Relationship between region abscess maxillofacial and climate in South Sulawesi

Objective: To determine the relationship between regiomaxilofacial abscesses with the monsoon and dry seasons. Material and Methods: Type of research used in this study is descriptive observational. The research design used in this study is the cross sectional study. Results: The results of this study are not significant in the designation of the relationship between abscess maxillofacial and climate in South Sulawesi, because it is caused by several factors including the number of samples and the interval of data used, as well as environmental factors such as temperature and air pressure. Conclusion: This study regarding the relationship between maxillofacial region abscess and climate in South Sulawesi showed that as many as 31 abscess cases in Ibnu Sina Hospital, 9 abscess cases in Unhas Teaching Hospital, 3 cases of abscesses in East of Indonesia University Hospital occurred during monsoon season, while 27 cases of Ibnu Hospital abscess Sina, 2 abscess cases in Unhas Teaching Hospital, 3 abscess cases in East of Indonesia University Hospital occurred during dry season. This indicates that there is a relationship between the development of abscesses when it’s monsoon season or when barometric pressure is low.


Introduction
Periapical abscess is a collection of pus which is confined to the aveloar bone at the apex of the tooth root and has spread to surrounding tissue after the tooth has pulpitis, by expanding the infection into the periradicular tissue through the apical foramen. The pus is formed from white blood cells that have died because of an attack on the infection. The ground can drain into the gum area, causing swelling of the gums around the root of the tooth. 1- 4 On the day when the barometer pressure or temperature is low, there is an increase in the frequency of tooth abscesses. In conclusion, bioclimatic or seasonal conditions affect health because of the low barometric pressure, which results in an increase in the number of patients with dental abscesses. The prevalence of life time abscesses in the oral cavity is reported to be between 5% and 43% depending on the basic status of the health care system. The majority of oral abscesses are caused by pathogenic bacteria from the oral cavity, such as species streptococcus, staphylococcus species prevotella, eikenella corrodens and others that migrate through damaged root canal teeth or periodontal pockets into the bone. 2

Research Data
Results of the primary data are processed manually, then the data is presented in the form of tables and diagrams. Data analysis is done descriptively by making a systematic description of the conditions of the research results.

Results
This study was carried out by retrieving data from the East of Indonesia University Hospital, Ibn Sina Hospital, Unhas Teaching Hospital, and Wahidin Sudirohusodo Hospital in the month of November 2018. Data taken from the Hospital was in the form of medical records for patients abscess of the maxillofacial region from 2011 to 2018. The process of retrieving the data is by recording important things such as the date of treatment, patient's name, patient's age, gender, and diagnosis. Based on the results of data collection there were a total of 92 cases of maxillofacial region abscess. Details of the number of maxillofacial region abscess cases can be seen in table 1, table 2, table 3, and table 4.
Other data was obtained from the Meteorology and Geophysics Agency (BMKG) in Makassar region IV. Data obtained in the form of rainfall data from 2011 to 2018. Detailed rainfall data in the city of Makassar from 2011 to 2018 can be seen in table 5.
Total of 11 patients were admitted to the Hasanuddin University Teaching Hospital with various diagnoses, such as zygomaticusabscess, mandibular abscess and submandibular abscess.
A total of 6 patients who were hospitalized in East Indonesia various diagnoses, such as facialabscesses, mandibular abscesses, cheek abscesses, and maxillary abscesses.
Total 21 patients treated at Dr. Wahidin Sudirohusodo Hospital with various diagnoses such as mouth abscess and periapical abscess.
From the results of statistical tests p value 0.05, which means that there is no significant difference between cases of maxillofacial abscess in the rainy and dry seasons. Figure 1.
This diagram shows the overall data of patients with abscesses maxillofacial and rainfall data in South Sulawesi from 2011 -2018, indicating that of abscess maxillofacial there were 48 casesin the rainy season and in the dry season there were 44 cases.

Discussion
Odontogenic infection is one of the most common infections in humans. In most patients this infection is minor or underestimated and is often

ORIGINAL RESEARCH
The bacteriological agents involved in causing dental abscesses consist of a mixture of anaerobic and facultative anaerobic bacteria. Data collection from culture and molecular studies shows that more than 460 unique taxa bacteria belonging to 100 genera and 9 phyla have been identified in various types of endodontic infections. Anaerobic bacteria are more abundant than facultative with a ratio that varies between 1.5 and 3: 1 in mixed infections. 5 The majority of oral abscesses are caused by oral cavity bacteria, such as species streptococcus, species staphylococcus, species prevotella, eikenella corrodens and others that migrate through decaying root canals or periodontal pockets into the bones. 4 In a study conducted by Aschoff and Wever stating that oral bacteria including abscess-causing germs showed the highest growth rate at 37°C. In humans, thermoregulation is very effective in keeping the body's core temperature constant while air temperature can significantly change the temperature of the body area outside of Depending on the air temperature from 5 C to 50 C, the temperature of the hand or foot ranges from 16 to 40 C, and the forehead is 27-39 C, while the core temperature remains stable between 36.5 and 38 C, so the human temperature remains optimal for bacterial growth. 6 The majority of previous studies focused on air temperature and experienced several limitations, namely only involving small numbers of patients and only involving one institution. Research that only includes one institution has the possibility of causing selection bias depending on the hours of practice, and a short study period can overlook high variations in weather parameters. When these and other relevant confounding factors have been considered, the question of whether the occurrence of oral abscesses is affected by outside temperature or other environmental factors remains unanswered. Therefore, the aim of the current retrospective and multicenter study is to investigate the effect of meteorological parameters, including daily average barometric temperature and pressure, on the frequency of oral abscesses in a large number of patients. To validate each observed relationship, the effects of confounding variables and parameters reflecting the work habits of a local dental facility (such as working days, working days and months) are also considered. 4 The results of this study were not significant in the designation of the relationship between region abscess maxillofacial and climate in South Sulawesi, because it was caused by several factors including the number of samples and the interval of data used, as well as environmental factors such as temperature and air pressure.
The number of samples has an important influence on the results of this study. In this study, researchers used a sample of 92 samples and obtained insignificant results on the relationship of region abscess maxillofacial to climate in South Sulawesi, whereas in a study conducted by Seemann R et al in 2015 using a sample of 19,225 significant results were obtained for abscess regional relationships. maxillofacial with climate. 4 Therefore, the above shows that the number of samples used has an important influence on the relationship ofregion abscess maxillofacial to climate.
In addition, the interval of data used is also one of the factors that can influence the results of the

ORIGINAL RESEARCH
study. In this study, researchers used data at intervals of 8 years, whereas in studies that obtained significant results, the research conducted by Seemann et al. 4 used data with a time interval of 14 years. 4 The third factor that can influence the results of the study is temperature. Temperatures in South Sulawesi tend to be higher, the difference between the temperature during the rainy season and the temperature during the dry season in South Sulawesi is also not large or below 10C, whereas according to the conduction method, high temperatures will move to areas that have lower temperatures, so that the heat in the room will move and affect the body temperature of the subject. In contrast to research conducted in areas that have cooler temperatures. When the body is in a cooler room and the body temperature is hotter, of course the body will emit heat and the body temperature will drop. 7 This increase in dental abscess can be caused because in low temperature conditions, the oxygen level will be a little too vice versa. If the oxygen level is small, this can benefit facultative anaerobic and anaerobic bacteria which are the dominant bacteria from abscesses. So that in areas that have low temperatures, the incidence of abscesses will increase. 8 Other factors that can cause the results of this study are not significant, namely air pressure. There is a relationship between barometric pressure and the occurrence of abscesses. In accordance with previous research that if barometric pressure eats the number of occurrences of abscesses will increase, and vice versa. This finding confirms the assumptions of the number of abscesses is significantly higher during cyclone weather conditions, especially during low barometric pressures. 4

Conclusion
Research on the relationship between region abscess maxillofacial and climatein South Sulawesi shows that as many as 31 abscess cases in Ibnu Sina Hospital, 9 abscess cases in Unhas Hospital, 3 cases of abscess in UIT Hospital occurred when rainfall was high, while 27 cases of RS abscesses Ibnu Sina, 2 RSP Unhas abscess cases, 3 cases of UIT Hospital abscess occurred when rainfall was low. This indicates that there is a relationship between the development of abscesses when high rainfall or when barometric pressure is low.