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Review
. 2009 Jan;22(1):46-64, Table of Contents.
doi: 10.1128/CMR.00028-08.

Microbiology of odontogenic bacteremia: beyond endocarditis

N B Parahitiyawa  1 , L J Jin, W K Leung, W C Yam, L P Samaranayake
Affiliations
Review

Microbiology of odontogenic bacteremia: beyond endocarditis

N B Parahitiyawa et al. Clin Microbiol Rev. 2009 Jan.

Erratum in

  • Clin Microbiol Rev. 2009 Apr;22(2):386

Abstract

The human gingival niche is a unique microbial habitat. In this habitat, biofilm organisms exist in harmony, attached to either enamel or cemental surfaces of the tooth as well as to the crevicular epithelium, subjacent to a rich vascular plexus underneath. Due to this extraordinary anatomical juxtaposition, plaque biofilm bacteria have a ready portal of ingress into the systemic circulation in both health and disease. Yet the frequency, magnitude, and etiology of bacteremias due to oral origin and the consequent end organ infections are not clear and have not recently been evaluated. In this comprehensive review, we address the available literature on triggering events, incidence, and diversity of odontogenic bacteremias. The nature of the infective agents and end organ infections (other than endocarditis) is also described, with an emphasis on the challenge of establishing the link between odontogenic infections and related systemic, focal infections.

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Figures

FIG. 1.
FIG. 1.
Possible routes of bacterial entry from teeth into the systemic circulation. Pathway 1, entry via the root canal (RC) or from periapical lesions (PA) into the alveolar blood vessels (AW); pathway 2, entry from the periodontium, where bacteria in the gingival crevices (GC) translocate to the capillaries (C) in the gingival connective tissues, possibly through the junctional epithelium (JE). E, enamel; D, dentine; L, periodontal ligament; and AB, alveolar bone. (Panels i and ii are modified from reference with permission from Elsevier. Panel iii is courtesy of Lu Qian [Oral Bio-Sciences, Faculty of Dentistry].) Note that the junctional epithelium was detached from the enamel due to processing for microscopy.
FIG. 2.
FIG. 2.
Chart indicating the time course distribution of the incidence of odontogenic bacteremias from 50 studies reported in the literature. The lowest and highest incidences reported at a given time point are annotated in the chart, with the percentage shown in bold. (Note that at time point A the sampling was done during the intervention or immediately thereafter.)
See this image and copyright information in PMC

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