OBJECTIVE: To analyze the composition, incidence and clinical characteristics of oral and maxillofacial infections in oral emergency. METHODS: A retrospective study on patients with oral and maxillofacial infections who visited the Department of Oral Emergency in Peking University School and Hospital of Stomatology from January 2017 to December 2019 was conducted. General characteristics, such as disease composition, gender, age distribution and position of involved teeth were analyzed. RESULTS: A total of 8 277 patients with oral and maxillofacial infections were finally collected, including 4 378 male patients (52.9%) and 3 899 female patients (47.1%), with gender ratio of 1.12:1. The common diseases were periodontal abscess (3 826 cases, 46.2%), alveolar abscess (3 537 cases, 42.7%), maxillofacial space infection (740 cases, 9.0%), sialadenitis (108 cases, 1.3%), furuncle & carbuncle (56 cases, 0.7%) and osteomyelitis (10 cases, 0.1%). Male patients were more easily affected by periodontal abscess, space infection and furuncle & carbuncle than female patients with the gender ratios 1.24:1, 1.26:1, 2.50:1 individually, while the incidence of alveolar abscess, sialadenitis, furuncle & carbuncle had no significant gender difference. Different diseases were prone to occur at different ages. The peak ages of alveolar abscess were 5-9 and 27-67 years, while the peak age of periodontal abscess was 30-64 years. Space infection tended to occur between 21-67 years. There were 7 363 patients with oral abscess (3 826 patients with periodontal abscess and 3 537 patients with alveolar abscess), accounting for 88.9% of all the patients with oral and maxillofacial infections, involving 7 999 teeth, including 717 deciduous teeth and 7 282 permanent teeth. Periodontal abscess usually occurred in permanent teeth, especially the molar teeth. Alveolar abscess may occur in both primary teeth and permanent teeth. In primary teeth, the most vulnerable sites were primary molar teeth and maxillary central incisors while in permanent teeth the most vulnerable sites were first molar teeth. CONCLUSION Understanding the incidence of oral and maxillofacial infection was conducive to the correct diagnosis and effective treatment of clinical diseases, as well as targeted education for patients of different ages and genders to prevent the occurrence of diseases.
Humans ; Male ; Female ; Animals ; Adult ; Middle Aged ; Abscess ; Retrospective Studies ; Periodontal Abscess ; Carbuncle ; Furunculosis ; Incisor ; Sialadenitis/epidemiology*

Anaerobic infections have been reported to be responsible for 3–10% of pyogenic liver abscesses in Korea, and reported anaerobes include Fusobacterium, Bacillus fragilis, and Bacteroides melaninogenicus. Parvimonas micra is an anaerobic, Gram-positive, non-spore-forming bacterial species and a constituent of normal flora on skin, vagina, gastrointestinal tract, and oral cavity that can cause opportunistic infections. However, it has only rarely been reported to be a cause of liver abscess; only one such case has been reported in Korea. We experienced a case of concomitant liver and brain abscesses caused by Parvimonas micra in a non-immunodeficient 65-year-old female patient without diabetes or periodontal disease. Parvimonas micra infection was confirmed by blood culture using VITEK® 2 cards and by bacterial 16s ribosomal RNA gene sequencing. We conclude that we should not overlook anaerobes as a cause of liver abscess.
Aged ; Bacillus ; Bacteria, Anaerobic ; Brain Abscess ; Brain ; Female ; Fusobacterium ; Gastrointestinal Tract ; Humans ; Korea ; Liver Abscess ; Liver Abscess, Pyogenic ; Liver ; Mouth ; Opportunistic Infections ; Periodontal Diseases ; Prevotella melaninogenica ; RNA, Ribosomal, 16S ; Skin ; Vagina

Bisphosphonate-Associated Osteonecrosis of the Jaw ; complications ; Humans ; Periodontal Abscess ; complications

OBJECTIVETo isolate and culture the predominant anaerobes from the periodontal abscesses, and to test the antibiotic susceptibility and drug resistant genes of the strains.

METHODSThe isolated strains were identified by both API20A biochemical method and polymerase chain reaction (PCR) method. The antibiotic susceptibility test was performed by agar dilution method. The resistant genes of the drug-resistant strains obtained were screened by PCR.

RESULTSThe anaerobes were detected in 48% (28/58) of the samples and Prevotella melaninogenica (Pm) was mostly identified in 43% (12/28). API20A biochemical method had 82% (23/28) agreement with the 16SrRNA method in identification rate. Anaerobes were resistant to metronidazole, clindamycin and cefmetazole. The erythromycin-resistant methylase genes F (ermF) gene was detected in three of eight clindamycin resistant strains. None of them was found coded on bacterial plasmids. However, no metronidazole resistant gene was detected on drug resistant strains.

CONCLUSIONSPm was the predominant species dectected in the periodontal abscess of the patients. The antibiotic agents should be used based on the genotypes and general condition of the patients.

Adult ; Anti-Bacterial Agents ; pharmacology ; Bacteria, Anaerobic ; isolation & purification ; Cefmetazole ; pharmacology ; Clindamycin ; pharmacology ; Drug Resistance, Bacterial ; genetics ; Erythromycin ; pharmacology ; Female ; Genes, Bacterial ; Humans ; Male ; Metronidazole ; pharmacology ; Microbial Sensitivity Tests ; Middle Aged ; Periodontal Abscess ; microbiology ; Prevotella ; isolation & purification

The Streptococcus milleri group, which also includes S. anginosus, S. intermedius and S. constellatus, is found in the oropharynx, upper respiratory tract, gastrointestinal tract, and urogenital tract mucosa. Bacteria in the Streptococcus milleri group are associated with bacteremia and abscess formation. Most of the reports of of Streptococcus milleri group (SMG) infection occur in patients with underlying medical conditions. Predisposing factors that have been associated with S. milleri group empyema include mucosal disturbances (sinusitis, periodontal disease, enteric disease), preceding to pneumonia, thoracic surgery, malignancy, neurological disease, alcohol abuse, and also diabetes mellitus. We report on a 42-year-old man with mental retardation. He who suffered from dyspnea and a fever that he had developed for over 14 days. S. constellatus and anaerobic bacterias (Prevotella buccae and Micromonas micros) were cultured. The patient was treated with the drainage of pleural effusion and clindamycin and levofloxacin.
Abscess ; Adult ; Alcoholism ; Bacteremia ; Bacteria ; Bacteria, Anaerobic ; Cheek ; Clindamycin ; Diabetes Mellitus ; Drainage ; Dyspnea ; Empyema ; Fever ; Gastrointestinal Tract ; Humans ; Intellectual Disability ; Mucous Membrane ; Ofloxacin ; Oropharynx ; Periodontal Diseases ; Pleural Effusion ; Pneumonia ; Respiratory System ; Streptococcus ; Streptococcus constellatus ; Streptococcus milleri Group ; Thoracic Surgery

Fusobacteria are anaerobic gram-negative, non-spore forming bacilli found in normal flora of the oral cavity, urogenital tract, and gastrointestinal tract. Fusobacterium nucleatum has been seldom reported as a cause of liver abscess, particularly in immunocompetent hosts. A 55-year-old man with frequent periodontal disease visited our hospital with intermittent fever and headache for 2 months. Abdominal CT scan revealed an 8.2x6 cm mass in the right hepatic lobe with central low density. Abscess culture revealed F. nucleatum as the causative organism. Percutaneous abscess drainage and intravenous administration of antibiotics for 4 weeks improved symptoms and decreased the abscess size. We report a rare case of liver abscess due to F. nucleatum in an immunocompetent man with periodontal disease.
Ampicillin/therapeutic use ; Anti-Bacterial Agents/therapeutic use ; Fusobacterium Infections/complications/*diagnosis/drug therapy ; Fusobacterium nucleatum/*isolation & purification ; Humans ; Injections, Intravenous ; Liver Abscess/*diagnosis/etiology/microbiology ; Male ; Middle Aged ; Periodontal Diseases/*diagnosis ; Sulbactam/therapeutic use

Adult ; Aggressive Periodontitis ; drug therapy ; therapy ; Amoxicillin ; therapeutic use ; Anti-Bacterial Agents ; therapeutic use ; Anti-Infective Agents ; therapeutic use ; Combined Modality Therapy ; Dental Scaling ; Denture, Partial, Fixed ; Humans ; Male ; Metronidazole ; therapeutic use ; Periodontal Abscess ; drug therapy ; therapy ; Root Canal Therapy ; Tooth Extraction ; Toothbrushing

Porphyromonas gingivalis is a gram-negative, anaerobic, rod-shaped bacterium originally classified within the Bacteroides genus, and a major etiological agent in the initiation and progression of severe periodontal disease. P. gingivalis has occasionally been involved in otitis media, lung abscesses, gas gangrene, appendicitis, sinusitis, paranasal mucocele, peri-tonsillar abscesses, pleura-pulmonary infections, and thoracic empyema. We report the case of a 44-year-old male who presented with a brain abscess in which the organism, presumably originated from his poor dentition. He was successfully treated with surgical drainage and antibiotics.
Abscess ; Adult ; Anti-Bacterial Agents ; Appendicitis ; Bacteroides ; Brain ; Brain Abscess ; Dentition ; Drainage ; Empyema, Pleural ; Gas Gangrene ; Humans ; Lung Abscess ; Male ; Mucocele ; Otitis Media ; Periodontal Diseases ; Porphyromonas ; Porphyromonas gingivalis ; Sinusitis

Porphyromonas gingivalis is a gram-negative, anaerobic, rod-shaped bacterium originally classified within the Bacteroides genus, and a major etiological agent in the initiation and progression of severe periodontal disease. P. gingivalis has occasionally been involved in otitis media, lung abscesses, gas gangrene, appendicitis, sinusitis, paranasal mucocele, peri-tonsillar abscesses, pleura-pulmonary infections, and thoracic empyema. We report the case of a 44-year-old male who presented with a brain abscess in which the organism, presumably originated from his poor dentition. He was successfully treated with surgical drainage and antibiotics.
Abscess ; Adult ; Anti-Bacterial Agents ; Appendicitis ; Bacteroides ; Brain ; Brain Abscess ; Dentition ; Drainage ; Empyema, Pleural ; Gas Gangrene ; Humans ; Lung Abscess ; Male ; Mucocele ; Otitis Media ; Periodontal Diseases ; Porphyromonas ; Porphyromonas gingivalis ; Sinusitis

abscess and periodontal abscess were next in order of freguency. In the care group of oral complications, the most freguent incidence(28.9%) was showed in the endodontic treatment(primary endodontic drainage), and followed by scaling, incision and drainage, only medications, restoration, ointment application onto the ulcer and daily dressing in order.]]>
Acute Kidney Injury ; Bandages ; Diagnosis ; Drainage ; Female ; Gangwon-do ; Gingivitis ; Hemorrhage ; Humans ; Incidence ; Insurance, Health ; Kidney Failure, Chronic ; Male ; Mucositis ; Oral Ulcer ; Periapical Abscess ; Periodontal Abscess ; Periodontitis ; Renal Insufficiency, Chronic ; Retrospective Studies ; Ulcer