Infectious Cellulitis of Endodontic Origin: An Integrative Review of Etiology, Diagnosis, and Management
DOI:
https://doi.org/10.36557/2674-8169.2026v8n4p722-740Keywords:
Infectious Cellulitis, Endodontics, Odontogenic Infection, Root Canal Therapy, Antibiotic TherapyAbstract
INTRODUCTION: Endodontic infectious cellulitis is an acute, diffuse bacterial infection of the cervicofacial soft tissues originating from necrotic root canals. It represents a public health problem due to the risk of severe and potentially fatal complications, such as Ludwig's angina, and the frequency of inadequate management, including incorrect antibiotic prescription. OBJECTIVES: To systematically and critically review the literature on endodontic infectious cellulitis to identify its etiological agents, analyze diagnostic methods, evaluate management strategies, and explore associated complications. METHODOLOGY: An integrative review was conducted through a systematic search in the PubMed database using the descriptors "endodontic infectious cellulitis," "endodontic-related cellulitis," and "cellulitis of endodontic origin." After applying inclusion and exclusion criteria, 16 studies were selected for critical analysis. CONCLUSION: The findings confirm a polymicrobial etiology but expand this paradigm by including the participation of viruses and fungi in specific contexts. A thorough clinical examination proved superior to imaging methods, such as ultrasound, for differential diagnosis. Effective management primarily depends on eliminating the infectious source through high-quality endodontic treatment, with antibiotic therapy being indicated only for cases with systemic dissemination, which contradicts the practice of empirical prescription. It is concluded that advancing the management of this condition requires a paradigm shift, valuing technical rigor and clinical reasoning over a cultural dependence on antibiotics.
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Copyright (c) 2026 Lucas Monteiro Baia, Caren Lorena Barros de Freitas , Thamiris Tereza da Cunha Bomfim Corrêa, Pedro Henrique Albuquerque Barros, Maisa da Silva Mendes, Diego Calvinho Imbiriba, Sérgius Paulo Amaral Bezerra Neto, Isabela Juliana Maia Cruz, Marielle Cabral Paixão, Daniel Mendes Costa, Paulo Vitor Rodrigues Pinheiro, Emily Evelyn Pinheiros Gomes, Flávia Melo Malato, Yasmin de Nazaré Corrêa Moraes, Sydney Santos de Souza
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