Complex odontogenic infections

1. Complex
Odontogenic
Infections
Yasaman
sherafatmand

2. #
Fascial Spaces
• Fascial spaces are fascia-lined tissue
compartments filled with loose, areolar
connective tissue that can become
inflamed when invaded by
microorganisms.

3. #

4. #
Based on their likelihood of
threatening the airway

5. #
Infections Arising from
Maxillary Teeth

6. #
Palatal space
• Etiology
• Latral
• Palatal roots of
premolar and
molars
• Without periosteal
perforation

7. #
Infraorbital Space
Boundaries-
 Superiorly: levator
superioris alaque nasi and
levator labii superioris
 Inferiorly: caninus muscle
 Medially: anterolateral
surface of maxilla
 Posteriorly: buccinator
mucsle.
 Anteriorly: orbicularis oris

8. #
 It is the region between anterior surface of maxilla and
overlying levator muscles of upper lip.
 obliterates the nasolabial fold
 Contains angular artery & vein, infraorbital nerve.
Etiology-
Maxillary canine & 1st
premolar infection & sometimes
mesiobuccal root of first molars.

9. #
Buccal Space
Boundaries-
 Superiorly: zygomatic arch.
 Inferior: inferior border of mandible.
 Laterally: skin & subcutaneous tissue.
 Medially: buccinator muscle
,buccopharyngeal fascia.
 Posteriorly: anterior edge of masseter
muscle.
 Anteriorly: posterior border of
zygomaticus major & depressor anguli
oris.
Contents-
 Buccal fat pad.
 Stenson’s duct.
 Facial artery.

10. #
Etiology-
 Infected mandibular &
maxillary premolars & molars.
Clinical Features-
 Buccal space associated with
temporal space – Dumb bell
shaped appearance due to lack
of swelling over zygomatic
arch.

11. #
Infratemporal Space
Boundaries-
 Superiorly: infratemporal surface of
greater wing of sphenoid.
 Inferiorly: lateral pterygoid muscle.
 Laterally: temporalis tendon &
coronoid process.
 Medially: lateral pterygoid plate &
lateral pharyngeal wall.
 Posteriorly: condyle & lateral
pterygoid muscles.
 Anteriorly: infratemporal surface of
maxilla & posterior surface of
zygomatic bone.

12. #
Contents-
 Pterygoid plexus of veins.
 Internal maxillary artery.
 Mandibular nerve & its branches.
Etiology-
 Infected maxillary 3rd
molars.
 Infected needles or contaminated LA solution.
Spread of Infection-
 To temporal space.
 Cavernous sinus thrombosis- infection spreads via pterygoid
plexus of veins.

13. #
Cavernous sinus

14. #
Infections Arising from
Mandibular Teeth

15. #
Perimandibular spaces

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17. #

18. #
Submental Space
Boundaries-
 Roof: mylohyoid muscle.
 Inferior: deep cervical fascia, platysma, superficial fascia & skin.
 Laterally: anterior belly of digastric.
 Posteriorly: submandibular space.
Contents-
 Lymph nodes, anterior jugular vein.
Etiology-
 Infected mandibular incisors.
 Anterior extension of submandibular space.
Clinical Features-
• Chin appears glossy & swollen.
• Pain & discomfort on swallowing.

19. #
Sublingual Space
Boundaries-
 Superiorly: mucosa of floor of mouth.
 Inferior: mylohyoid muscle.
 Posteriorly: body of hyoid bone.
 Anteriorly & laterally: inner aspect of mandibular body.
 Medially: geniohyoid,styloglossus,genioglossus muscle.
Contents-
 Deep part of Submandibular gland.
 Wharton’s duct.
 Sublingual gland.
 Lingual & hypoglossal nerves.
 Terminal branches of lingual artery.

20. #
Etiology-
 Infected mandibular premolar & 1st
molar.
Clinical Features-
 Swelling of floor of mouth without extraoral swelling
 Elevated tongue
 Pain & discomfort on swallowing.

21. #
Submandibular Space
Boundaries-
 Superiorly: mylohyoid muscle, inferior border of mandible.
 Inferior: anterior & posterior belly of digastric.
 Laterally: deep cervical fascia, platysma, superficial fascia & skin.
 Medially: hyoglossus,styloglossus,mylohyoid muscle.
 Posteriorly: to hyoid bone.
 Anteriorly: submental space.
Contents-
 Submandibular salivary gland.
 Proximal portion of Wharton’s duct.
 Lingual & hypoglossal nerves.
 Branches of facial artery- palatine,tonsillar,glandular,submental.

22. #
Etiology-
 Infected mandibular 2nd
& 3rd
molars.
 From submental,sublingual spaces.
Clinical Features-
• Indurated swelling in submandibular region.
• Usually bulges over lower border of mandible.
Spread of Infection-
 Across midline to contralateral space.
 To contiguous pharyngeal spaces.

23. #
Ludwig’s angina
 Etiology
 Odontogenic infections
 Clinical features
 Trismus
 Dysphagia
 treatment
 I&D
Air way

24. #
Pterygomandibular Space
Boundaries-
 Superiorly: lower head of lateral pterygoid muscle.
 Laterally: medial surface of ramus.
 Medially: medial pterygoid muscle.
 Posteriorly: deep part of parotid.
 Anteriorly: pterygomandibular raphe.
Contents-
 Inferior alveolar neurovascular bundle.
 Lingual & auriculotemporal nerves.
 Mylohyoid nerve & vessels.

25. #
Masticatory spaces

26. #
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