Komplikacije odontogenih upala

master's thesis

• Title (english): COMPLICATIONS OF ODONTOGENIC INFLAMMATION
• Author: Karmen Santini
• Mentor: Dragana Gabrić (mentor)
• Committee member: Dragana Gabrić (predsjednik povjerenstva)
• Committee member: Marko Granić (član povjerenstva)
• Committee member: Ivona Bago (član povjerenstva)
• Granter: University of Zagreb; School of Dental Medicine; (Department of Oral Surgery); Zagreb
• Defense date and country: 2019-10-09, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Dental Medicine; Oral Surgery

Abstract

Odontogena upala predstavlja infekciju čiji je uzročnik zub. Izraz potječe od starogrčkih riječi odonto (zub) i genos (rođenje). Znanje o mikrobiologiji i patofiziologiji ključno je za razumijevanje dijagnostike i liječenje. Loša anatomska omeđenja i rahlost maksilofacijalnih struktura stvaraju uvjete za neometano širenje infekcije. U početku je svaka infekcija lokalizirana i usko vezana uz zub uzročnik. Ako se kao takva ne liječi, dolazi do propagacije gnoja iz primarno aficiranih prostora i razvoja komplikacija.
Sekundarni prostori mjesta su koja nisu inicijalno zahvaćena infekcijom, a ako postanu sijela infekcije, razvijaju lokalne komplikacije. S obzirom na lokalizaciju dijele se na maksilarne i mandibularne prostore te su granice usko povezane s anatomijom, čime je dijagnostika zuba uzročnika jednostavna. Klinički se očituju tipičnim simptomima upale (tumor, dolor calor, rubor, funtio laesa), a zbog blizine žvačne muskulature slabije ili jače izraženim trizmusom. Otekline kompromitiraju oralne funkcije (žvakanje, gutanje, govor), pri čemu u većini slučajeva nema prisutnih općih simptoma. Lokalne komplikacije liječe se ambulantno, a ispravnom eliminacijom uzročnika dolazi do potpunog oporavka bolesnika.
Sistemske komplikacije prikazuju posljedicu učinka infekcije na udaljene organske sustave. Razvijaju se nakon što se uspostave anatomske komunikacije između sekundarnih prostora i organskih sustava. Maksilarne sekundarne infekcije najčešće ascendentno putuju preko obilnih venskih anastomoza u kranijalne strukture. Infekcija mandibularnih zubi ima tendenciju descendentnom direktnom širenju preko fascijalnih ravnina, čime se aficiraju torakalni organi. Sve komplikacije predstavljaju hitna stanja koja zahtijevaju hospitalizaciju. Pacijenti su životno ugroženi i infekcije se očituju pozitivnim općim simptomima. Zahtijevaju iscrpnu diferencijalnu dijagnostiku i multidisciplinaran pristup u liječenju.

Abstract (english)

Odontogenic infection is an infection caused by a tooth. The term is derived from the ancient Greek words odonto (tooth) and genos (birth). Knowledge of microbiology and pathophysiology is crucial to understanding diagnostics and treatment of ofontogenic infection. The nature of anatomical boudaries and fragile maxillofacial structures create conditions for unobstructed spread of the infection. Initially, each infection is localized and closely related to the tooth pathogen. If left untreated, the pus propagates from primary afflicted spaces and complications develop.
Secondary spaces are sites which are not initially affected by the infection, and if they become infected with the infection, local complications develop. In terms of the localization, they are divided into maxillary and mandibular spaces, and the borders are closely related to the anatomy, making the identification of the trigger tooth easy. They are clinically manifested by the typical symptoms of inflammation (tumor, dolor calor, rubor, funtio laesa) and, due to the proximity of the masticatory muscles, to a lesser or more pronounced trismus. The swelling compromises oral functions (chewing, swallowing, and speech). In most cases general symptoms of the inflammation are present. Local complications are treated on an outpatient basis and correct elimination of the causative agent results in complete recovery of the patient.
Systemic complications are the consequence of the effect of the infection on distant organ systems. They develop after anatomical communications are established between secondary spaces and organ systems. Maxillary secondary infections most often ascend as they travel via copious venous anastomoses to the cranial structures. Infection of the mandibular teeth tends to descend directly via fascial planes, thereby affecting the thoracic organs. All complications are considered emergency conditions which require hospitalization. Such infections are life-threatening and they manifest with positive general symptoms. The treatment requires comprehensive differential diagnosis and a multidisciplinary approach.

• Keywords: odontogena upala; zub uzročnik; lokalne komplikacije; sistemske komplikacije
• Keywords (english): odontogenic infection; trigger tooth; local compliocations; systemic complications
• Language: croatian
• URN:NBN: urn:nbn:hr:127:976044
• 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: 2020-01-21 10:45:02