title: Role of ultrasonography in differentiating facial swellings of odontogenic origin.
abstract: BACKGROUND
  Differentiating an acute, odontogenic facial swelling clinically as cellulitis or an abscess has not been thoroughly investigated in endodontics. It has been suggested in the medical and dental literature that the use of ultrasound may aid in differentiating cellulitis from an abscess. Therefore, if ultrasound were more accurate than a blind incision for drainage procedure in locating purulence, perhaps the outcome of the incision for drainage procedure would be beneficial in the resolution of odontogenic infections. The purpose of this prospective study was to compare clinical examination plus ultrasonography versus clinical examination alone in differentiating cellulitis from abscesses in patients with facial swelling of odontogenic origin.
  
  
  METHODS
  Eighty-two emergency patients participated in this study. Each patient was examined and diagnosed by clinical examination and clinical examination plus ultrasonography. An incision for drainage procedure was performed, and a definitive diagnosis was recorded as cellulitis (no purulence) or an abscess (presence of purulence).
  
  
  RESULTS
  With the incision for drainage procedure, cellulitis occurred 37% of the time and abscesses 63%. With clinical examination alone, a correct diagnosis was made 68% of the time. With clinical examination plus ultrasonography, a correct diagnosis was made 70% of the time. There was no statistically significant difference between the 2 examination methods.
  
  
  CONCLUSIONS
  The addition of ultrasonography to a clinical examination did not significantly increase the number of correct diagnoses.
authors.affiliation: Private Practice, Columbus, Ohio.
authors.forename: Lisa
authors.initials: L
authors.lastname: Poweski
authors.affiliation: Division of Endodontics, The Ohio State University, Columbus, Ohio.
authors.forename: Melissa
authors.initials: M
authors.lastname: Drum
authors.affiliation: Division of Endodontics, The Ohio State University, Columbus, Ohio. Electronic address: reader.2@OSU.edu.
authors.forename: Al
authors.initials: A
authors.lastname: Reader
authors.affiliation: Division of Endodontics, The Ohio State University, Columbus, Ohio.
authors.forename: John
authors.initials: J
authors.lastname: Nusstein
authors.affiliation: Division of Oral Biology, The Ohio State University, Columbus, Ohio.
authors.forename: Mike
authors.initials: M
authors.lastname: Beck
authors.affiliation: Division of Oral and Maxillofacial Pathology, The Ohio State University, Columbus, Ohio.
authors.forename: Jahanzeb
authors.initials: J
authors.lastname: Chaudhry
mesh_terms: D000038:Abscess / Q000000981:diagnostic imaging*; D000328:Adult; D002481:Cellulitis / Q000000981:diagnostic imaging*; D003788:Dental Pulp Diseases / Q000000981:diagnostic imaging*; D003790:Dental Pulp Necrosis / Q000000981:diagnostic imaging; D003937:Diagnosis, Differential; D004322:Drainage / Q000379:methods; D004487:Edema / Q000000981:diagnostic imaging; D005145:Face / Q000000981:diagnostic imaging*; D005157:Facial Pain / Q000000981:diagnostic imaging; D005260:Female; D005491:Focal Infection, Dental / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods; D010173:Palpation; D011446:Prospective Studies; D013492:Suppuration; D014098:Toothache / Q000000981:diagnostic imaging; D014463:Ultrasonography; D055815:Young Adult
keywords: Abscesses; cellulitis; facial; symptomatic necrotic teeth; ultrasound