Cervical-thoracic necrotizing fasciitis of odontogenic origin in a diabetic patient: a case report.

Necrotizing fasciitis (NF) is a severe bacterial infection with rapid and aggressive progression. The infection generally affects individuals with comorbid conditions that lead to immunologic and microvascular deficiencies. It is characterized by necrosis of tissues, mainly in the extremities, trunk, and perineum, and is rarely found in the head and neck. This case report describes the course of NF in a 55-year-old man, highlighting diagnosis, surgical treatment, drug therapy, and supportive measures. The patient, who had chronic alcoholism, systemic arterial hypertension, a smoking habit, and decompensated diabetes (glucose level of 490 mg/dL), was admitted to the hospital with a volume increase in the cervical and thoracic areas with a duration of about 7 days. He presented with fever, dyspnea, and inflammatory signs bilaterally in the submandibular, submental, and superior thoracic regions as well as severe trismus. The patient underwent a surgical procedure to drain the infectious process and to place drains. The patient developed cutaneous necrosis in the cervical and superior thoracic regions, diagnosed as NF. Surgical debridement of all affected tissue was performed. After resolution of the infection, the patient underwent skin grafting with a satisfactory outcome.

Impact of Tooth Loss on Quality of Life

Objective: To evaluate the impact of tooth loss on the quality of life of patients at the Cesmac University Center. Material and Methods: A cross-sectional study was performed, whose sample was composed of 224 volunteers from various health units of the selected health service with at least 12 years of age and one missing tooth. Quality of Life (QOL) was assessed using the Oral Health Impact Profile (OHIP -14) and tooth loss was assessed with the dental chart. A structured interview that assessed the socio-economic condition of the individual was also applied. For interpretation of the OHIP-14, values were assigned using the multiplicative method: 0-3 points = no impact; 3.01 to 6 points = low impact; 6.01 to 10 points = moderate impact; and> 10.01 points = high impact. All volunteers received guidance on oral health and, when necessary, a referral to the dental care provided by this institution was performed. Results: The mean OHIP ranged from no impact (30.9%) to high impact (27.8%). The correlation between the number of missing teeth and QOL scores was statistically significant (p <0.05), as well as the correlation between number of missing teeth and age of volunteers (p <0.0001). The dimensions of the OHIP-14 that showed the most influenced domains were pain, psychological discomfort, psychological disability. Conclusion: Increasing age has shown influence on tooth and tooth loss affected the QOL of volunteers. QOL may be influenced by other factors such as loss of anterior teeth and schooling.