Cases reported "Periapical Abscess"

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11/86. Infected total knee replacement following a dental procedure in a severe haemophiliac.

    This article documents the late infection of a total knee replacement in a haemophiliac following a dental procedure. It underlines the need for reconsideration of the current British guidelines regarding antibiotic prophylaxis for dental procedures in patients with total joint replacement.
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12/86. Treatment of middle-apical level root fracture in necrotic teeth.

    The purpose of this paper is to present two case reports of dental trauma with middle-apical level root fractures and pulp necrosis. The treatment consisted of programmed applications of calcium hydroxide until a calcified barrier was formed at the fracture level. The technique presented here proved efficient in treating horizontal fractures at the middle and apical thirds of the root.
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13/86. Fatal cervical necrotizing fasciitis (a report of two cases of confirmed odontogenic origin and one of possible odontogenic origin).

    Three cases of cervical necrotizing fasciitis (CNF), two of confirmed odontogenic origin and one of probable odontogenic origin, were observed from 1993-1999. This is in addition to three cases previously reported by this office. A rare sequelae of dental infection, CNF can be a severe, rapidly progressing infection of the cervical tissues having a mortality rate of up to 50%. "Hospital gangrene" was first described during the Civil war. It was later to be described as necrotizing fasciitis and later yet was designated as a separate clinicopathological diagnosis.
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14/86. Pott's puffy tumor and epidural abscess arising from dental sepsis: a case report.

    OBJECTIVE: To present an unusual case of two uncommon cranial complications of frontal sinusitis: Pott's puffy tumor and epidural abscess arising from frontal sinusitis of dental origin, and also two systemic complications of sinusitis: septicemia and empyema, all occurring in an immunocompetent patient. STUDY DESIGN: A 21-year-old man presented with a scalp swelling and epidural abscess. magnetic resonance imaging and computed tomographic scans revealed unilateral opacification of the frontal sinus and an epidural abscess with a direct connection to the scalp abscess. Further history revealed that his symptoms occurred coincidentally with a tooth extraction 2 months before, and he was hospitalized soon after the tooth extraction for sepsis and a lung abscess. methods: A combined neurosurgical and otolaryngologic approach was required to treat the sinusitis and the associated epidural and scalp abscess. RESULTS: Cultures returned as streptococcus intermedius from all three sites. The patient was free of disease at the 3-month follow-up. CONCLUSIONS: Odontogenic maxillary sinusitis is well documented; however, there is little reported of frontal sinusitis arising from dental disease. The prevalence of sinusitis of dental origin will be reviewed, including the microbiology of this particularly virulent organism that persisted despite earlier treatment with ampicillin. Also, the current thoughts on management of these cases will be discussed with particular reference to local therapy for sinusitis in addition to systemic treatment with antibiotics.
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15/86. Chronic dental infections mimicking temporomandibular disorders.

    BACKGROUND: trismus and jaw pain are not only caused by temporomandibular disorders (TMD), but also by various pathologies, namely infection, trauma, or neoplasms. TMD-like symptoms, as a result of the pathologies, may be confusing to a clinician. This paper reports two cases of chronic dental infection mimicking TMD. methods: Two patients were initially diagnosed with, and treated for, TMD. However the patients did not respond to the treatment. Limited range of motion and jaw pain were then clinically evaluated for differential diagnoses. Laboratory examinations and computerized tomography (CT) scans were carried out to disclose any underlying lesion. RESULTS: Laboratory examination, such as, c-reactive protein helped to detect latent infection. CT scans revealed insidious chronic dental infection imitating TMD. Surgical drainage and chemotherapy resolved the symptoms. CONCLUSION: The importance of a rational diagnostic process, including clinical and laboratory examinations and radiologic imaging, cannot be over-emphasized in elucidating true cause of the symptoms.
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16/86. Facial sinus of dental origin: a case report.

    Sinus tracts of dental origin opening on the skin can be a diagnostic challenge. A delay in correctly diagnosing these lesions can result in ineffective and inappropriate treatment; however, if recognized early, the sinus tract usually resolves after appropriate endodontic therapy or extraction. We report a case of a cutaneous sinus tract secondary to a periapical abscess of the mandibular first molar tooth. The case was successfully treated by extraction and the sinus tract healed.
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17/86. Case challenge. Chronic maxillary inflammation.

    A 30-year old male was referred by a dental practitioner to the Department of Oral radiology at the University of Lund, sweden, for a radiological evaluation of chronic symptoms of inflammation on the right side of the maxilla. According to the patient, at age 12 he had surgery to remove a non-erupted maxillary right second premolar. Postoperatively, a draining sinus tract appeared on the buccal aspect of the alveolar process. Thirteen years later, at age 25, surgery was again performed and the sinus tract reappeared. Intermittent discharge of exudate from the sinus tract occurred since the second surgery. Clinical and radiological examinations were conducted prior to a third surgery. The clinical examination revealed pus draining from the tract located on the buccal aspect of the alveolar process between the right maxillary first molar and first premolar. The radiological examination included periapical radiographs of the right maxillary first premolar and canine, a panoramic radiograph, and frontal tomograms of the maxillary right premolar area.
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18/86. Apical healing of an endodontically treated tooth with a temporary restoration.

    A 35-yr-old, healthy male presented to the graduate endodontic clinic at indiana University School of dentistry for treatment of tooth #26. Two and one-half yr after treatment, the patient returned to the dental school for comprehensive treatment. The canal access opening had been restored with an intact interim restorative material restoration. The tooth was asymptomatic, and radiographic examination showed evidence of apical healing. In this article, a review of the literature concerning crown-down leakage is presented. A case report is given in which healing occurred after the tooth was restored with only an interim restorative material for an extended period of time.
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19/86. Persistent cutaneous fistula in the neck.

    A cutaneous fistula may develop from an infected tooth. The lesion usually arises without dental symptoms and for this reason is often incorrectly diagnosed. For correct diagnosis intraoral radiographs and essential. Elimination of the infectious process and curettage of the periapical lesion are indicated. Usually no further treatment is warranted.
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20/86. Cutaneous dental sinus tract, a common misdiagnosis: a case report and review of the literature.

    Cutaneous sinus tracts of dental origin are often initially misdiagnosed and inappropriately treated because of their uncommon occurrence and the absence of symptoms in approximately half the individuals affected. patients are often referred with a recurrent or chronic cyst, a furuncle, or an ulcer on the face or neck. Correct diagnosis is based on a high index of suspicion and on radiologic evidence of a periapical root infection. Appropriate treatment results in predictable and rapid healing of these lesions. We present a case report of this common misdiagnosis and a review of the literature with regard to diagnosis and treatment.
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