Radiography-based score indicative for the pathogenicity of bacteria in odontogenic infections.
OBJECTIVE
To develop a new radiography-based score to assess the potential of bacteria to cause odontogenic infections derived from the occurrence of bacteria at small or large radiographical lesions.


METHODS
The patients analyzed were a sub-population from a large randomized clinical trial comparing moxifloxacin and clindamycin in the treatment of inflammatory infiltrates and odontogenic abscesses. Routine radiographs were used to analyze the area of the periapical radiolucent lesions. Lesions were stratified by their radiographically measured area as large (>9 mm(2)) or small (≤9 mm(2)). A risk ratio was calculated for each species from the frequency of their occurrence in large vs in small lesions.


RESULTS
Fifty-one patients, 19 with abscesses and 32 with infiltrates, were evaluated. Overall, the radiographical lesion areas ranged from 0.4-46.2 mm(2) (median = 9 mm(2)). An increased risk (risk ratio >1) to occur at large abscess lesions was observed for Prevotella (P.) oralis, P. buccae, P. oris, P. intermedia, Fusobacterium nucleatum and Streptococcus (Strep.) anginosus group. An increased risk to occur at large infiltrate lesions was found for Strep. salivarius, Strep. parasanguis, Strep. anginosus group, Capnocytophaga spp., Neisseria (N.) sicca, Neisseria spp., Staphylococcus (Staph.) aureus, P. intermedia, P. buccae, Prevotella spp. and P. melaninogenica.


CONCLUSIONS
The radiography-based score suggests that certain Prevotella spp., F. nucleatum and Strep. anginosus groups play a crucial role in the pathogenesis of odontogenic abscesses, and that various streptococci, Neisseria spp., Capnocytophaga spp., Staph. aureus and Prevotella spp. are involved in the pathogenesis of odontogenic infiltrates.
Center for Oral and Dental Medicine, Department of Restorative and Preventive Dentistry.
Georg
G
Cachovan
Marco
M
Blessmann
Gerhard
G
Schön
Uwe
U
Rother
Max
M
Heiland
Enno
E
Stürenburg
Ursula
U
Platzer
Ingo
I
Sobottka
D000038:Abscess / Q000000981:diagnostic imaging*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001419:Bacteria / Q000472:pathogenicity*; D016866:Bacteroidaceae Infections / Q000000981:diagnostic imaging; D002981:Clindamycin / Q000627:therapeutic use; D004311:Double-Blind Method; D005260:Female; D024841:Fluoroquinolones / Q000627:therapeutic use; D005674:Fusobacterium Infections / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D000077266:Moxifloxacin; D010482:Periapical Abscess / Q000382:microbiology; D010508:Periodontal Abscess / Q000000981:diagnostic imaging / Q000382:microbiology*; D011446:Prospective Studies; D011859:Radiography; D013203:Staphylococcal Infections / Q000000981:diagnostic imaging; D013290:Streptococcal Infections / Q000000981:diagnostic imaging; D014076:Tooth Diseases / Q000000981:diagnostic imaging / Q000382:microbiology*; D014774:Virulence; D055815:Young Adult
D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones; D002981:Clindamycin; D000077266:Moxifloxacin
X-ray; antibiotics; bacterial isolates; periapical radiolucent lesions