Odontogenic Infections Flashcards
Are fascia-lined tissue compartments filled with loose, areolar connective tissue that can become inflamed when invaded by microorganism
Facial spaces
Six possible fascial space locations
- Vestibular sace
- Buccal space
- Maxillary sinus
- Submandibular space
- Sublingal space
- Palatal abscess
Deep fascial space infections associated with any tooth
Vestibular
Buccal
Subcutaneous
Deep fascial space infection associated with maxillary teeth
Buccal
Infratemporal
Infraorbital
Maxillary and other paranasal sinuses
Cavernous sinus thrombosis
Deep fascial space infections associated with mandibular teeth
Space of the body of the mandible
Perimandibular space
Submandibular
Sublingaul
Submental
Masticator space
Submasseteric
Pterygomandibular
Superficial temporal
Deep temporal
Deep fascial space of the neck
Lateral pharyngeal
Retropharyngeal
Pretracheal
Danger space
Prevertebral
Low severity - little threat to the airway or vital structure
Vestibular
Buccal
Subperiosteal
Space of the body of the mandible
Infraorbital
Moderate severity - hindered access to the airway
Perimandibular space
Submandibular
Sublingual
Submental
Masticator space
Submasseteric
Pterygomandibular
Superficial temporal
Deep temporal
High severity - direct threat to the airway or vital structures
Deep neck spaces
Lateral pharyngeal
Retropharyngeal
Pretracheal
Danger space
Mediastinum
Intracranial infections
Cavernous sinus thrombosis
Brain abscess
Necrotizing fasciitis
Thin potential space between the levator anguli oris and the levator labii superioris muscles
Results from the infection from the maxillary canine tooth or by extenion of infections from the buccal space
Infraorbital space
Swelling of the anterior face obliterates the nasolabial fold
Infraorbital space
Bounded by the overlying skin of the face on the lateral aspect and the buccinator muscle on the medial aspect
Buccal space
Extension of infection from maxillary teeth through the bone superior to the attachment of the buccinator of the alveolar process of the maxilla
Buccal space
What tooth are commonly associated with buccal space infection
Posterior maxillary teeth
Bucaal space infections may follow the extension of the buccal fat pad into the?? __ __ __ __
Superficial temporal space
Infratemporal space
Infraorbital space
Periorbital space
This space lies posterior to the maxilla
Laterally and superiorly, it is continuous with the deep temporal space
Infra temporal space
Infratemporal space contains?
Branches of maxillary artery
Pterygoid venous plexus (importantly the emissary veins)
Infratemporal space is the origin of the posterior route by which inections may spread into the ____ sinus
Cavernous sinus
The usual cause Infratemporal space infection
Maxillary third molar
How many % of cases of maxillary sinusitis are odontogenic?
20%
This infection may spread superiorly through the ethmoid sinus or the orbital floor to cause secondary periorbital or orbital infections
Maxillary sinus
High mortality rate of odontogenic infection
Cavernous sinus
Cavernous sinus ocurs when maxillary odontogenic infections erode into the???? _______ in the infraorbital space or the ______ via the sinuses, they can follow the ______ vein through the superior orbital fissure and extend directly into the cavenous sinue
Infraorbital vein
Inferior ophthalmic vein
Common ophthalmic vein
Name of the cavenous sinus infection
Septic cavernous sinus thrombosis
An infection erode through the buccal cortical bone but does not perforate the periosteum, it can essentially peel the periosteal layer of soft tissue of the bony surface
Subperiosteal space
A swelling that assumes the shape of the underlying mandible, it can appear as if the bone itself has been enlarged
Subperiosteal space
The factor that determines whether the infection is submandibular or sublingual is the attachment of the _____ on the ______________
Mylohyoid muscle , mylohyoid ridge of the medial aspect of the mandible
Lies between the oral mucosa of the floor of the mouth and the mylohoid muscle
Sublingual space
the posterior border off the sublingual space is open, and therefore, it freely communicates with the ___ Space
Submandibular space
Lies between the anterior bellies of the right and left digastric muscles and between the mylohyoid muscle and thee overlying fascia
Submental space
Submental space involvement is the result of the spread of a _____ space infection
Submandibular space
Associated teeth with submental space
Mandibular incisors
this infection is rapidly spreading cellulitis that can obstruct the airway and commonly spreads posteriorly to the deep fascial spaces of the neck
Perimandibular spaces (ludwig angina)
The infection cannot be called as Ludwig’s angina unless?
All submandibular spaces are involved
Spaces involved in ludwig’s angina
Primarily the submandiular, secondary and sublingual and submental spaces
Common teeth source infection of ludwig
2nd and 3rd molars
Trismus, drolling, and difficulty swallowing and sometimes breathing
Ludwig’s angina
Formed by the splitting of the anterior layer of the deep cervical fascia, also called the superficial or the investing layer of the deep cervical fascia, to surround the muscles of mastication
Masticatory space
Four compartments of the masticatory space
- Submasseteric space
- Pterygomandibular space
- Superficial temporal space
- Deep temporal space
Infection most commonly as the result of spread from the buccal space of soft tissue infection around the mandibular third molar (pericoronitis)
Submasseteric space
When the submasseteric is involved, the masseter muscle also becomes __ and __
Inflamed and swollen
What is pericoronitis
Swelling and infection of the gum tissue around the WISDOM TOOTH
__ caused by inflammation of the masseter muscle in submasseteric space infection
Trismus
Infection spread primarily from the mandibular third molar
When this space is involved, little or no facial swelling is observed; however, the patient almost always has significant trismus
Pterygomandibular space
Relationship of terygomandiblar space with anesthetic?
It is the area where local anesthetic solution is deposited during IANB
Defined as the inflammation of bone and its marrow contents.
Infections spread through the bone to a larger extent
Osteomyelitis
A serious sequela of Periapical infection that often results in a diffuse spread of infection throughout the medullary spaces, with subsequent necrosis of a variable amount of bone.
Acute osteomyelitis
Most frequent cause of acute osteomyelitis of the jaw
Dental infection
Most comon bacyeria in acute osteomyelitis
Anaerobes such as Bacteriodes, porphyromonas or prevotalla species also predominate
Staphylococcus aureus and staphylococcus albus
Supperative infetction with a mixed bacterial flora, much of which forms a biofilm of sequestra of bone
Acute osteomyelitis
Clinical features of acute osteomyelitis
Severe pain, trismus, paresthesia of the lips, difficult in eating, increase WBC
Pus may exude from the gingival margin
Radiographc features ofacute osteomyelitis
Cannot be seen until at least 1-2 weeks
Diffuse lytic change in the bone
Trabeculae become fuzzy and indistinct
Treatment and management of acute osteomyelitis
Debridement, drainage, antimicrobial
If large sequestrum, surgical removal
May develop in adequately treated acute osteomyelitis or may arise from dental infection without a preceding acute stage.
Arises from infection by weakly virulent bacteria
Chronic osteomyelitis
Presistent low grade infection is associated with hronic inflammation, activation of osteoclastic bone destruction and granulation tissue formation
Sequestra will usually separate spontaneously during months or years may be several centimeters in length
Chronic osteomyelitis
Common in children because their bone is better vascularized and produces more reactive bone deposition around the infection
A mild bacteria infection entering the bone though a carious tooth in persons who have a high degree of tissue resistance and tissue reactivity
Tissue reacts to the infection by proliferation rather than destruction
Chronic focal sclerosing osteomyelitis
Term given to a localized area of sclerosis without evidence of infection
Sclerosing osteitis
Inflammation or infection causes the periosteum of the surrounding bone to become active and lay down layers of new bone around the cortex as a healing response
Proliferaive periostitis
Radiograph feature of proliferative periositits
Onion skinning
Two major origins of odontogenic infection
Periapical and periodontal
