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Odontogenic infections (4)

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  • For years, I was plagued by chronic yeast infections, including but not limited to: rashes, weight gain, insomnia, acne, constipation, chronic fatigue, depression, sensitivity to chemicals, you name it. After following your program, I had made a significant progress. My thrush, acne and rashes had vanished. My skin had almost completely cleared up. I hadn�t looked that good in 15 years. I felt rejuvenated, energized, happier and so much healthier... ➤➤ https://tinyurl.com/y3flbeje
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  • DOWNLOAD FULL. BOOKS INTO AVAILABLE FORMAT, ......................................................................................................................... ......................................................................................................................... 1.DOWNLOAD FULL. PDF EBOOK here { https://tinyurl.com/y8nn3gmc } ......................................................................................................................... 1.DOWNLOAD FULL. EPUB Ebook here { https://tinyurl.com/y8nn3gmc } ......................................................................................................................... 1.DOWNLOAD FULL. doc Ebook here { https://tinyurl.com/y8nn3gmc } ......................................................................................................................... 1.DOWNLOAD FULL. PDF EBOOK here { https://tinyurl.com/y8nn3gmc } ......................................................................................................................... 1.DOWNLOAD FULL. EPUB Ebook here { https://tinyurl.com/y8nn3gmc } ......................................................................................................................... 1.DOWNLOAD FULL. doc Ebook here { https://tinyurl.com/y8nn3gmc } ......................................................................................................................... ......................................................................................................................... ......................................................................................................................... .............. Browse by Genre Available eBooks ......................................................................................................................... Art, Biography, Business, Chick Lit, Children's, Christian, Classics, Comics, Contemporary, Cookbooks, Crime, Ebooks, Fantasy, Fiction, Graphic Novels, Historical Fiction, History, Horror, Humor And Comedy, Manga, Memoir, Music, Mystery, Non Fiction, Paranormal, Philosophy, Poetry, Psychology, Religion, Romance, Science, Science Fiction, Self Help, Suspense, Spirituality, Sports, Thriller, Travel, Young Adult,
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  • Great book! I'm on the second week and seeing definite improvement on my yeast infection symptoms. I must also note that the texture of my skin became very soft and consistent. I completely agree with many of your arguments in the book especially those about conventional methods for treating Yeast Infection. I wanted to let you know that I feel so fine you have no idea. I am not so tired all the time and I feel very energetic. The rashes on my neck and on the right side of my nose have also cleared up. I wish you all the health and happiness in the world and thanks so much for helping me. I really appreciate your time and efforts to assist me. ★★★ https://tinyurl.com/y4uu6uch
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Odontogenic infections (4)

  1. 1. ODONTOGENIC INFECTIONS Prepared by: Dr. Rea Corpuz
  2. 2. Odontogenic Infections (1) Cellulitis (2) Ludwig’s Angina (3) Cavernous Sinus Thrombosis (4) Osteomyelitis
  3. 3. (1) Cellulitis if abscess is NOT able to establish drainage through the surface of skin or into oral cavity  may spread diffusely through facial planes of soft tissue  acute + edematous spread of acute inflammatory process
  4. 4. (1) Cellulitis two dangerous forms:  Ludwig’s Angina  Cavernous Sinus Thrombosis
  5. 5. (2) Ludwig’s Angina named after German physician who described the seriousness of disorder in 1836 Angina comes from Latin word angere  strangle
  6. 6. (2) Ludwig’s Angina 70% of cases, develop from spread of an acute infection from lower molar teeth prevalence in patients who are immunocompromised secondary to disorders such as:  diabetes mellitus  organ transplantation  acquired immunodeficiency syndrome (AIDS)  aplastic anemia
  7. 7. (2) Ludwig’s Angina Clinical Features  massive swelling on neck  often extends close to clavicle  involvement of sublingual space results in • elevation Woody Tongue • posterior enlargement can compromise • protrusion of tongue airway
  8. 8. (2) Ludwig’s Angina
  9. 9. (2) Ludwig’s Angina Clinical Features  involvement of submandibular space results in • enlargement • tenderness of neck above level of hyoid bone Bull Neck • pain in neck + floor of mouth • restricted neck movement
  10. 10. (2) Ludwig’s Angina Clinical Features  involvement of submandibular space results in • dysphagia • dysphonia • dysarthria • drooling • sore throat
  11. 11. (2) Ludwig’s Angina Clinical Features  involvement of lateral pharyngeal space • respiratory obstruction secondary to laryngeal edema • tachypnea • dyspnea • tachycardia • patient needs to maintain erect position
  12. 12. (2) Ludwig’s Angina Treatment & Prognosis  centers around 4 activities • maintenance of airway • incision + drainage • antibiotic therapy • elimination of original focus of inflammation
  13. 13. (2) Ludwig’s Angina Treatment & Prognosis  initial observation many clinicians administer • systemic corticosteroid medications such as intravenous (IV) dexamethasone  attempt to reduce cellulitis
  14. 14. (2) Ludwig’s Angina Treatment & Prognosis  if signs or symptoms of impending airway obstruction: • fiber-optic nasotracheal intubation • tracheostomy • cricothyroidotomy
  15. 15. (2) Ludwig’s Angina Treatment & Prognosis  if signs or symptoms of impending airway obstruction: • cricothyroidotomy  sometimes performed instead of tracheostomy  perceived lower risk of spreading infection to mediastinum
  16. 16. (2) Ludwig’s Angina Treatment & Prognosis • cricothyroidotomy
  17. 17. (2) Ludwig’s Angina Treatment & Prognosis  high dose of penicillin penicillin-  Clindamycin OR sensitive  Choramphenicol patients  anitbiotic medication is adjusted according to patient’s response + culture result from aspirates of fluid from enlargement
  18. 18. (2) Ludwig’s Angina Treatment & Prognosis  if infection remains:  diffuse surgical intervention  indurated is at discretion of clinician  brawny + often governed by patient’s response to noninvasive therapy
  19. 19. (2) Ludwig’s Angina Treatment & Prognosis  complications: • Pericarditis • Pneumonia • Mediastinitis • Sepsis • Empyema • Respiratory Obstruction
  20. 20. (3) Cavernous Sinus Thrombosis edematous periorbital enlargement with involvement of eyelids + conjunctiva
  21. 21. (3) Cavernous Sinus Thrombosis in cases, involving canine space  swelling along lateral border of nose  may extend up to medial aspect of eye + periorbital area  protrusion + fixation of eyeball
  22. 22. (3) Cavernous Sinus Thrombosis in cases, involving canine space  induration + swelling of adjacent forehead + nose  pupil dilation  lacrimation may also  photophobia occur  loss of vision
  23. 23. (3) Cavernous Sinus Thrombosis in cases, involving canine space  pain over eye + along distribution of: • opthalmic Trigeminal • maxillary branches Nerve
  24. 24. (3) Cavernous Sinus Thrombosis Treatment & Prognosis  surgical drainage + high-dose antibiotic medication similar to those administered for patient’s with Ludwig’s Angina
  25. 25. (4) Osteomyelitis an acute or chronic inflammatory process in extends  medullary spaces OR away from  cortical surfaces of bone initial site of involvement
  26. 26. (4) Osteomyelitis caused by bacterial infections result in expanding lytic destruction of involved bone  with suppuration  sequestra formation
  27. 27. (4) Osteomyelitis patients of all ages can be affected strong male predominance most cases involves mandible
  28. 28. (4) Osteomyelitis Acute Supporative Osteomyelitis Chronic Suppporative Osteomyelitis
  29. 29. (4) Osteomyelitis (Acute Supporative Osteomyelitis) acute inflammatory process spreads through medullary spaces of bone insufficient time has passed for body to react to presence of inflammatory infiltrate
  30. 30. (4) Osteomyelitis (Acute Supporative Osteomyelitis) Clinical Features  symptoms of acute inflammatory process less than1 month in duration  fever  leukocytosis
  31. 31. (4) Osteomyelitis (Acute Supporative Osteomyelitis) Clinical Features  lymphadenopathy  soft tissue swelling of affected area  on occasion, paresthesia of lower lip
  32. 32. (4) Osteomyelitis (Acute Supporative Osteomyelitis) Histopathologic Features  biopsy material from patients • liquid content • lack of soft tissue component • consist predominantly of necrotic bone
  33. 33. (4) Osteomyelitis (Acute Supporative Osteomyelitis) Histopathologic Features  necrotic bone • loss of osteocytes • peripheral resorption • bacterial colonization • acute inflammatory infiltrate  consists of polymorphonuclear leukocytes
  34. 34. (4) Osteomyelitis (Acute Supporative Osteomyelitis) Radiographic Features  ill- defined radioluscency  periosteal new bone formation may be seen • response to subperiosteal spread of infection • proliferations more common in young patients
  35. 35. (4) Osteomyelitis (Acute Supporative Osteomyelitis) Radiographic Features  periosteal new bone formation may be seen • single-layered radioopaque line • separated from normal cortex by an intervening radiolucent band
  36. 36. (4) Osteomyelitis (Acute Supporative Osteomyelitis) Radiographic Features  on occasion, exfoliation of fragments of necrotic bone  fragment of necrotic bone that has separated from adjacent vital bone is teremed sequestrum
  37. 37. (4) Osteomyelitis (Acute Supporative Osteomyelitis) Radiographic Features  on occasion, fragments of necrotic bone may become surrounded by new vital bone, known as involucrum
  38. 38. (4) Osteomyelitis (Acute Supporative Osteomyelitis) Treatment  if obvious abscess formation, • antibiotics  penicillin  clindamycin  cephalexin  cefotaxime  gentamicin • drainage
  39. 39. (4) Osteomyelitis (Chronic Supporative Osteomyelitis) defensive response leads to production of granulation tissue  subsequent forms dense scar tissue • attempt to wall off infected area
  40. 40. (4) Osteomyelitis (Chronic Supporative Osteomyelitis)
  41. 41. (4) Osteomyelitis (Chronic Supporative Osteomyelitis)  subsequent forms dense scar tissue • encircled dead space acts as reservoir for bacteria • antibiotic medications have great difficulty reaching the site
  42. 42. (4) Osteomyelitis (Chronic Supporative Osteomyelitis) Clinical Features  if acute osteomyelitis is not resolved expeditiously  entrenchment of chronic osteomyelitis occurs  sometimes may arise without previous acute episode
  43. 43. (4) Osteomyelitis (Chronic Supporative Osteomyelitis) Clinical Features  swelling  pain  sinus formation  purulent discharge  sequestrum formation  tooth loss  pathologic fracture
  44. 44. (4) Osteomyelitis (Chronic Supporative Osteomyelitis) Clinical Features  may experience acute exacerbations or periods of decreased pain associated with chronic smoldering progression
  45. 45. (4) Osteomyelitis (Chronic Supporative Osteomyelitis) Histophathologic Features  biopsy material from patient • soft tissue component • consists of chronically or subacutely inflammed connective tissue filling the intertrabecular areas of bone • scattered sequestra + pockets of abscess formation
  46. 46. (4) Osteomyelitis (Chronic Supporative Osteomyelitis) Radiographic Features  patchy  ragged  ill-defined radiolucency • often contains central radiopaque sequestra
  47. 47. (4) Osteomyelitis (Chronic Supporative Osteomyelitis) Radiographic Features
  48. 48. (4) Osteomyelitis (Chronic Supporative Osteomyelitis) Treatment  difficult to manage medically • pockets of dead bone • organisms are protected from antibiotic drugs  due to surrounding wall of fibrous connective tissue
  49. 49. (4) Osteomyelitis (Chronic Supporative Osteomyelitis) Treatment  surgical intervention is mandatory  antibiotic medications are similar to those used in acute form • but must be given intravenously in high doses
  50. 50. References: Books Neville, et. al: Oral and Maxillofacial Pathology 3rd Edition • (pages 138-144)

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