orofacial 2, dental caries, perio Flashcards
fascial space infections can come from
- pericoronitis
- bacterial sialadenitis
two things that can result from fascial space infection
- ludwig’s angina
- cavernous sinus thrombosis
dentoalveolar abscess can lead to
- osteomyelitis
- dry socket
- fascial space infection
- endocarditis
what can cause dentoalveolar abscess
- periodontal abscess
- endodontic infection
periodontitis is associated with what systemic disease
endocarditis
dry socket usually occurs in which teeth
lower 2nd and 3rd molars
fascial space infections usually occur in what region
submandibular
pericoronitis
infected flap over tissue over 3rd molar (DO surface)
bacteria can spread along
muscle attachments
how do bacteria spread along muscle attachments
-produce hyaluronase and other matrix destructive enzymes
where do the bacteria target the muscles ad which teeth are effected
sublingual area
mandibular 2nd and 3rd molars due to
deep fascial space infections usually come from which teeth
lower 2nd and 3rd molars
symptoms of space infection
board like hardness
which bacteria cause space infections
- normal oral flora (often the strep bacteria)
- anaerobic oral bacteria may be present
which Abx will you give for fascial space infection
- penicillin (to kill the strep)
- clindamycin if they dont get better with pen (bc anaerobic) OR metronidazole +pen
dentoalveolar infections can lead to what (most commonly)
maxillary sinusitis
cavernous sinus thrombosis follows the spread of odontogenic infection along 2 pathways:
- anterior facial vein
- pterygoid plexus of veins
symptoms of cavernous sinus thrombosis
- swelling of eyelids
- protrusion of eyeball
- restricted movement of eyeball
- bleeding in retina
ludwig’s angina description
- swelling of head and neck spaces
- difficulty breathing
main cause of ludwig’s angina
cellulitis
*50-90% of cases were due to dental cource of infetion
teeth most commonly involved with ludwig’s angina
mandibular 2nd and 3rd molars
treatment for ludwig’s angina
- parenteral abx
- airway monitoring
- i and d
non odontogenic infections of oral cavity
- pericoronitis
- bacterial sialadenitis
- angular cheilitis
- ulcerative mucositis
- noma (gangrenous stomatitis)
pericoronitis
- infection of flap of gum tissue
- usually 3rd molars
- pts usually older teens and early 20s
bacterial sialadenitis
stone in the stensons duct (parotid duct)
angular cheilitis
C albicans and s aureus at edge of lips
ulcerative mucositis
- chemotherapy associated
- bacteria and yeasts
noma (gangrnous stomatitis)
- polymicrobial
- opportunistic in immunocompromised
bacteria that cause pericoronitis
- p intermedia
- anaerobic strep
- fusobacterium
- A A
- tannerella forsythia
pericoronitis can lead to
spread of infection along facial plane (if drainage is interrupted)
main cause of bacterial sialadenitis
s aureus (post surgery)
abx for bacterial sialadenitis
pen
erythromycin
metro
patients that usually get bacterial sialadenitis
- pt with xerostomia
- age
- medication
- parkinsons
predisposing factors of angular cheilitis
- low B vit
- dry mouth
- overclosure
- habits or drooling
- immunosuppression
- poor fitted dentures
ANUG
- sudden onset painful infection of gums
- common in students around march
cause of ANUG
- fusobacterium and spirochetes like trep denticola
- stress and immunosuppression
abx for ANUG
metro
bacteria that cause actinomycosis
- opportunistic
- cross tissue planes
cervicofacial actinomycosis
- Actinomyces (esp A israelii)
- rock-hard induration
- SPONTANOUS DRAINING OF SINUS TRACT
once an enamel caries reaches dentin, it
fans out and lesion gets bigger
what happens to biofilms when they cause disease
they become PLANKTONIC!
types of study designs
- cross sectional design
- longitudinal design
cross sectional study design
-compare microflora in health and disease at single point in time
longitudinal design
-compare in a single patient at different points in time
no single microbe has satisfied
koch’s postulates for plaque-mediated disease
specific plaque hypothesis
only few species involed in disease (eg RED organisms)
non-specific plaque hypothesis
disease is outcome of overall activity of total plaque biome
ecological plaque hypothesis
- bacteria found in both healthy and disease
- disease is a shift in balance of resident bacteria due to change in environmental conditions
bacteria that cause root surface caries
- strep mutans
- s sanguinis
- a naeslundii
specific model of enamel demin
- s mutans only
- surface
non specific model of enamel demin
- s mutans AND Veillonella
- deep lesions
two things that are lost in perio
- collagen in gingiva
- bone
dental abscess are __ while perio is ___
acute, chronic
what happens to MMPs and TIMPs in perio
- activate MMPs
- degrade TIMPs
recognition of quorum sensing
plaque => biofilm
red complex organisms
-p gingivalis
-t forsythia
t denticola
-AA
gingivitis
- precedes perio
- reversible
periodontal disease
- chronic
- gingivitis but will loss of attachment between root surface, ging, and albeolar bone
- bone loss
- irreversible
perio disease is a combo of what
biofilm (direct) + host immune response (indirect)
advanced lesion
- comes after established lesion (red gums)
- conversion of ging to perio!
- “leukocte wall” is unique
main destruction in perio is due to
indirect mechanisms - immune response!
