Spread Of Infection Flashcards
The inflammation of pulp tissue which can be reversible or irreversible
Pulpitis
Infection spread into periapical tissue causes…
Periapical periodontitis
Accumulation of pus within the PDL
Periodontal abscess
Inflammation of the surrounding tissue around a partially erupted wisdom tooth
Pericoronitis
Odontogenic infection within the confines of the jaw
Osteomyelitis
What would you diagnose if:
Toxins from carious bacteria stimulate an acute inflammatory reaction within pulp tissue
Reversible pulpitis
What would you diagnose if:
Bacterial colonisation of the pulp occurred which could lead to pulp necrosis if untreated
Irreversible pulpitis
How would you treat irreversible pulpitis?
Root canal treatment
What would you diagnose if:
Toxins from carious bacteria move into PDL space, triggering acute inflammation.
Periapical periodontitis
How can toxins from bacteria move from the pulp into PDL space to cause periapical periodontitis?
Through lateral canals off pulp chamber
What does acute inflammatory reaction of the PDL stimulate?
A build up of hydrostatic pressure and subsequent build up of fluid
What triggers osteoclastic bone resorption?
Hydrostatic pressure and fluid pressure on the adjacent bone
What leads to bone loss around the apex of a tooth?
Osteoclastic bone resorption
how would periapical periodontitis appear on a radiograph?
As a periapical radiolucency and loss of lamina dura
What would be the next step in treatment of periapical periodontitis id endodontic treatment fails?
Extraction of the tooth
The final stage of periodontitis, generally non-painful condition that presents in the apical portion of the apical canal around the apex of a tooth, causing long-lasting inflammation.
Chronic periapical periodontitis
What Odontogenic infection is associated with periapical cyst formation?
Chronic periapical periodontitis
What is a very rare, but possible extra oral swelling as a result of chronic periapical periodontitis?
Oral cutaneous fistula
How does swelling relating to periapical periodontitis usually initially present?
Intra-orally
In odontogenic infection from maxillary teeth, where could intra-oral swelling present?
Buccal or palatal
What blade would you use to incise and drain pus?
Number 11 blade
What will “follow the path of least resistance”?
Pus
Where are apices of most teeth close to?
The buccal cortex
What are the more common intra-oral swellings and why?
Buccal swellings because the apices of most teeth are closer to the buccal cortex than the lingual/palatal cortex
What are the three ways that you could treat intra-oral swellings?
- Extrication and sterilisation of the pulp
- Extraction
- Excise and drain puss
What are the 4 potential paths of infection spread fro maxillary 6’s and 7’s?
- palatal swelling
- buccal swelling
- facial swelling
- maxillary Sinusitis
What is the most likely presentation of swelling if the muscle attachments are higher than the tooth root?
Intra-oral swelling
What is the most likely presentation of swelling if the muscle attachments are lower than the tooth root?
Extra-oral swelling
What special investigation result would indicate periapical inflammatory process?
If a tooth is tender to percussion (TTP)
What is the reason you would do culture and sensitivity testing for a patient with suspected abscess?
It would give you an idea of what bacteria is involved in the infection and also indicate what antibiotic is most appropriate for treatment
What type of bacteria is mostly involved in the formation of an abscess?
Anaerobic
what antibiotic would be the primary choice for treatment of a periapical abscess?
Metronidazole
How would a canine space infection present and why?
Would present as an infra-orbital swelling.
This is because the canine roots are long and pass the muscle attachments of facial expression.
Where do buccal space infection most commonly originate from?
Odontogenic infection in maxillary molars
What facial plane infection is a rare but possible result of odontogenic infection of a maxillary 8?
Infratemporal space infection
why is there a particular need for infratemporal space infection to be recognised and treated early?
Because, if allows to progress, infection will do so posteriorly towards the pterygoid plexus of veins. This plexus connects with the cavernous sinus.
Swelling of tissues as a consequence of acute inflammatory oedema OR Transient swelling caused by the build-up of oedema fluid in tissues.
Cellulitis
If an infected mandibular molar root is closer to the buccal cortex, what would be the likely presentation of swelling?
Intra-oral buccal swelling
If an infected mandibular molar root is closer to the buccal/inferior cortex, what would be the likely presentation of swelling?
Infection spread under mylohyoid, presenting as an extra-oral submandibular space swelling in the neck
If an infected mandibular molar root is closer to the lingual cortex, what would be the likely presentation of swelling?
Either:
Submental swelling
OR
Sublingual swelling
If an infected mandibular molar root is closer to the lingual cortex, and infection spreads to the anterior belly of digastric muscles, what would be the likely presentation of swelling?
Submental swelling
If an infected mandibular molar root is closer to the lingual cortex, and infection spreads above the mylohyoid, what would be the likely presentation of swelling?
Sublingual swelling
What does cervical facial planes refer to?
Spaces that connect the head, neck and mediastinum
If infection spreads to prevertebral spaces in the neck, what could be the sequelae of this?
Infection of whole mediastinum ( mediastinitis)
If infection spreads to retropharyngeal space in the neck, what could be the sequelae of this?
Secondary infection of posterior mediastinum
As a dentist, what would you do if a patient came in presenting with a large extra-oral swelling?
Refer to secondary care immediately
What are the main bacteria associated with Ludwig’s angina?
Streptococcus and staphylococcus
what life-threatening condition involves swelling of submandibular, sublingual and submental spaces?
Ludwig’s angina
