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BACKGROUNDOdontogenic infection is one of the common infectious diseases in oral and maxillofacial head and neck regions. Clinically, if early odontogenic infections such as acute periapical periodontitis, alveolar abscess, and pericoronitis of wisdom teeth are not treated timely, effectively and correctly, the infected tissue may spread up to the skull and brain, down to the thoracic cavity, abdominal cavity and other areas through the natural potential fascial space in the oral and maxillofacial head and neck. Severe multi-space infections are formed and can eventually lead to life-threatening complications (LTCs), such as intracranial infection, pleural effusion, empyema, sepsis and even death.CASE SUMMARYWe report a rare case of death in a 41-year-old man with severe odontogenic multi-space infections in the oral and maxillofacial head and neck regions. One week before admission, due to pain in the right lower posterior teeth, the patient placed a cigarette butt dipped in the pesticide "Miehailin" into the "dental cavity" to relieve the pain. Within a week, the infection gradually spread bilaterally to the floor of the mouth, submandibular space, neck, chest, waist, back, temporal and other areas. The patient had difficulty breathing, swallowing and eating, and was transferred to our hospital as an emergency admission. Following admission, oral and maxillofacial surgeons immediately organized consultations with doctors in otolaryngology, thoracic surgery, general surgery, hematology, anesthesia and the intensive care unit to assist with treatment. The patient was treated with the highest level of antibiotics (vancomycin) and extensive abscess incision and drainage in the oral, maxillofacial, head and neck, chest and back regions. Unfortunately, the patient died of septic shock and multiple organ failure on the third day after admission.CONCLUSIONOdontogenic infection can cause serious multi-space infections in the oral and maxillofacial head and neck regions, which can result in multiple LTCs. The management and treatment of LTCs such as multi-space infections should be multidisciplinary led by oral and maxillofacial surgeons.

Purpose: To compare the clinical efficacy of disposable multifunctional drainage tube (DMDT)-assisted irrigation with the traditional abscess incision rubber drainage technique in patients with severe multi-space infections in oral and maxillofacial head and neck regions. Patients and Methods: The data of 74 patients with severe multi-space infections in oral and maxillofacial head and neck regions, who were admitted to the Department of Oral and Maxillofacial Surgery, Central Hospital of Panzhihua City, Sichuan Province, China, between January 2015 and January 2019, were retrospectively studied. According to the treatment method, the patients were divided into 2 groups: the DMDT-assisted irrigation group and the abscess incision rubber drainage group. Cure rate, complications, length of hospitalization, days of antimicrobial use, cost of antimicrobial drugs, total hospitalization cost, number of dressing changes, and patient pain during dressing changes were compared between the 2 groups. Results: Of the 74 patients, 38 were treated with the DMDT-assisted irrigation, and 36 with the traditional abscess incision rubber drainage. Compared with the traditional treatment group, the total hospitalization cost of the DMDT-assisted irrigation group is not much different (P = 0.72), but the patients in the DMDT-assisted irrigation group have higher cure rate, fewer complications, less antibiotics cost, shorter hospitalization length and fewer dressing changes than the control group (P < 0.05). Conclusions: The DMDT-assisted irrigation technique not only improves the cure rate, reduces complications, shortens hospitalization, reduces the use of antibiotics, and alleviates patient pain during dressing changes, but also improves clinical and therapeutic efficacy by reducing the number of dressing changes.