Odontogenic facial cellulite

Odontogenic facial cellulite . Diffuse inflammation of the soft tissues of the face, product of the infestation caused by a carious tooth , which spreads through the spaces through the tissues to more than one anatomical region or aponeurotic space of the same. It is one of the pathological entities most frequently observed in the stomatological emergency consultation in the Primary Health Care in Cuba .

Summary

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  • 1 Etiology
  • 2 General syndromic picture
  • 3 Hematologic chart
  • 4 Progress of the process
    • 1 prevalence
  • 5 Medical criteria
    • 1 Conduct to follow
  • 6 Conclusions
  • 7 Sources
  • 8 External links
  • 9 See also

Etiology

The most recognized etiology is that of pyogenic origin , caused by a streptococcus – sometimes associated with other bacteria – although an exaltation in the virulence of golden staphylococcus may be the causative pathogen.

Predisposing factors are also associated, which affect the host, such as malnutrition, diabetes and immunosuppression.

If the germs are extremely virulent or the inappropriate use of antibiotics creates a resistance of the germ to them, the infection advances through the surrounding tissues to remote areas of the site of origin.

If this condition persists and the physiological response fails to control the progress of the infection and the therapeutic agents prove to be futile, the patient’s life is compromised.

General syndromic picture

It is usually confined to the maxillary area  at its beginning. A syndromic picture can be seen or observed, generally made up of gross edematization of the soft tissues of the face, swelling , often hard on palpation, flushing and heat of the area in which stage suppuration does not occur, there being no location of the infection.

It can also show a severe systemic reaction to the infection with general health status, presenting high temperature and general discomfort.

Hematologic chart

From the hematological point of view, vasodilation will occur in the affected area, with increased permeability of the vessels, leading to the exit of an exudate towards the Interstitium | Interstitium.

Generally increases the speed of erythrocyte sedimentation and the white blood cell count, altering this formula. The heart rate is racing, trying to make up for the slowing down of the circulation . The electrolyte balance changes, which influences the discomfort reported by the patient.

The hematological changes mentioned are due to substances involved in vascular changes, called chemical mediators, for example: prostaglandins , cytokines , vasoactive amines, vasoactive amines such as serotonins , whose actions are similar to those of histamine . These chemical mediators promote vasodilation and increased vascular permeability.

Progress of the process

If the infection continues to progress and is not stopped by the physiological defense, the purulent material can carve its way to the surface where it can evacuate spontaneously, depending on its location and the proximity of the anatomical structures that guide its advance.

Prevalence

Odontogenic facial cellulitis occurs more frequently in young patients between the ages of 20 and 30, and in children between the ages of 6 and 11.

The most affected area is that of the mandibular, submandibular and genial region, where there are important adjacent structures.

Medical criteria

When diagnosed, regardless of the stage it is in and its evolutionary characteristics, it has urgent criteria for referral to hospital care, where it must be attended, given the resources necessary for its treatment.

Conduct to follow

Its treatment is dependent on the condition of the patient and the evolutionary state of the clinical picture that generates the appropriate indications that counteract it, such as the patient’s admission if warranted, the possible drainage of the lesion that alleviates the patient and modifies in benefit the present picture, as well as keep track of it to define when and how to eliminate the cause that gave rise to said clinical picture. Consequently, odontogenic facial cellulitis is one of the entities considered among the most careful emergencies, since its torpid management, with the consequent delay or loss of time, may or may not favor the evolution of the existing condition, endangering the life of the patient. patient.

Conclusions

The cellulite facial odontogenic is an entity caused by no proper care in the infestation of a dental organ ( tooth decay ), which is established acutely abruptly with symptoms and signs of great discomfort for patients, with a preference for young patients and children in whom the entity evolves rapidly if it is not controlled in time.

It causes important changes in hemodynamics for patients who present it, so it must be diagnosed, oriented and attended to as quickly as it is received, with all the necessary resources for its control and resolution.

It is an injury that can ruin the patient’s life, so it must be known at its different stages to take the correct actions and avoid regretting adverse complications.

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