Orbital inflammation after dental procedures.

This study reports 3 cases of acute orbital inflammation that occurred within 3 weeks of various dental procedures and offers a possible mechanism as to their cause. The charts of 3 patients were retrospectively examined. Clinical notes, laboratory testing, and imaging studies were reviewed. The cases involved a 36-year old woman, a 61-year-old woman, and a 44-year-old woman who developed acute dacryoadenitis after tooth extraction in the former case and after routine dental cleaning in the latter 2. All cases were initially treated with an oral steroid taper over 6 to 8 weeks. The first 2 cases resolved promptly and have remained quiescent. The last individual had recurrent symptoms prompting lacrimal gland biopsy that demonstrated chronic, nongranulomatous inflammation without monoclonality. The patient subsequently responded to periorbital steroid injection only to have a recurrent bout of inflammation after repeat dental cleaning. Another periorbital steroid injection resulted in resolution of inflammation. The authors propose that a subset of acute orbital inflammation may represent an autoimmune response triggered by dental manipulation. These cases are suggestive of an atypical variant of noninfectious, microbe-induced inflammation.