Abstract | Odontogena upala označava upalni proces u tijelu koji je povezan sa zubom. Najčešći uzroci
odontogenih infekcija povezani su s prodorom bakterija kroz inficiranu zubnu pulpu, parodont
ili druge okolne strukture.
U početnoj fazi odontogene infekcije prevladavaju aerobne bakterije, odnosno, bakterije ovisne
o kisiku, dok se u kasnijim fazama upale mikrobna flora uglavnom sastoji od anaeroba,
odnosno, bakterija koje nisu ovisne o kisiku. Odontogena upala može se podijeliti na akutnu
fazu praćenu bolovima, gdje dolazi do stvaranja edema i celulitisa, te na kroničnu fazu koju
označava stvaranje apscesa, tj. ograničene gnojne upale. Širenje odontogene upale ovisi o
okolnim mišićima i fascijama te se većina infekcija pojavljuje na točno određenim mjestima
glave i vrata. Ukoliko se odontogena infekcija ne liječi, može doći do teških komplikacija od
kojih su neke i po život opasne infekcije.
Terapija odontogenih infekcija sastoji se od uklanjanja uzročnika upale (endodontska terapija
ili ekstrakcija zuba), uklanjanja purulentnog sadržaja, uspostavljanja drenaže (trepanacija zuba,
ekstrakcija zuba, intraoralna ili ekstraoralna incizija) i antibiotske terapije. Empirijski antibiotik
izbora u liječenju odontogene upale je penicilin, odnosno, amoksicilin s klavulanskom
kiselinom. Ovisno o težini upale uz spomenuti penicilin može se dodati metronidazol. Ako je
pacijent alergičan na penicilinske antibiotike, propisuje se klindamicin. |
Abstract (english) | Odontogenic inflammation is an inflammatory process in the body related to teeth. The most
common causes of odontogenic infections are connected with invasion of bacteria through an
infected tooth pulp, periodontal tissue or other surrounding structures.
The aerobic bacteria, which is oxygen dependent, is prevalent in the early stages of odontogenic
infection while in the later stages the microbial flora is mostly consisted of anaerobes which are
not oxygen dependent bacteria. Odontogenic inflammation can be divided into an acute phase,
when edema and cellulitis occur followed by pain, and a chronic phase which is characterised
by abscess forming, namely a limited purulent infection. Spreading of odontogenic
inflamamtion depends on the surrounding muscles and fascia and for that reason the majority
of infections appear on specific places of the head and neck. If the odontogenic infection is not
treated it could lead to severe complications out of which some are even life-threatening.
The therapy of odontogenic inflamamation consists of removing the source of the inflammation
(endodontic treatment or tooth extracion), eliminating pus, achieving drainage (opening the
tooth, tooth extraction, intraoral and extraoral incision) and antibiotic therapy. Empirical
antibiotic of choice in managing odontogenic inflammation is penicillin, i.e. amoxicillin with
clavulanic acid. Metronidazole can be added, depending on the severity of the infection,
alongside aforementioned penicillin. If the patient is allergic to penicillin, clindamicin is
prescribed. |