2 - Spread of infection

Question 1

How does odontogenic infection spread?

Answer 1

• looks for easiest route to escape
• dictated by site of infection, bone density, muscle attachments

Question 2

What effect does the mylohyoid line have on the spread of mandibular odontogenic infection?

Answer 2

• in relation to the apices of the tooth, the mylohyoid line dictates whether the spread of infection becomes a sublignual abscess or a submandibular abscess
• infection can spread between the sublinugal and submandibular spaces towards the posterior of the mandible as the ridge becomes more open

Question 3

6

List the posterior potential spaces.

Answer 3

• superficial temporal space
• deep temporal space
• infratemporal space
• pterygomandibular space
• masseteric space
• lateral pharyngeal space

Question 4

What are the posterior potential spaces also known as?

Answer 4

Masticatory spaces

Question 5

Why is spread of infection to the lateral pharyngeal space dangerous?

Answer 5

• contains major vessels and swelling can also obstruct the airway
• infection can spread to brain or chest

Question 6

How can odonotogenic infection cause cavernous sinus thrombosis?

Answer 6

• infection from maxillary teeth with roots located near the inferior ophthalmic vein
• infection from mandibular teeth spreading into infratemporal space where the pterygoid plexus is located

Question 7

Where is the most common place for infection to spread from upper anterior teeth?

Answer 7

• lip
• nasolabial region
• lower eyelid

Question 8

Where is the most common place for infection to spread from upper laterals?

Answer 8

Palate

Question 9

Where is the most common place for infection to spread from upper premolars and molars?

Answer 9

• cheek
• infratemporal region
• maxillary antrum (rare)
• palate

Question 10

Where is the most common place for infection to spread from lower anteriors?

Answer 10

Mental and submental space

Question 11

Where is the most common place for infection to spread from lower premolars and molars?

Answer 11

• buccal space
• submasseteric space
• sublingual space
• submandibular space
• lateral pharyngeal space

Question 12

What is ludwig’s angina?

Answer 12

Bilateral cellulitis of sublingual and submandibular spaces

Question 13

What are the extra- and intraoral features of ludwig’s angina?

Answer 13

EO
- diffuse redness and swelling bilaterally in submandibular region
IO
- raised tongue
- difficulty breathing
- difficulty swallowing
- drooling

Question 14

What are the systemic features of ludwig’s angina?

Answer 14

• increased heart rate
• increased respiratory rate
• increased temperature
• increased WCC