Incidence et facteurs associés des cellulites cervico-faciales d’origine dentaire au niveau du CHU Tlemcen « 2013-2016 »

Abstract

Incidence and associated factors of cervico-facial cellulitis of dental origin at the CHU Tlemcen "2013-2016" Introduction Cervical-facial cellulitis of dental origin (CCFOD) is an infection of the adipose tissue, face and neck, with extensive potential which can sometimes be serious and life threatening. Materials and methods : This is a prospective descriptive study at the level of the CHU of Tlemcen, going from October 2013 to September 2016. Among a population of 2500 individuals coming to consult the Service of Pathology and Oral Surgery of the CHL Tlemcen, 258 cases of CCFOD been collected and representing 10.32% of the workforce. The annual incidence has been estimated at 86 cases. Results and discussion : In our series, we have 58% men and 42% women, a sex ratio of 1.38. The average age of our series is 24.52 years with extremes ranging from 5 to 67 years. Clinically, we had 230 circumscribed CCFODs and 28 diffuse CCFODs. Pain and swelling are the two most common signs with a rate of 95.37%. Fever, asthenia and trismus were found with rates of 79.85%, 79.85% and 70.2%, respectively. The main risk factors associated with CCFOD are dental caries found at 89.1% and poor oral hygiene with a rate of 83.3%. Inappropriate antibiotic therapy was found in 61.17%, previous NSAID use was found in 36.43%, AIS in 6.20% and self-medication in 22.5% of cases. Tobacco, medical history (diabetes, heart disease, etc.) and alcohol are found at rates ranging from 4.70% to 21.7%. In 55.43%, the causal teeth are the mandibular molars. Signs of severity are dysphagia (15.5%), dyspnea (5%) and dysphonia (3.5%). Diffusion was mediastinal in 0.77% and cervical in 20.93% of our patients. The highest severity score, according to the Flynn classification, was the floor buccal / cervical diffusion association, low genial localization, mediastinal diffusion and low genial localization / cervical extension. The bacterial flora responsible was mixed aero-anaerobic with a predominance of anaerobic germs. Therapeutic care was provided on an outpatient basis in 90.70% of our patients. Hospitalization concerned 13.2% of them, including 28 diffuse cellulites and 6 suppurative circumscribed cellulites. The evolution was favorable in 99.61%. The death occurred in a diabetic patient. The majority of the results obtained are similar to the data in the literature. Conclusion Despite their common appearance, CCFODs can be serious and cause major complications. It would therefore be wise to continue this study in order to better understand this condition in our population.