Dental focal infection

Secondary (localized) infection spreading of MIO from dental focus to the

distant organs. Dental focus can be localzsed in the tissues of marginal or
apical periodontium. May cause local propagation, systemic infection (sepsis)
and metastatic infections.

Source of infection, which is

activated may cause severe,
possibly life-threathening
complications in
imunocompromised patients:
Haemoblastoses
Treatment - chemotherapy,
corticoids...)
Imunosupresive th after transplants
 Risk groups
(doctor- medical specialists requires dental consultation)

Immunosupressed patients
organ transplantation
HIV
Cancer

Prosthetic heart valves

Hip replacement
Heart surgery
 Most common examples of
focal infection
tonsillitis
upper respiratory tract infections
sinusitis
genitourinary tract infections
dental infection
 What is considered as possible source od dental focal
infection
non-vital teeth, not treated endodonticaly
periodontitis apicalis acuta, chronica, ostitis
unsufficient endodontic treatment of non-vital teeth
persistent roots (radix relicta)
fractured teeth or subluxation
deep periodontal pockets ( 6mm), periodontal
absces, cysts
persistent milky teeth
semi-erupted teeth, dentitio difficilis (3rd molars)
dental caries proximal to pulp
extremely overhanging fillings in aproximal surfaces
non-optimal fixed prosthetic
foreign bodies
mucosal lesions (ulcerations)
 Examination of patient

Clinical exam. : extraoral

intraoral
aspekcia, palpation
vitality of teeth

Rtg: OPG

A dentist decides wheather a systemic disease has its origin in

dental focal infection/risk of dental focal infection

Treatment Options

1.If the patient comes two to three weeks before surgery EXTRACTION
2.If we have adequate time we treat the patient (e.g. endodontic treatment)
3. Combination endodontic treatment and surgery-resection of root apex
 Propagation and dissemination of
focal infection

KVS: infective endocarditis, endarteritis,

myocarditis
UGS: nephritis, pyelonephritis
GIT: cholecystitis,
OFT: iridocyclitis, retinitis, chorioiditis,
NERV: neuritis, paresis nervi facialis,neuralgie
DER: akne, furunkulosis , eczema
SKELETAL DISOR.: arthritis
 Infective endocarditis
life-threatening inflammation of the lining of the
heart muscle and its valves
caused by a bacterial infection
common in people with certain heart conditions-
The American Heart Association and American
Dental Association now suggest that you receive
antibiotics prior to dental treatment if you have:
had bacterial endocarditis before
prosthetic (artificial) cardiac valve or prosthetic material used in valve
repair,
cardiac valve disease and have had a cardiac transplant Congenital
(present at birth) heart disease.
Signs and symptoms of IE
Fever occurs in 97% of people; malaise, fatigue in 90% of people.[6]
A new or changing heart murmur, weight loss, and coughing occurs
in 35% of people.[6]
Vascular phenomena: septic embolism (causing thromboembolic
problems such as stroke or gangrene of fingers), Janeway lesions
(painless hemorrhagic cutaneous lesions on the palms and soles),
intracranial hemorrhage, conjunctival hemorrhage, splinter
hemorrhages, kidney infarcts, and splenic infarcts.[7]
Immunologic phenomena: Glomerulonephritis which allows for blood
and albumin to enter the urine,[2] Osler's nodes (painful
subcutaneous lesions in the distal fingers), Roth's spots on the
retina, positive serum rheumatoid factor
Other signs may include; night sweats, rigors, anemia, spleen
enlargement
Radix relicta
Periapical lesions
Deep caries
Overhanging fillings
Non-optimal crowns
Semi-erupted teeth
Deep periodontal pockets, terminal periodontitis