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.

Maxillary odontogenic sinusitis, complicated with cerebral abscess--case report.

Maxillary sinus inflammation, when untreated or incorrectly treated, may extend locoregionally, the remaining paranasal sinuses being the first affected anatomical structures. This is why the understanding of the inflammatory pathology of the maxillary sinus, and particularly of the complications it can generate, is extremely important. The purpose of this presentation is to point out that inflammations of the paranasal sinuses are susceptible to develop complications in certain conditions and threaten the patient's life due to the proximity of vital structures. This is the case of a 16 years old male patient who developed a left maxillary and frontal sinusitis, complicated with cerebral abscess. Early detection, multidisciplinary approach and proper indication of surgical treatment, as well as early suspicion of complication, especially in young male adolescents, are extremely important.

[Clinical study of sinus grafts and implants integration, in the posterior maxilla]. / Studiu clinic privind integrarea grefelor sinusale si a implanturilor in regiunea maxilara posterioara.

UNLABELLED: In this study we have tried to evaluate the degree of integration for endosinusal grafting and implant placement in the posterior maxilla. MATERIAL AND METHOD: We included in our study a number of 136 patients with sinus lift surgery. We have established the stability of the implants using the periotest. RESULTS: The presence of the antral septum favoured the sinus membrane to tear, the results of our study are obvious (23.46%). Aloplastic materials for sinus grafting is our first choice because the results are comparable with the cases in wich we used autografts, and the advantage is that we don't need a second surgery place. Implant insertion after sinus grafting integration, increases the rate of succes in sinus grafting and implant insertion compared with sinus grafting and implant insertion made in the same operative step.