Spread of infection Flashcards
what is irreversible pulpitis?
bacteria invade the pulp chamber and root canal system from a carious lesion. Patient feels pain but cant identify tooth
what is periapical periodontitis?
bacteria then invade periapical tissue and PDL inciting an acute inflammatory response. Patient feels pain and can identify tooth which is TTP
how does bone resorption occur in periapical periodontitis?
Pus then accumulates due to polymorphonuclear leucocytes forming an abscess. This increases the hydrostatic pressure which triggers an osteoclastic reaction causing bone resorption
in periapical periodontitis the bone resorption expands until it breaches the cortex via what?
the path of least resistance
what tooth anatomy causes buccal/labial swelling?
short roots close to the buccal cortex
(most teeth except maxillary lateral incisors)
what tooth anatomy causes palatal swelling?
roots close to the palatal cortex (maxillary lateral incisors)
what tooth anatomy causes sublingual swelling?
roots are short and close to the lingual cortex
what tooth anatomy causes swelling of the maxillary sinus and nose?
roots close to the sinus/nose
what tooth anatomy causes swelling in the face?
roots are long relative to the muscles in the maxilla (upper molars and canines)
what tooth anatomy causes swelling in the neck?
roots are long relative to the muscles in the mandible (lower molars and canines)
what is cellulitis?
diffuse inflammation of soft tissue that tends to spread through tissue spaces along fascial planes
cellulitis is characterised by what? 5
Oedema
Erythema
Pain
Heat
Loss of function (trismus -> inability to open mouth)(closure of eye)
what special investigations would be used to diagnose periapical periodontitis?
vitality, TTP, mobility, radiograph
how is periapical periodontitis treated?
Eradicate the source of infection -> remove pulp and endodontic treatment
Drain pus (suppuration)
Antibiotics to treat periapical tissue infection
what are the limitations to antibiotics? 2
Only treat surrounding tissue not eradicate the source so chronic infection still persists
Need a blood supply to be delivered into the infected area to eliminate bacteria
when should antibiotics be used?
Use if systemic involvement, significant cellulitis, compromised host defence, involvement of fascial spaces
Only prescribed when essential and local measures have been done to prevent antibiotic resistance
when should you refer periapical periodontitis?
Rapid progress
Difficulty breathing or swallowing
Involvement of fascial tissue spaces
Temperature >39
Compromised host defences
what causes infection of the canine space?
usually maxillary canine root long enough to pass muscles of facial expression
infection of the canine space causes swelling where, what is this called?
infraorbital
peri-orbital cellulitis
what causes infection of the buccal space?
usually maxillary molars -> erosion of pus above buccinator muscle
infection of the buccal space causes swelling where?
cheek below the zygomatic arch
infection of the infratemporal space is caused by what?
usually upper 8
infection of the infratemporal space causes what? 3
trismus
bulging of temporalis
cavernous sinus thrombosis
what causes infection of the sublingual space?
usually lower molars with short roots
infection of the sublingual space causes swelling where?
floor of the mouth under the tongue
what causes infection of the submandibular space?
usually lower molars with long roots
infection of the submandibular space causes swelling where?
mandible
infection of the submental space causes swelling where?
under the chin
what causes infection of the submental space?
usually lower incisors
what is ludwig’s angina?
severe cellulitis in submandibular, submental and sublingual spaces bilaterally
what is glottal oedema?
swelling of the glottic region causing suffocation
what is mediastinitis?
inflammation/infection of the mediastinum
infection of the retropharyngeal space leads to secondary infection where?
posterior mediastinum
infection of the prevertebral space leads to infection where?
the whole mediastinum as inferior boundary is diaphragm
infection of the peritonsillar region leads to what?
quinsy: abscess between tonsil and throat
what is sepsis?
bodies response to infection causes damage to own tissues and organs
what are the symptoms of sepsis?
Slurred speech or confusion
Extreme shivering or muscle pain
Passing no urine in a day
Severe breathlessness
Feels like you are going to die
Skin discolouration
