Odontogenic Infections Flashcards
Most odontogenic infections due to
mixed flora
edema
Refers to the stage in which the invading
bacteria begin to colonize and typically occurs in the first 3 days of
onset of symptoms
Cellulitis
is spreading infection of lose CT
Abscess
is circumscribed collection of bus in pathological tissue space.
Most maxillary teeth presents as
buccal vestibular abscess.
Lateral incisor and palatal root of the
first maxillary molar or premolar may
present palatally.
Management of acute dental abscesses:
– Drainage:
– Removal of the source of infection
– Supportive antibiotic therapy
• Severe spreading infection
• Systemic toxicity
• Medically compromised
Hilton’s method:
No 11 blade
using hemostat to breakup
any loculations
Drainage sutured in place.
Indications for therapeutic use of antibiotics:
- Swelling extending beyond the alveolar process.
- Cellulites.
- Trismus.
- Lymphadenopathy.
- High temperature (> 39 C).
- Severe pericoronitis.
- Osteomyelitis.
C & S is not cost effective in
odontogenic bacteria
Indications for C &S testing:
- Infection spreading beyond the alveolar process
- Rapidly progressive infection
- Previous multiple antibiotic therapy
- Nonresponsive infection (after more than 48 hrs)
- Recurrent infection
- Compromised host
Anatomic spaces involved in odontogenic infections:
– Primary maxillary spaces
• Canine
• Buccal
• Infratemporal
– Primary mandibular spaces
• Submental
• Buccal
• Submandibular
• Sublingual
– Secondary fascial spaces
• Submasseteric
• Pterygomandibular
Canine Space Treatment
: I & D
Halton method
Buccal Space Most infections caused by
posterior maxillary teeth.
Submasseteric Space associated with
Severe trismus
Ludwig’s Angina definition
life-threatening cellulitis
infection of the tissues of the floor of the mouth, usually occurring in adults with concomitant dental infections. It
involve submandibular, sublingual and submental spaces simultaneously and bilaterally.
Ludwig’s Angina Etiology:
Odontogeneic: The most frequent cause
Ludwig’s Angina
Management
– Emergency hospital
management
– Maintain adequate airway
– Drainage and decompression (extraoral
and bilateral).
– Removal of the cause
– High doses of IV antibiotics
– Steroids
– Supportive treatment
