periodontal abcess antibiotics

INTRODUCTION: Cerebral abscess is a rare but serious and life-threatening infection. Dental infections have occasionally been reported as the source of bacteria for such an abcess. PATIENT AND METHODS: A 54-year-old man was admitted with a right hemiparesis and epileptic fits. After clinical, laboratory and imaging examination, the diagnosis of a cerebral abscess of the left parietal lobe was made. The intraoral clinical examination as well as a panoramic radiograph confirmed the presence of generalized periodontal disease, multiple dental caries, and periapical pathology...

Infectious dental complications are quite frequent given the high incidence of tooth decay. Other pathologies not related to dental decay can cause mouth infectious such as periodontal infections, alveolitis, peri-coronitis of impacted wisdom tooth and secondary infection of dental fragments. Dental infection can be localised to apex (top of the root) or progress to soft and bony tissues surrounding the teeth. The most frequent germs involved in these infections are generally the same as saprophyte buccal flora but are often associated to other anaerobic germs...

Our experience with operative treatment of 70 patients with osteomyelitis of the mandible showed that the incision and drainage of soft-tissue abcesses combined with antibiotic therapy led to healing in 22 patients. More extensive measures, such as sequestectomy, decortication, resection of whole areas of the mandible, and transplantation of autologous cancellous bone, however were necessary with 48 of the patients. A detailed description of the various operative techniques was presented; the respective indications were mentioned...

Between 1965 and 1974, 1002 patients were treated on an in-patient basis for odontogenous soft-tissue infections. Abcesses were observed in 960 patients; inflammatory infiltrate, in 39 patients; a phlegmon, in 3 patients. The relation of male to female patients was 56:44. The 21- to 30-year-old age group was most frequently affected. Antibiotic therapy was administered over a period of weeks prior to admission in 87% of the patients. Operative procedures prior to admission had been performed on only a few patients...

According to this investigation, antibiotic treatment of odontogenous abcesses should be directed primarily against streptococcus and staphylococcus, even if gram-negative pathogens have apparently increased. The response on the part of streptococcus to antibiotics has not changed essentially during the last five years. Staphylococcus however has developed a resistance to penicillin and ampicillin.