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References

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Gore MR. Odontogenic necrotizing fasciitis: a systematic review of the literature. BMC Ear Nose Throat Disord. 2018; 18 https://doi.org/10.1186/s12901-018-0059-y
Stevens DL, Bryant AE. Necrotizing soft-tissue infections. N Engl J Med. 2017; 377:2253-2265 https://doi.org/10.1056/NEJMra1600673
Wong CH, Chang HC, Pasupathy S Necrotizing fasciitis: clinical presentation, microbiology, and determinants of mortality. J Bone Joint Surg Am. 2003; 85:1454-1460
Bayetto K, Cheng A, Sambrook P. Necrotizing fasciitis as a complication of odontogenic infection: a review of management and case series. Aust Dent J. 2017; 62:317-322 https://doi.org/10.1111/adj.12508
Ord R, Coletti D. Cervico-facial necrotizing fasciitis. Oral Dis. 2009; 15:133-141 https://doi.org/10.1111/j.1601-0825.2008.01496.x
Jakovljevic A, Nikolic N, Jacimovic J Prevalence of Apical Periodontitis and Conventional Nonsurgical Root Canal Treatment in General Adult Population: An Updated Systematic Review and Meta-analysis of Cross-sectional Studies Published between 2012 and 2020. J Endod. 2020; 46:(10)1371-1386.e8 https://doi.org/10.1016/j.joen.2020.07.007
Brunworth J, Shibuya TY. Craniocervical necrotizing fasciitis resulting from dentoalveolar infection. Oral Maxillofac Surg Clin North Am. 2011; 23:(3)425-432 https://doi.org/10.1016/j.coms.2011.04.007
Bali RK, Sharma P, Gaba S, Kaur A, Ghanghas P. A review of complications of odontogenic infections. Natl J Maxillofac Surg. 2015; 6:(2)136-143 https://doi.org/10.4103/0975-5950.183867
Weiss A, Nelson P, Movahed R, Clarkson E, Dym H. Necrotizing fasciitis: review of the literature and case report. J Oral Maxillofac Surg. 2011; 69:(11)2786-94 https://doi.org/10.1016/j.joms.2010.11.043
Yadav S, Verma A, Sachdeva A. Facial necrotizing fasciitis from an odontogenic infection. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012; 113:(2)e1-4 https://doi.org/10.1016/j.tripleo.2011.06.010
Wolf H, Rusan M, Lambertsen K, Ovesen T. Necrotizing fasciitis of the head and neck. Head Neck. 2010; 32:(12)1592-1596 https://doi.org/10.1002/hed.21367
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Necrotizing fasciitis: a severe complication of odontogenic infection

From Volume 49, Issue 6, June 2022 | Pages 500-504

Authors

Lewis Olsson

BDS(Hons), MFDS, RCPSG

Year 3 Medical Student, University of Glasgow

Articles by Lewis Olsson

Email Lewis Olsson

Hannah Muir

BDS, MFDS, RCPSG

DCT3 Oral Surgery, Edinburgh Dental Institute

Articles by Hannah Muir

Jaime Grant

MBChB, MRCSEd, BDS(Hons), FRCS(OMFS)

Craniofacial Fellow, Birmingham Women's and Children's Hospital

Articles by Jaime Grant

Marieke T Brands

DDS, MD, LLM, PhD

OMFS Consultant, University Hospital Monklands

Articles by Marieke T Brands

Drazsen Vuity

MD, DMD, FRCSEd (OMFS)

OMFS Consultant, University Hospital Crosshouse

Articles by Drazsen Vuity

Abstract

Necrotizing fasciitis is a rare complication of dental infection and is associated with a significant mortality rate. Prompt recognition and urgent referral are therefore essential. Surgical debridement and broad-spectrum intravenous antibiotic therapy are the mainstay of management. This report outlines a case of necrotizing fasciitis of odontogenic origin in an otherwise healthy 32-year-old patient.

CPD/Clinical Relevance: This article highlights odontogenic necrotizing fasciitis to the dental team, discusses its management and serves as a reminder of the potential severe complications of unmanaged dental infection.

Article

Necrotizing fasciitis (NF) is a rare but severe complication of odontogenic infection.1,2 The infection spreads rapidly from the peri-apical tissues via the fascial spaces, causing necrosis of the soft tissue layers while not respecting anatomic boundaries. As a result, the patient is often systemically unwell and a mortality rate of 9.8% is associated with NF of odontogenic origin.2

Prompt diagnosis is crucial, with early surgical intervention and appropriate antimicrobial therapy being key in obtaining a good outcome.3,4,5 Patients often require aggressive surgical resection of necrotic tissues, which can lead to significant morbidity in both form and function in the head and neck.6

This case report documents NF originating from a dental source. It highlights NF as a severe complication of a common dental presentation and outlines the basic principles of management of NF to the dental team. In doing so, the authors hope to inform the readership of the crucial role they may play in expediting care and improving outcomes for these patients.

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