Endodontology
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Orbital complications due to an acute odontogenic focus in a child. A case report

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The full clinical manifestations of complications due to odontogenic foci are rarely seen in daily dental practice and can take a clinically foudroyant course of development in young people owing to anatomic conditions, as demonstrated in this clinical case in a 12-year-old girl. Endodontic treatment of the first right upper molar was started owing to increasing toothache and swelling of fossa canina and the periorbital region. During the course of treatment, the patient exhibited an acute increase in orbital inflammation, which required immediate surgical intervention with postsurgical intravenous antibiotic administration. This case should serve to emphasize the crucial requirement for intensive attention to orbital symptoms after dental procedures.

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Case Description

A 12-year-old girl was referred to our institution because of orbital swelling. Initial toothache had developed 8 days before admission with an increasing intensity.

At the day of admission, the patient saw her dentist because of a slightly swollen eye and toothache. The first right maxillary molar, which had extensive carious lesions and periapical lesions (Fig. 1,arrowheads), was diagnosed as the origin of the inflammatory process. The dentist removed the coronal restoration of the tooth and

Discussion

Orbital phlegmons are acute inflammations of the contents of the orbit, characterized by exophthalmos, chemosis, swelling of the eyelids, restriction in mobility of the eye, and strongly impaired general condition with fever.2 The preseptal form is anatomically distinguished from the postseptal intraorbital form of orbital phlegmons. The former is an inflammation of the orbital subcutaneous tissue in front of the orbital septum, without development of exophthalmos. Pupillary reaction is

Summary

Odontogenic or periodontal infection foci can rapidly spread to neighboring anatomic structures owing to anatomic proximity of periapical lesions to the maxillary sinus and the cranial organs. The acute spread to the orbital socket is particularly serious. In children, orbital inflammation due to odontogenic infection is rare. However, an accident in endodontic treatment may exacerbate a chronic sinus maxillary and induce further orbital inflammation. Close medical examination and monitoring,

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