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KMID : 1033920130090020075
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Journal of The Korean Academy of Geriatric Denstry
2013 Volume.9 No. 2 p.75 ~ p.81
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Effect of endodontic drainage for control of advanced odontogenic infection in the aged patient with Ludwig's angina and thyroid cancer : Report of a case
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Oh Ji-Hyeon
Son Jeong-Seog
Yoo Jae-Ha
Kim Jong-Bae
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Abstract
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A decrease in the immunologic response of the host may lead to a higher incidence of infection or malignancy in the aged. Odontogenic infections have two major origins : periapical and periodontal routes. The complex infection will spread
through the cancellous bone until it encounters a cortical plate. If this cortical plate is thin in the aged patient, the infection
erodes through the bone and enters the soft tissues and fascial spaces. Ludwig's angina is an overwhelming, generalized
cellulitis that may be spreaded inferiorly to the thyroid gland. Therefore, thyroid gland tumor must be differentiated
simultaneously. The thyroid cancer is usually treated surgically. On the other hand, dental treatment of odontogenic
infection is done by endodontic treatment, dental extraction, incision & drainage, and systemic supportive care. Especially
the drainage treatment of the necrotic pulp is important. The basic principles underlying the treatment of pulpless teeth are those underlying surgery in general. An aseptic technique, debridement of the wound, drainage, and gentle treatment of the tissues with both instruments and drugs are the cardinal principles of surgery. This is a case report of endodontic drainage for control of advanced odontogenic infection in the aged patient with Ludwig's angina and thyroid cancer.
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KEYWORD
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Ludwig's angina, Thyroid cancer, The aged, Endodontic drainage
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