title: Deep neck infection with dental origin: analysis of 85 consecutive cases (2000-2006).
abstract: CONCLUSIONS
  Diagnostic work-up should include contrast-enhanced computed tomography (CT) and mandible orthopantogram. When a dental origin of deep neck infection is suspected, the intravenous antibiotic regimen has to be active against gram-positive bacteria, both aerobes and anaerobes. Surgical exploration and drainage may be mandatory at presentation, or in cases not responding to medical therapy within the first 24 h.
  
  
  OBJECTIVE
  Deep neck infections are still associated with significant morbidity and mortality rates when complications occur. Despite worldwide improvement in dental care and oral hygiene, a significant prevalence of deep neck infections caused by dental infections has been described recently (> 40%).
  
  
  METHODS
  We analysed retrospectively 85 cases of deep neck infection with dental origin out of 206 consecutive cases of deep neck infection diagnosed in our institution between 2000 and 2006.
  
  
  RESULTS
  The most frequent dental source was a periapical infection of the first mandibular molar, followed by second and third molar, respectively. Submandibular space infection involvement was diagnosed in 73 of 85 patients (85.9%), masticatory space infection in 28 (32.9%); in 56 patients (65.9%) the infection involved more than one space. Twenty-four patients (28.2%) were treated only with intravenous antibiotic therapy; 61 patients (71.8%) required both medical and surgical procedures.
authors.affiliation: Department of Medical and Surgical Specialties, Section of Otolaryngology, University of Padova, Padova, Italy. gino.marioni@unipd.it
authors.forename: Gino
authors.initials: G
authors.lastname: Marioni
authors.forename: Roberto
authors.initials: R
authors.lastname: Rinaldi
authors.forename: Claudia
authors.initials: C
authors.lastname: Staffieri
authors.forename: Rosario
authors.initials: R
authors.lastname: Marchese-Ragona
authors.forename: Giorgia
authors.initials: G
authors.lastname: Saia
authors.forename: Roberto
authors.initials: R
authors.lastname: Stramare
authors.forename: Andy
authors.initials: A
authors.lastname: Bertolin
authors.forename: Roberto
authors.initials: R
authors.lastname: Dal Borgo
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Ragno
authors.forename: Alberto
authors.initials: A
authors.lastname: Staffieri
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D003131:Combined Modality Therapy; D015897:Comorbidity; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000601:surgery; D010038:Otorhinolaryngologic Diseases / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D010482:Periapical Abscess / Q000150:complications* / Q000175:diagnosis* / Q000601:surgery; D010485:Periapical Periodontitis / Q000150:complications* / Q000175:diagnosis* / Q000601:surgery; D011862:Radiography, Panoramic; D012307:Risk Factors; D018461:Soft Tissue Infections / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D014076:Tooth Diseases / Q000150:complications* / Q000175:diagnosis* / Q000601:surgery; D014463:Ultrasonography
chemical_list: D000900:Anti-Bacterial Agents