Odontogenic Infection Associated with Facial Vascular Malformation: Diagnostic, Surgical, and Quality-of-Life Considerations That Should Not Be Overlooked

Background and Clinical Significance: Vascular lesions of the face, particularly arteriovenous malformations (AVM) and mixed hemangiomas (MH), pose significant diagnostic and therapeutic challenges because of their complex anatomy, unpredictable behavior, and high risk of bleeding. Surgical planning should be individualized and often requires a staged approach with meticulous interdisciplinary coordination to ensure patient safety. The presence of a concomitant odontogenic infection further complicates management, as local inflammation may exacerbate vascular instability and increase the risk of life-threatening complications. Local inflammation and infection might cause some life-threatening conditions, especially when an abscess occurs in the area of any vascular lesion. Ensuring that the oral cavity is free from potential odontogenic infections is a particularly important issue in many complex cases, especially in patients treated for oral, head, and neck cancer or in those with other coexisting morbidities affecting the oral and facial regions. Case Presentation: A 72-year-old man was referred for management of a severe odontogenic infection associated with an extensive facial vascular lesion. The patient's medical history was significant for arterial hypertension and chronic liver dysfunction (CLD) of unclear etiology. Complete blood testing, including coagulation assessment and liver ultrasonography, was performed, with no contraindication to surgery identified. The scope of odontogenic-related infections was scheduled for simultaneous removal during initial surgery. Preparation for surgery included the local application of sclerotherapy agents. Conclusions: Quite often, a routine panoramic radiograph can help in assessing the status of bone and dentition to undertake all necessary treatment. Severe odontogenic disease, including multiple retained roots, periapical infections, and odontogenic cystic lesions in the context of poor oral hygiene, may lead to the occurrence of possible inflammation. In case of any vascular lesion, a careful diagnostic and therapeutic strategy is needed. This case report highlights that maintaining an infection-free oral environment is a critical component of care in patients with complex facial MH and should be regarded as an essential element of overall treatment planning.