative evaluations were not significantly different between the two image modalities. Conclusions: Surgical treatment planning of impacted maxillary canines was not significantly different between panoramic and cone beam CT images.status: publishe