Suppurative head and neck infections of odontogenic origin are the most frequent type of head and neck infections. According to the literature, 7-10% of all antibiotics are currently prescribed for their treatment. Since penicillin was invented, the overall antibiotic sensitivity and resistance pattern of the isolated pathogenic microflora has continuously changed. The response of microorganisms to antibiotics and the development of resistance to their action is a purely evolutive process characterized by genetic mutations, acquisition of genetic material or alteration of gene expression and metabolic adaptations. All this makes challenging and difficult the correct choice of empirical antibiotic treatment for head and neck space infections even today. The aim of this paper was to evaluate the literature and to evidence the most frequent locations of odontogenic head and neck infections, the dominant pathogenic microbial flora, the genetic mutations and metabolic changes necessary for bacteria in order to aquire antibiotic resistance and as well its susceptibility and resistance to common antibiotics. We also aimed to highlight the possible changes in bacterial resistance to antibiotics over time, and to assess whether or not there is a need for fundamental changes in the empirical antibiotic treatment of these infections and show which these would be.

The oral microbiome can be influenced by many factors and its dysbiosis can have negative effects on oral and general health. The purpose of this study was to analyze the intensity of 11 periodontal pathogenic microorganisms identified in the oral cavity of a sample of children and adolescents from Oradea, Romania and to investigate the association of some variables (age, gender, body mass index, diet, and salivary pH) with the identified microorganisms. The cross-sectional study was conducted on a group of clinically healthy patients under the age of 18 years from Oradea, Romania. For the analysis of the periodontal pathogens, the micro-IDent kit was used, which determines 11 bacterial markers for periodontitis and peri-implantitis. The kit is based on the polymerase chain reaction (PCR). Bacterial sampling was carried out according to the manufacturer’s instructions. A total of 60 children (23 male, 37 female) were included in this study, and were divided into three different age categories. No statistically significant results were identified for gender. However statistically significant results were obtained for other variables. Positive results for Prevotella intermedia and Bacteroides forsythus were associated with ages between 13 and 18 years, while positive results for Capnocytophaga spp. were associated with ages between 2 and 5 years. Positive results for Prevotella intermedia, Bacteroides forsythus, Peptostreptococcus micros, Campylobacter rectus and Eikenella corodens were associated with an overweight BMI. Negative results for Prevotella intermedia and Eikenella corodens were associated with a natural diet in the first 6 months of life. Positive results for Fusobacterium nucleatum and Campylobacter rectus were associated with an acidic salivary pH. In this study, the identified periodontal pathogens were associated with age, body mass index, diet in the first 6 months of life, and salivary pH.

Background/Objectives: Early childhood caries (ECC) is a significant global health issue, particularly affecting deciduous teeth in young children. ECC is prevalent in Romania, where nearly half of children experience dental caries. This study aimed to assess the influence of gender, age, and living environment on parents’ knowledge, attitudes, and practices (KAP) regarding ECC in Bihor County, Romania, using a KAP-type questionnaire. Methods: A cross-sectional study was conducted between March and September 2024, utilizing an online KAP questionnaire distributed via social networks. The sample comprised 419 parents of children under six years old. Respondents provided socio-demographic data and answered questions regarding their knowledge, attitudes, and practices concerning ECC prevention, treatment, and oral health. Statistical analysis was conducted using Chi-square tests to assess associations between demographic factors and parental KAP. A p-value of less than 0.05 was considered statistically significant. Results: Of the 419 respondents, 83.1% were female, and 62.5% were between the ages of 31 and 40. Significant gender-based differences were found in knowledge about pain from caries (93.7% of female participants vs. 81.7% of male participants, p = 0.004) and the importance of brushing twice daily (93.7% of female respondents vs. 80.3% of male respondents, p = 0.010). Younger parents (aged 18–30) were more likely to affirm the effectiveness of fluoride (65.4%) compared to those aged 31–40 (53.1%, p = 0.02). Urban parents were more likely to correctly identify the timing of tooth eruption (59.1% vs. 52.6% of rural parents, p = 0.021). Conclusions: The study highlights gender, age, and urban–rural disparities in parental knowledge and attitudes towards ECC. These findings underscore the need for targeted educational interventions to improve oral health outcomes and reduce ECC prevalence in the Bihor region. Tailored public health strategies addressing demographic factors could enhance preventive oral health behaviors and reduce the healthcare burden associated with untreated dental caries.

Background/Aim: Midface fractures represent a challenge for medical practitioners due to the severe esthetic and functional consequences. This study aimed to determine the causes and to provide a demographic analysis of zygomatic bone fractures in our geographical area, with a view to implementing the necessary prevention methods, training the medical staff for a certain type of patients and decreasing the required costs. Patients and Methods: A retrospective statistical epidemiological analysis of 242 patients with zygomatic bone fractures over a 10-year period was performed. Results: The most affected age group was 20-29 years (27.27%). The most affected were men (n=211, 87.19%) from urban areas (n=140, 57.85%), and without education (n=122, 50.41%). The most frequent cause was interpersonal violence (54.04%), followed by falls (17.36%) and road traffic accidents (16.53%). Conclusions: Interpersonal violence as a cause of zygomatic bone fractures is currently reaching epidemic proportions. Taking legal measures to prevent aggression is a public health emergency that would considerably decrease the incidence of these fractures in our population.

Pediatric facial fractures have different clinical patterns and require different therapeutic approaches in comparison with those of facial fractures that occur among adults. The aim of this study was to describe the main clinical characteristics of pediatric facial fractures (such as fracture location, fracture pattern, treatment, complications and evolution) in a group of pediatric patients from NW Romania. This research was a retrospective study that was conducted for 10 years in a tertiary hospital for oral and maxillofacial surgery from NW Romania. A total of 142 pediatric patients were included in this study, with ages between 0 and 18 years. Mandibular (66.2%), midface (25.4%) and combined fractures (8.5%) were identified, and patients from the 13–18 years age group were more frequently affected by facial fractures (78.9%). Most of the diagnosed fractures among all three types of fractures were total fractures, and most mandibular (92.6%) and midface (80.6%) fractures were without displacement. Hematomas, lacerations and abrasions were identified as associated lesions. Patients with associated lesions were more frequently associated with combined fractures or midface fractures than mandibular fractures. The instituted treatment was, in general, orthopedic, for all three types of fractures (mandibular—86.2%; midface—91.7%; combined—66.7%). Most fractures, mandibular (96.8%), midface (100%) and combined (91.7%) fractures, had a favorable evolution. Most fractures did not present any complications at the follow-up. Pediatric facial fractures have unique patterns and must be treated with caution, considering the particularities of pediatric facial anatomy.

Pediatric facial fractures are not as common as facial fractures occurring in the adult population. Their therapeutic approach is different because they affect patients with active growth, and have an etiology and epidemiology that vary depending on different cultural, religious and demographic factors. This research aimed to identify the main factors involved in the etiology of pediatric facial fractures, as well as the epidemiology of pediatric facial fractures in a sample of children and adolescents from North-Western Romania. This 10-year retrospective study was performed in a tertiary center for oral and maxillofacial surgery in North-Western Romania. Medical files of patients that were admitted between 1 January 2002 and 31 December 2022 were analyzed. Pediatric patients aged 0 to 18 years were included in this study. The final sample consisted of 142 children and adolescents diagnosed with facial fractures, with this number representing 14.1% of all patients affected by facial fractures. Most frequently, fractures were identified in the 13–18 age group (78.9%, n = 112), which were more often associated with fractures caused by interpersonal violence than caused by road traffic accidents, falls or animal attacks. Boys were more affected (88%, n = 125), and were more frequently associated with fractures caused by interpersonal violence. The most frequently identified etiological factors included interpersonal violence (50%, n = 71), falls (18.3%, n = 26) and road traffic accidents (11.3%, n = 16). In terms of location, the mandible was the most affected facial bone structure (66.2%, n = 94), and patients with mandibular fractures were more frequently associated with fractures caused by interpersonal violence. The incidence of pediatric facial fractures should be lowered because they may interfere with the proper development of the facial skeleton. Establishing measures aimed at preventing interpersonal violence, as well as other causes involved in the etiology of facial fractures is imperative.