Complications of Severe Odontogenic Infections: A Review

Abstract

Severe odontogenic infections are routinely treated with little associated morbidity and mortality. Improvements in surgical techniques, antibiotic treatments, and imaging modalities have made associated complications exceedingly rare. A number of complications have been described in the literature including airway obstruction, descending necrotizing mediastinitis, orbital abscess, septic cavernous sinus thrombosis, cerebral abscess, sepsis, necrotizing fasciitis, and Lemierre's syndrome. The purpose of this article is to discuss the pathophysiology of severe odontogenic infections and the risk factors associated with the development of complications. Given the morbidity and mortality of these conditions, it is important to review the clinical features of each and the diagnostic tools that aid in early recognition.

Keywords: abscess; infection; odontogenic.

Figure 1

Axial (a) and sagittal (b) computed tomography scan views of patient with right submandibular, sublingual, and submental abscess with associated odontogenic severity score of six.

Figure 2

Axial (a) and sagittal (b) computed tomography scan views of a patient with Ludwig’s angina.

Figure 3

Axial (a) and sagittal (b) computed tomography scan views of a patient with a left parapharyngeal space infection with significant gas formation. Air and fluid extended within the retropharyngeal space to the level of C6/7. Bacteremia was present, with blood cultures positive for Streptococcus anginosus.

Figure 3

Axial (a) and sagittal (b) computed tomography scan views of a patient with a left parapharyngeal space infection with significant gas formation. Air and fluid extended within the retropharyngeal space to the level of C6/7. Bacteremia was present, with blood cultures positive for Streptococcus anginosus.