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01 February 2012

Dentigenous infectious foci – a risk factor of infective endocarditis

Beata Wisniewska-SpychalaABCDEFG, Jerzy SokalskiG, Stefan GrajekBD, Marek JemielityB, Olga TrojnarskaB, Irena Choroszy-KrolCD, Anna SójkaB, Tomasz MaksymiukAEF

DOI: 10.12659/MSM.882464

Med Sci Monit 2012; 18(2): CR93-104

Abstract

Background: Dentigenous, infectious foci are frequently associated with the development of various diseases. The role of such foci in the evolution of endocarditis still remains unclear. This article presents the concluding results of an interdisciplinary study verifying the influence of dentigenous, infectious foci on the development of infective endocarditis.
Material/Methods: The study subjects were 60 adult patients with history of infective endocarditis and coexistent acquired heart disease, along with the presence at least 2 odontogenic infectious foci (ie, 2 or more teeth with gangrenous pulp and periodontitis). The group had earlier been qualified for the procedure of heart valve replacement. Swabs of removed heart valve tissue with inflammatory lesions and blood were then examined microbiologically. Swabs of root canals and their periapical areas, of periodontal pockets, and of heart valves were also collected.
Results: Microbial flora, cultured from intradental foci, blood and heart valves, fully corresponded in 14 patients. This was accompanied in almost all cases by more advanced periodontitis (2nd degree, Scandinavian classification), irrespective of the bacterial co-occurrence mentioned. In the remaining patients, such consistency was not found.
Conclusions: Among various dentigenous, infectious foci, the intradental foci appear to constitute a risk factor for infective endocarditis.

Keywords: Endocarditis - etiology, Adult, Periodontitis - microbiology, Risk Factors

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750