No abstract

Cervical necrotizing fasciitis (CNF) is a life-threatening bacterial infection that runs aggressively in the subcutaneous tissue and fascia in the head and neck area with clinical presentation of extensive necrotic tissue that develops from infection of the teeth or gingiva and other supporting tissues accompanied by an endosteal or periosteal infection of the jaw. This research aims to obtain information about characteristic patients with cervical necrotizing fasciitis (CNF). This study is an observational study with a retrospective descriptive approach. Based on medical record data, the research was conducted at Hasan Sadikin General Hospital (RSHS) Bandung from March 2019 – March 2021. The data collected include age, gender, onset, nutritional status, region, clinical diagnosis, microbiology, antibiotic sensitivity resistance, length of stay, and source focal infection. In this study, 23 medical records were obtained. The most frequent characteristics of the subjects were elderly aged more than 50 years (47.8%) and males (61%). The most frequent locations were the submandible area (100%), and the most frequent source of focal infection was from mandibular posterior teeth (60.46%). From the onset to the symptoms frequently 7-14 days with the nutritional status, most patients were malnourished (58%). Regarding microbiology gram negative dominantly (66,6%), with the most bacterial that worsening the spread of CNF being Acinobacter Baumanii (26.0%), Tigecycline becomes antibiotic most sensitive (43,47%), Cefazoline is the most resistance (73.91%). Most patients were treated by surgery necrotomy debridement (95, 6 %), and most improved (76 %). The ability to diagnose quickly and take aggressive action is needed to treat patients with Cervical Necrotizing Fasciitis (CNF) because of its high progression.

ABSTRAKPendahuluan: Kismis Thompson seedless raisin (Vitis vinifera sultanina) mengandung fruktosa dan glukosa yang dapat meningkatkan rangsang manis. Rangsang manis akan meningkatkan sekresi saliva yang berpengaruh pada pH saliva. Tujuan penelitian ini untuk mengetahui perbedaan pH saliva sebelum dan sesudah konsumsi kismis Thompson seedless raisin. Metode: Jenis penelitian eksperimental semu dengan analisis statistik uji Wilcoxon. Jumlah sampel 38 mahasiswa Kedokteran Gigi Universitas Padjadjaran berusia 18-24 tahun. Pengukuran pH saliva dilakukan sebelum dan sesudah mengonsumsi kismis Thompson seedless raisin. Hasil: Nilai rata-rata pH saliva sebelum mengonsumsi kismis Thompson seedless raisin adalah 6,87 dan sesudah mengonsumsi kismis Thompson seedless raisin adalah 7,20. Analisis statistik menunjukan peningkatan pH saliva yang bermakna (p-value < 0,05) antara sebelum dan sesudah mengonsumsi kismis Thompson seedless raisin. Simpulan: Terdapat peningkatan nilai pH saliva sebelum dan sesudah konsumsi kismis Thompson seedless raisin. Kata kunci: Kismis Thompson seedless raisin, pH saliva Differences in the salivary pH after consumption of Thompson seedless raisin ABSTRACT Introduction: Thompson seedless raisin (Vitis vinifera sultanina) contains fructose and glucosewhich can increase sweet stimulation bud. Sweet stimulation will increase salivary secretion which affects the salivary pH. The purpose of this study was to determine differences in the salivary pH before and after consumption of Thompson seedless raisin. Methods: This research type was quasi-experimental research with Wilcoxon test statistical analysis. The number of samples was as much as 38 dentistry students from Universitas Padjadjaran aged 18 -24-years-old. Measurement of the salivary pH was performed before and after consuming Thompson seedless raisin. Result: The average value of salivary pH before consuming Thompson seedless raisin was 6.87 and after consuming Thompson seedless raisin was 7.20. Statistical analysis showed a significant increase in the salivary pH (p-value < 0.05) before and after consuming Thompson seedless raisin. Conclusion: There was a significant increase in the salivary pH value before and after consumption of Thompson seedless raisin.

Subcutaneous emphysema is an uncommon complication of dental procedures. This complication arises when air forced beneath the tissue. In dentistry it may appear with the use of high-speed bur and could cause a serious complication including airway obstruction. This case report highlights a complication during dental procedure to give information for the clinician the factors, diagnosis, and management of subcutaneous emphysema.A 33 years old male patient with difficulty in breathing and swelling at right lower jaw, neck and chest region. The swelling occurred about 2 hours before admission during tooth extraction of second right lower molar using a high-speed bur about 30 minutes, then he started to feel difficulty in breathing with swelling at right lower jaw, neck and chest region occurred and pain. Then he was transferred to Hasan Sadikin Emergency Department for further treatment. The patient was diagnosed with subcutaneous emphysema at right lower jaw, neck and chest region due to suspect iatrogenic. The management of this patient was conservative treatment with oxygenation 3 lpm, close observation vital sign and wide emphysema, IVFD ringer lactate 1500 cc/ 24 hours, medication with Ceftriaxone 1 gr, Ketorolac 30 mg, Omeprazole 20 mg intravenous and being hospitalized for 4 days. After general condition stable he was performed tooth extraction.Iatrogenic subcutaneous emphysema could be a serious and potentially life-threatening, so dentist has to be more careful while using high-speed bur for tooth extraction.