Dentoalveolar abscess

Question 1

Dentoalveolar abscess

Answer 1

acute lesion characterised by a localised collection of pus in structures that surrounded the teeth
conditions that lead to abscess:
- periapical periodontitis
- periodontal disease
- acute periodontitis
- infection of a cyst

Question 2

pathogenesis of dentoalveolar abscess

Answer 2

due to bacterial infection from necrotic pulp and periapical pathology
arises as a result of failure to eradicate source of infection
membrane classically consist of granulation tissue but in a rapidly expanding lesion may simply be a rim of inflammatory cells
soft tissue surrounding dentoalveolar abscess may become swollen as a result of inflammatory exudate

Question 3

Causative microorganisms

Answer 3

facultative anaerobes
- strep viridans
- strep anginosus

strict anaerobes
- prevotella
- fusobacterium
- anaerobic cocci

Question 4

cellulitis

Answer 4

spreading infection of CT typical of strep. organisms
spreads through tissue spaces
associated with trismus, cervical lymphadenopathy, malaise, pyrexia
develops quickly
inadequately managed

Question 5

ludwig’s angina

Answer 5

spreading cellulitis involving submandibular, sublingual and submental spaces bilaterally
gross swelling (oedema)
elevation of the tongue (drooling of saliva)
airway compromise
emergency

Question 6

cavernous sinus thrombosis

Answer 6

maxillary dentoalveolar infection
blood clot within the cavernous sinus
thrombophlebitis of facial vein
intracranial spread via venous system