A Multidisciplinary Analysis for Clinical Implications of Denture Use in Patients Presenting With Deep Neck Infections

Abstract

Background: Deep neck infection (DNI) is a potentially life-threatening condition, most commonly arising from odontogenic sources. Dentures frequently act as reservoirs for polymicrobial biofilms, facilitating the persistence and potential transmission of oral pathogens. Despite their widespread use, the role of dentures in predisposing individuals to DNI has not been thoroughly investigated. This study seeks to elucidate the possible association between denture use and the incidence of DNI, thereby addressing a gap in the current understanding of orodental risk factors in DNIs. Methods: A total of 337 patients diagnosed with DNI between August 2018 and July 2024 were retrospectively enrolled in this study. Among them, 29 individuals were identified as denture wearers. Relevant clinical parameters, including demographic data, comorbidities, infection characteristics, and treatment outcomes, were systematically analyzed to assess potential associations with denture use. Results: Involvement of the parapharyngeal (P = .0172), submandibular (P = .0190), and parotid (P = .0213) spaces in DNI was significantly more frequent in patients with dentures compared to those without. Univariate analysis identified age ≥60 years (odds ratio [OR] 27.000; 95% confidence interval [CI], 2.5034-291.19; P = .0010), C-reactive protein (CRP) level ≥220 mg/L (OR 8.5000; 95% CI, 1.2471-57.933; P = .0201), and involvement of ≥3 deep neck spaces (OR 8.4444; 95% CI, 1.2261-58.159; P = .0258) as significant risk factors for prolonged hospitalization. However, in multivariate logistic regression analysis, only age ≥60 years remained a significant independent predictor of prolonged hospitalization (OR 18.494; 95% CI, 1.5789-216.63; P = .0201). Conclusion: In patients with DNI who wore dentures, univariate analysis identified age 60 years or older, CRP levels of 220 mg/L or higher, and involvement of three or more deep neck spaces as significant predictors of prolonged hospitalization. However, multivariate analysis demonstrated that only age 60 years or older remained an independent risk factor for extended hospital stay. These findings highlight the need for targeted health education and preventive measures in elderly denture users to reduce the risk of severe DNI and its complications.