Odontogena infekcija - iskustva iz prakse

master's thesis

• Title (english): Odontogenic infection- experiences from practice
• Author: Petra Miholić
• Mentor: Ivan Zajc (mentor)
• Committee member: Ivan Zajc (predsjednik povjerenstva)
• Committee member: Jelena Dumančić (član povjerenstva)
• Committee member: Marko Granić (član povjerenstva)
• Granter: University of Zagreb; School of Dental Medicine; (Department of Oral Surgery); Zagreb
• Defense date and country: 2017-09-26, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Dental Medicine; Oral Surgery

Abstract

Odontogena infekcija je infekcija nastala u vezi sa zubima čiji je uzrok najčešće inficirani korijenski kanal zuba, a rjeđe inficirani periodontalni ili perikoronarni prostor zuba. Fiziološku floru usne šupljine čine različite vrste bakterija koje su ujedno i mogući uzročnici infekcije koja nastaje kao posljedica poremećaja ravnoteže između njihove patogenosti i obrane domaćina. Mikrobna flora u odontogenoj infekciji mijenja se tijekom vremena u korist anaerobnih bakterija. Prodorom mikroorganizama u periapikalno tkivo nastaje upalna reakcija koja može biti akutna, subakutna ili kronična. Upalni proces iz periapikalne regije može se proširiti, obično kroz bližu i tanju koštanu stijenku, perforirati periost i dospjeti u meka tkiva. Lokalizacije upalnog procesa u mekom tkivu i kasniji putovi širenja ovise o anatomskoj poziciji mišića i fascija glave i vrata pa apscesi mogu nastati intraoralno ili ekstraoralno. Simptomi i klinički znakovi zajednički većini apscesa uključuju: oteklinu tkiva, bol, crvenilo okolne sluznice, a u težim slučajevima, kada dođe do širenja infekcije, mogu se javiti komplikacije praćene općim simptomima. Terapija odontogene infekcije uključuje: uklanjanje uzroka (bilo ekstrakcijom zuba uzročnika ili njegovim endodontskim liječenjem), osiguravanje drenaže upalnog procesa (incizijom, ekstrakcijom, kortikalnom trepanacijom ili trepanacijom zuba), upotrebu antibiotika (kada postoji indikacija za njih) te primjenu dodatnih mjera kao što su hidratacija organizma ili upotreba analgetika po potrebi. Od antibiotika najdjelotvorniji je amoksicilin s klavulanskom kiselinom uz koji, ako nema poboljšanja nakon lokalnog stomatološkog liječenja u sljedeća dva dana, treba ordinirati i metronidazol koji ima dobar učinak na Gramm (-) anaerobne bakterije.

Abstract (english)

An odontogenic infection is an infection associated with teeth and is most commonly caused by infected root canal while the less common cause can be infected periodontal or pericoronar tooth area. The normal microbal flora of the oral cavity consists of different types of bacteria which can become causative agent of infection if between their pathogenicity and the host defense occur disturbances. The microbial flora of odontogenic infection changes over time in favor of anaerobes. After extension of microorganisms to periapical tissue, the body responses by inflammation that can have acute, subacute and chronical course. The inflammatory process from periapical region usually expands through closer and thinner bone wall, can perforate the periosteum and reach the soft tissue. The localization of the inflammatory process in the soft tissue and the later pathways of the spread depend on the anatomic position of the muscles and head and neck fascias so the abscesses can be formed intraorally or extraorally. Symptoms that are common to most abscesses, include swelling of the tissue, pain, redness of the surrounding mucosa, while in some harder cases, when the infection spreads, complications accompanied by general symptoms may occur. Treatment of odontogenic infection may involve elimination of the affected tooth by extraction or endodontic treatment, drainage of inflammation process by incision, extraction, cortical trepanation or trepanation of tooth, the use of antibiotics, when they are indicated, and some additional measures such as hidratation of organism or use of analgetics if needed. Amoxicillin with clavulanic acid is the most effective antibiotic. If there is no improvement while using amoxicillin with clavulanic acid after local dental treatment for the next two days, metronidazole, that is effective with Gramm (-) anaerobic bacteria, should be ordered.

• Keywords: odontogena infekcija; mikroorganizmi; širenje apscesa; antibiotici
• Keywords (english): odontogenic infection; microorganism; spread of abscess; antibiotics
• Language: croatian
• URN:NBN: urn:nbn:hr:127:838342
• Study programme: Title: dental medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica dentalne medicine (doktor/doktorica dentalne medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2018-01-17 12:39:50