The role of unfinished root canal treatment in odontogenic maxillofacial infections requiring hospital care
DOI: 10.1007/s00784-012-0710-8
Abstract
Objectives
The aim of this study was to evaluate clinical and radiological findings and the role of periapical infection and antecedent
dental treatment of infected focus teeth in odontogenic maxillofacial abscesses requiring hospital care.
Materials and methods
In this retrospective cohort study, we evaluated medical records and panoramic radiographs during the hospital stay of patients
(n = 60) admitted due to odontogenic maxillofacial infection originating from periapical periodontitis.
Results
Twenty-three
(38 %) patients had received endodontic treatment and ten (17 %) other
acute dental treatment. Twenty-seven (45
%) had not visited the dentist in the near past.
Median age of the patients was 45 (range 20–88) years and 60 % were
males.
Unfinished root canal treatment (RCT) was the major
risk factor for hospitalisation in 16 (27 %) of the 60 cases (p = .0065). Completed RCT was the source only in 7 (12 %) of the 60 cases. Two of these RCTs were adequate and five inadequate.
Conclusions
The
initiation of inadequate or incomplete primary RCT of acute periapical
periodontitis appears to open a risk window for
locally invasive spread of infection with local
abscess formation and systemic symptoms. Thereafter, the quality of the
completed
RCT appears to have minor impact. However, a
considerable proportion of the patients had not received any dental
treatment
confirming the importance of good dental health. Thus,
thorough canal debridement during the first session is essential for
minimising the risk for spread of infection in
addition to incision and drainage of the abscess. If this cannot be
achieved,
tooth extraction should be considered.
Clinical relevance
Incomplete or inadequate canal debridement and drainage of the abscess may increase the risk for spread of endodontic infection.
Comments