This document discusses the fascial spaces of the jaws and their management. It begins by introducing fascia and fascial spaces, and then provides detailed descriptions of the primary and secondary fascial spaces of the maxilla and mandible, including their boundaries, contents, etiologies and clinical features. It also discusses the microbiology of odontogenic infections, investigation methods, and management approaches like antibiotic therapy and surgical drainage. Ludwig's angina is introduced as a firm, acute, toxic cellulitis involving the submandibular, sublingual and submental spaces bilaterally.
The document discusses various fascial spaces of the jaws including the canine, buccal, temporal, infratemporal, submental, sublingual, submandibular, masticatory (masseteric, pterygomandibular), and lateral pharyngeal spaces. It describes the boundaries, contents, potential causes of infection, and clinical signs of infections in each space. Proper classification, diagnosis, and surgical management of fascial space infections are important due to the risk of spread to surrounding critical areas like the cavernous sinus.
This document describes the primary spaces where odontogenic infections can spread in the maxilla and mandible. It defines the boundaries and clinical features of the canine space, buccal space, infraorbital space, submental space, submandibular space, and sublingual space. Infections originating from teeth in these areas can spread to adjacent spaces through connective tissue planes following the path of least resistance.
The document discusses deep fascial space infections, including their anatomy, classification, pathways of spread, diagnostic aids, and treatment. It describes several key fascial spaces of the face and neck that are clinically significant for odontogenic infections, such as the buccal, submandibular, sublingual, and submental spaces. Signs and symptoms, as well as surgical drainage techniques for managing infections in these different spaces are outlined.
The document defines and classifies the various fascial spaces in the head and neck region. There are two types of spaces: primary spaces associated with specific anatomical structures like the maxilla and mandible, and secondary fascial spaces located between layers of deep cervical fascia. The primary spaces include the infraorbital, buccal, infratemporal, submandibular, sublingual, submasseteric, pterygomandibular, superficial temporal, and masticatory spaces. The secondary fascial spaces include the peritonsillar, retropharyngeal, prevertebral, parapharyngeal, parotid, carotid sheath, and vestibular spaces. These spaces are
This document discusses the anatomy of the facial spaces and fascia of the head and neck region. It defines fascia as sheets of dense connective tissue that separate structures. The facial spaces are potential spaces within the layers of fascia that can become infected. It then describes the various layers of fascia, including the superficial fascia and three layers of deep cervical fascia. It also lists the main muscles of the face and neck along with their origins, insertions and blood supply.
This document discusses various fascial spaces in the head and neck region that can become infected. It describes the boundaries, contents, teeth involved, clinical features, and surgical management for primary spaces like the canine, buccal, infratemporal, submental, submandibular, and sublingual spaces. It also briefly mentions secondary spaces like the masseteric, pterygomandibular, temporal, and others. The document provides detailed anatomical information to help clinicians properly diagnose and treat infections in these potentially dangerous head and neck spaces.
The document discusses various fascial spaces of the jaws including the canine, buccal, temporal, infratemporal, submental, sublingual, submandibular, masticatory (masseteric, pterygomandibular), and lateral pharyngeal spaces. It describes the boundaries, contents, potential causes of infection, and clinical signs of infections in each space. Proper classification, diagnosis, and surgical management of fascial space infections are important due to the risk of spread to surrounding critical areas like the cavernous sinus.
This document describes the primary spaces where odontogenic infections can spread in the maxilla and mandible. It defines the boundaries and clinical features of the canine space, buccal space, infraorbital space, submental space, submandibular space, and sublingual space. Infections originating from teeth in these areas can spread to adjacent spaces through connective tissue planes following the path of least resistance.
The document discusses deep fascial space infections, including their anatomy, classification, pathways of spread, diagnostic aids, and treatment. It describes several key fascial spaces of the face and neck that are clinically significant for odontogenic infections, such as the buccal, submandibular, sublingual, and submental spaces. Signs and symptoms, as well as surgical drainage techniques for managing infections in these different spaces are outlined.
The document defines and classifies the various fascial spaces in the head and neck region. There are two types of spaces: primary spaces associated with specific anatomical structures like the maxilla and mandible, and secondary fascial spaces located between layers of deep cervical fascia. The primary spaces include the infraorbital, buccal, infratemporal, submandibular, sublingual, submasseteric, pterygomandibular, superficial temporal, and masticatory spaces. The secondary fascial spaces include the peritonsillar, retropharyngeal, prevertebral, parapharyngeal, parotid, carotid sheath, and vestibular spaces. These spaces are
This document discusses the anatomy of the facial spaces and fascia of the head and neck region. It defines fascia as sheets of dense connective tissue that separate structures. The facial spaces are potential spaces within the layers of fascia that can become infected. It then describes the various layers of fascia, including the superficial fascia and three layers of deep cervical fascia. It also lists the main muscles of the face and neck along with their origins, insertions and blood supply.
This document discusses various fascial spaces in the head and neck region that can become infected. It describes the boundaries, contents, teeth involved, clinical features, and surgical management for primary spaces like the canine, buccal, infratemporal, submental, submandibular, and sublingual spaces. It also briefly mentions secondary spaces like the masseteric, pterygomandibular, temporal, and others. The document provides detailed anatomical information to help clinicians properly diagnose and treat infections in these potentially dangerous head and neck spaces.
This document presents a case of a 45-year-old male with uncontrolled diabetes who presented with right facial swelling and discharge from his right ear and cheek. CT scan revealed multiple right facial space infections, including in the infratemporal space. The infratemporal space is a rare site for infection that can spread dangerously if not treated immediately. It is difficult to diagnose due to surrounding bones limiting visible symptoms. However, trismus may indicate infratemporal space infection when accompanied by swelling and pain. Aggressive treatment is needed for these serious odontogenic infections.
This document discusses the fascial spaces of the head and neck region and how odontogenic (dental) infections can spread between these spaces. It begins by defining fascia and describing the superficial and deep fascial layers of the head and neck. It then discusses the various fascial spaces, including the vestibular, buccal, parotid, masticator, and pharyngeal spaces. It explains how infections can spread from the primary spaces adjacent to infected teeth to the secondary spaces. The document provides details on the boundaries, contents, and clinical features of involvement for each space.
This document provides an overview of fascial space infections, including their classification, stages, microbiology, and management. It discusses various fascial spaces of the head and neck region that can become infected, including the maxillary spaces (canine, palatal, infratemporal), mandibular spaces (submental, submandibular, sublingual), and secondary spaces (lateral pharyngeal, retropharyngeal). It also outlines the progression of odontogenic infections and signs of cellulitis versus abscess formation. The principles of treatment involve determining infection severity, surgical drainage, medical support, and antibiotic selection.
Detailed description of diagnosis and management of maxillofacial and neck space infections. Discussion of anatomy of the spaces is also done in details. Drainage of such spaces are also discussed. Medical management is also discussed. Complications are also discussed.
This document discusses infections that can occur in the five masticatory spaces. It describes the boundaries, contents, causes, clinical features, and treatment for infections of the pterygomandibular space, submasseteric space, and the three temporal spaces (superficial, infratemporal, and deep). Infections in these spaces can spread between adjacent spaces and present with symptoms like trismus, swelling, and pain. Treatment involves incision and drainage through intraoral, extraoral, or combined approaches depending on the specific infected space.
The document discusses various types of dental injections including local infiltration, nerve blocks, and field blocks. It provides details on specific injections for the maxilla, such as the posterior superior alveolar nerve block, which is used to anesthetize the maxillary first, second, and third molars. The document describes injection techniques, target areas, and expected outcomes for different maxillary injections.
This document discusses techniques for mandibular anesthesia. It focuses on the inferior alveolar nerve block, which anesthetizes the inferior alveolar nerve, mental nerve, and incisive nerve. The technique involves locating anatomical landmarks like the coronoid notch and pterygomandibular raphe, then inserting the needle 1 cm above the occlusal plane of the mandibular posteriors and advancing it to the bone near the mandibular foramen to deposit the solution within 1 mm of the inferior alveolar nerve. Precautions are taken to avoid forceful bone contact. Failure can occur if the injection is too low or anterior, or due to accessory innervation. Complications include hematoma, tr
This document describes various fascial spaces of the head and neck region that can become infected from complex odontogenic infections. It outlines the boundaries, contents and typical etiologies for infections arising in maxillary spaces like the palatal, infraorbital, and buccal spaces, as well as mandibular spaces like the submental, sublingual, submandibular, and pterygomandibular spaces. Dangerous infections like Ludwig's angina that can involve multiple contiguous spaces are also discussed.
The document discusses the posterior palatal seal, which provides retention for complete dentures through light pressure on the junction of the hard and soft palates. It describes the anatomy and functions of the posterior palatal seal, techniques for recording it such as the conventional and fluid wax methods, and troubleshooting issues like under or over extension. The posterior palatal seal is important for retaining dentures and reducing discomfort.
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
The document discusses various techniques for mandibular nerve anesthesia, including both intraoral and extraoral approaches. Intraoral techniques covered include the inferior alveolar nerve block (both direct and indirect techniques), lingual nerve block, buccinator nerve block, mental nerve block, incisive nerve block, infiltration of terminal branches, and submucosal infiltration. Extraoral techniques discussed are the mandibular nerve block, mental nerve block, infraorbital nerve block, and inferior alveolar nerve block. The document then provides more detailed descriptions and illustrations of specific techniques such as the inferior alveolar nerve block, Vazirani-Akinosi closed mouth technique, Gow-Gates mandibular
This document discusses various spaces in the mandible that can become infected from dental infections, including the submental, sublingual, submandibular, masseteric, pterygomandibular, and temporal spaces. It describes the anatomy and boundaries of each space, potential causes of infection, clinical signs and symptoms, and surgical approaches for incision and drainage. Infections can spread between spaces if not properly treated.
Space infections of the head and neck are common in oral and maxillofacial practice. While most infections can be managed successfully with minimal complications, some can cause serious morbidity or death depending on the virulence of microorganisms and host resistance. Bacterial infections have the potential to spread beyond the bony confines of jaw bones into surrounding soft tissues. It is important for oral and maxillofacial surgeons to understand the anatomy of fascial spaces and spread of infection to properly manage infections and prevent complications.
This document discusses odontogenic infections, which originate from tooth-related pathology. It describes how infections can spread from primary fascial spaces around the teeth to secondary spaces deeper in the head and neck region. Virulence of microorganisms and host immune response determine if an infection remains localized or becomes diffuse. Enzymes help degrade tissues, allowing spread through paths of least resistance. Clinical features may include swelling, pain, and fever. Diagnosis involves history, examination, radiographs, and culture/sensitivity testing. Treatment involves antibiotics, surgery to drain or remove the dental cause, and follow up.
- The peri-implant epithelium (PIE) forms a seal around dental implants that is similar to the junctional epithelium (JE) around natural teeth, comprising peri-implant, sulcular, and oral epithelia.
- However, the PIE has a lower adhesion to titanium than the JE does to enamel/cementum, resulting in a weaker protective seal. The connective tissue attachment is also inferior around implants compared to teeth.
- Maintaining a healthy peri-implant soft tissue seal is critical for implant success, as it protects the underlying bone from bacterial invasion and peri-implant disease, similar to the role of the JE around teeth. Care should be taken during probing
This document provides information on the maxillary nerve block technique. It begins with an overview of the trigeminal nerve and its branches, including the maxillary nerve. It then describes the course and branches of the maxillary nerve in detail. It discusses the pterygopalatine ganglion and its branches. The document outlines different maxillary nerve block techniques including posterior superior alveolar, anterior superior alveolar, greater palatine, and nasopalatine nerve blocks. It concludes with a description of a maxillary nerve block and intraligamentary anesthesia technique.
This document discusses periodontal disease and bone loss. It states that changes in bacteria from healthy to diseased states are associated with progression from gingivitis to periodontitis. Periodontitis is characterized by inflammatory changes in the gingiva and connective tissue caused by bacteria, leading to destruction of collagen fibers and bone loss. The rate of bone loss without treatment is approximately 0.2mm per year on facial surfaces and 0.3mm per year on proximal surfaces. Bone loss occurs episodically with periods of activity and inactivity.
This document discusses the classification and pathways of spread of odontogenic infections. It begins by classifying fascial spaces as primary or secondary, and by clinical significance. Key primary spaces include the maxillary (canine, buccal, infratemporal) and mandibular (submental, sublingual, buccal, submandibular). Secondary spaces include the masseteric, pterygomandibular, temporal, and pharyngeal spaces. Odontogenic infections most commonly spread from the infected tooth to surrounding soft tissues and fascial spaces. The document then discusses specific spaces like the buccal, submandibular, and lateral pharyngeal spaces. Microbiology, clinical
This document provides information on fascial spaces of the head and neck region. It begins by defining fascial spaces as clefts or compartments containing connective tissue. It then classifies the spaces based on mode of involvement and clinical significance. Several key fascial spaces are described in detail, including boundaries, contents, etiology, clinical features, and spread of infection. These include the buccal, sublingual, submandibular, pterygomandibular, masseteric, temporal, lateral pharyngeal, and retropharyngeal spaces. The objectives and microbiology of odontogenic infections are also summarized.
This document presents a case of a 45-year-old male with uncontrolled diabetes who presented with right facial swelling and discharge from his right ear and cheek. CT scan revealed multiple right facial space infections, including in the infratemporal space. The infratemporal space is a rare site for infection that can spread dangerously if not treated immediately. It is difficult to diagnose due to surrounding bones limiting visible symptoms. However, trismus may indicate infratemporal space infection when accompanied by swelling and pain. Aggressive treatment is needed for these serious odontogenic infections.
This document discusses the fascial spaces of the head and neck region and how odontogenic (dental) infections can spread between these spaces. It begins by defining fascia and describing the superficial and deep fascial layers of the head and neck. It then discusses the various fascial spaces, including the vestibular, buccal, parotid, masticator, and pharyngeal spaces. It explains how infections can spread from the primary spaces adjacent to infected teeth to the secondary spaces. The document provides details on the boundaries, contents, and clinical features of involvement for each space.
This document provides an overview of fascial space infections, including their classification, stages, microbiology, and management. It discusses various fascial spaces of the head and neck region that can become infected, including the maxillary spaces (canine, palatal, infratemporal), mandibular spaces (submental, submandibular, sublingual), and secondary spaces (lateral pharyngeal, retropharyngeal). It also outlines the progression of odontogenic infections and signs of cellulitis versus abscess formation. The principles of treatment involve determining infection severity, surgical drainage, medical support, and antibiotic selection.
Detailed description of diagnosis and management of maxillofacial and neck space infections. Discussion of anatomy of the spaces is also done in details. Drainage of such spaces are also discussed. Medical management is also discussed. Complications are also discussed.
This document discusses infections that can occur in the five masticatory spaces. It describes the boundaries, contents, causes, clinical features, and treatment for infections of the pterygomandibular space, submasseteric space, and the three temporal spaces (superficial, infratemporal, and deep). Infections in these spaces can spread between adjacent spaces and present with symptoms like trismus, swelling, and pain. Treatment involves incision and drainage through intraoral, extraoral, or combined approaches depending on the specific infected space.
The document discusses various types of dental injections including local infiltration, nerve blocks, and field blocks. It provides details on specific injections for the maxilla, such as the posterior superior alveolar nerve block, which is used to anesthetize the maxillary first, second, and third molars. The document describes injection techniques, target areas, and expected outcomes for different maxillary injections.
This document discusses techniques for mandibular anesthesia. It focuses on the inferior alveolar nerve block, which anesthetizes the inferior alveolar nerve, mental nerve, and incisive nerve. The technique involves locating anatomical landmarks like the coronoid notch and pterygomandibular raphe, then inserting the needle 1 cm above the occlusal plane of the mandibular posteriors and advancing it to the bone near the mandibular foramen to deposit the solution within 1 mm of the inferior alveolar nerve. Precautions are taken to avoid forceful bone contact. Failure can occur if the injection is too low or anterior, or due to accessory innervation. Complications include hematoma, tr
This document describes various fascial spaces of the head and neck region that can become infected from complex odontogenic infections. It outlines the boundaries, contents and typical etiologies for infections arising in maxillary spaces like the palatal, infraorbital, and buccal spaces, as well as mandibular spaces like the submental, sublingual, submandibular, and pterygomandibular spaces. Dangerous infections like Ludwig's angina that can involve multiple contiguous spaces are also discussed.
The document discusses the posterior palatal seal, which provides retention for complete dentures through light pressure on the junction of the hard and soft palates. It describes the anatomy and functions of the posterior palatal seal, techniques for recording it such as the conventional and fluid wax methods, and troubleshooting issues like under or over extension. The posterior palatal seal is important for retaining dentures and reducing discomfort.
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
The document discusses various techniques for mandibular nerve anesthesia, including both intraoral and extraoral approaches. Intraoral techniques covered include the inferior alveolar nerve block (both direct and indirect techniques), lingual nerve block, buccinator nerve block, mental nerve block, incisive nerve block, infiltration of terminal branches, and submucosal infiltration. Extraoral techniques discussed are the mandibular nerve block, mental nerve block, infraorbital nerve block, and inferior alveolar nerve block. The document then provides more detailed descriptions and illustrations of specific techniques such as the inferior alveolar nerve block, Vazirani-Akinosi closed mouth technique, Gow-Gates mandibular
This document discusses various spaces in the mandible that can become infected from dental infections, including the submental, sublingual, submandibular, masseteric, pterygomandibular, and temporal spaces. It describes the anatomy and boundaries of each space, potential causes of infection, clinical signs and symptoms, and surgical approaches for incision and drainage. Infections can spread between spaces if not properly treated.
Space infections of the head and neck are common in oral and maxillofacial practice. While most infections can be managed successfully with minimal complications, some can cause serious morbidity or death depending on the virulence of microorganisms and host resistance. Bacterial infections have the potential to spread beyond the bony confines of jaw bones into surrounding soft tissues. It is important for oral and maxillofacial surgeons to understand the anatomy of fascial spaces and spread of infection to properly manage infections and prevent complications.
This document discusses odontogenic infections, which originate from tooth-related pathology. It describes how infections can spread from primary fascial spaces around the teeth to secondary spaces deeper in the head and neck region. Virulence of microorganisms and host immune response determine if an infection remains localized or becomes diffuse. Enzymes help degrade tissues, allowing spread through paths of least resistance. Clinical features may include swelling, pain, and fever. Diagnosis involves history, examination, radiographs, and culture/sensitivity testing. Treatment involves antibiotics, surgery to drain or remove the dental cause, and follow up.
- The peri-implant epithelium (PIE) forms a seal around dental implants that is similar to the junctional epithelium (JE) around natural teeth, comprising peri-implant, sulcular, and oral epithelia.
- However, the PIE has a lower adhesion to titanium than the JE does to enamel/cementum, resulting in a weaker protective seal. The connective tissue attachment is also inferior around implants compared to teeth.
- Maintaining a healthy peri-implant soft tissue seal is critical for implant success, as it protects the underlying bone from bacterial invasion and peri-implant disease, similar to the role of the JE around teeth. Care should be taken during probing
This document provides information on the maxillary nerve block technique. It begins with an overview of the trigeminal nerve and its branches, including the maxillary nerve. It then describes the course and branches of the maxillary nerve in detail. It discusses the pterygopalatine ganglion and its branches. The document outlines different maxillary nerve block techniques including posterior superior alveolar, anterior superior alveolar, greater palatine, and nasopalatine nerve blocks. It concludes with a description of a maxillary nerve block and intraligamentary anesthesia technique.
This document discusses periodontal disease and bone loss. It states that changes in bacteria from healthy to diseased states are associated with progression from gingivitis to periodontitis. Periodontitis is characterized by inflammatory changes in the gingiva and connective tissue caused by bacteria, leading to destruction of collagen fibers and bone loss. The rate of bone loss without treatment is approximately 0.2mm per year on facial surfaces and 0.3mm per year on proximal surfaces. Bone loss occurs episodically with periods of activity and inactivity.
This document discusses the classification and pathways of spread of odontogenic infections. It begins by classifying fascial spaces as primary or secondary, and by clinical significance. Key primary spaces include the maxillary (canine, buccal, infratemporal) and mandibular (submental, sublingual, buccal, submandibular). Secondary spaces include the masseteric, pterygomandibular, temporal, and pharyngeal spaces. Odontogenic infections most commonly spread from the infected tooth to surrounding soft tissues and fascial spaces. The document then discusses specific spaces like the buccal, submandibular, and lateral pharyngeal spaces. Microbiology, clinical
This document provides information on fascial spaces of the head and neck region. It begins by defining fascial spaces as clefts or compartments containing connective tissue. It then classifies the spaces based on mode of involvement and clinical significance. Several key fascial spaces are described in detail, including boundaries, contents, etiology, clinical features, and spread of infection. These include the buccal, sublingual, submandibular, pterygomandibular, masseteric, temporal, lateral pharyngeal, and retropharyngeal spaces. The objectives and microbiology of odontogenic infections are also summarized.
1. The document discusses the anatomy and infections of the neck spaces. It describes the layers of cervical fascia and the various neck spaces such as retropharyngeal, masticator, parotid, and submandibular spaces.
2. Common neck space infections discussed include retropharyngeal abscess, Ludwig's angina, parotid abscess, and submandibular space infections. Symptoms, causes, and treatment involving incision and drainage or needle aspiration are described for each infection.
3. Successful treatment of neck space infections requires identifying the involved space, administering antibiotics, and surgically draining any abscess while protecting the airway.
This document discusses deep neck space infections, including anatomy of the cervical fascia and deep neck spaces. It covers the pathophysiology, clinical evaluation, and treatment of deep neck space infections. The key points are:
1. Deep neck space infections can arise from spread of infection from oral cavity/face or lymphadenopathy and spread between neck spaces along paths of communication.
2. Clinical evaluation includes history, physical exam focusing on localizing signs, and imaging studies like CT to determine involved spaces requiring drainage.
3. Treatment priorities are airway management to prevent mortality and drainage of involved spaces to prevent spread of infection.
Space infections of the head and neck are common in oral and maxillofacial practice. While most infections can be managed successfully with minimal complications, some can cause serious morbidity or death depending on the virulence of microorganisms and host resistance. Bacterial infections have the potential to spread beyond the bony confines of jaw bones into surrounding soft tissues. It is important for oral and maxillofacial surgeons to understand the anatomy of fascial spaces and spread of infection to properly manage infections and prevent complications.
ORAL INFECTIONS and facial space infectionsWezzySinkala
The document discusses fascial spaces in the head and neck region. It defines fascial spaces as potential spaces between fascial layers that can be infected by spread of odontogenic infections. It describes various primary and secondary fascial spaces, including the canine space, buccal space, infratemporal space, submental space, sublingual space, submandibular space, pterygomandibular space, masseteric space, temporal spaces, and deep neck spaces like the lateral pharyngeal space and retropharyngeal space. It provides details on the boundaries, contents, etiology, clinical features, and spread of infection for each space. The document emphasizes that infections can readily spread between
Space infection. by Dr. Amit T. Suryawanshi, Oral Surgeon, Pune All Good Things
Hi. This is Dr. Amit T. Suryawanshi. Oral & Maxillofacial surgeon from Pune, India. I am here on slideshare.com to share some of my own presentations presented at various levels in the field of OMFS. Hope this would somehow be helpful to you making your presentations. All the best.
Space infection. by Dr. Amit Suryawanshi .Oral & Maxillofacial Surgeon, Pun...All Good Things
Hi. This is Dr. Amit T. Suryawanshi. Oral & Maxillofacial surgeon from Pune, India. I am here on slideshare.com to share some of my own presentations presented at various levels in the field of OMFS. Hope this would somehow be helpful to you making your presentations. All the best & your replies are welcomed!
This document discusses space infections, including:
1. It classifies space infections based on the involved fascial space and describes the microbial aspects and pathways of spread.
2. The surgical anatomy of various fascial spaces like the buccal, submandibular, infratemporal, and pterygomandibular spaces are outlined along with their clinical features.
3. Secondary spaces like the temporal, pharyngeal, and prevertebral spaces are also discussed. Case reports are presented to illustrate routes of spread from odontogenic infections.
Oral and maxillofacial spaces of infection lo2lo226
This document summarizes various oral and maxillofacial spaces of infection, including the submental, submandibular, sublingual, buccal, submasseteric, pterygomandibular, parapharyngeal, retropharyngeal, carotid sheath, and parotid spaces. For each space, the document outlines etiology, boundaries, contents, clinical presentation, and treatment approaches. Common causes of infection include dental issues and spread from adjacent infected spaces. Management typically involves incision and drainage followed by antibiotic administration and supportive care.
The document discusses facial spaces of periodontal interest. It begins with an introduction to fascia and spaces in the head and neck region. It then covers classification of spaces, formation of spaces, maxillofacial odontogenic infections, individual spaces such as the vestibular space, communications between spaces, and complications of infections. The document also mentions a case report and conclusion. It provides detailed information on anatomy and clinical aspects of various fascial spaces in the head and neck region relevant to periodontal infections.
1. The document discusses various deep neck spaces and infections that can arise within them, including Ludwig's angina (submandibular space infection), retropharyngeal abscess, and parapharyngeal abscess.
2. These deep neck space infections commonly arise from dental infections or tonsillitis and can spread rapidly, potentially causing airway obstruction.
3. Management involves intravenous antibiotics, incision and drainage of abscesses, and tracheostomy if needed to secure the airway. Proper identification of the involved neck space guides surgical drainage approach.
Oral and maxillofacial spaces of infectionlo2lo226
The document summarizes various oral and maxillofacial spaces of infection, including the submental, submandibular, sublingual, buccal, submasseteric, pterygomandibular, parapharyngeal, retropharyngeal, and carotid sheath spaces. For each space, the summary discusses etiology, boundaries, clinical presentation, and treatment approaches, which typically involve incision and drainage followed by antibiotic administration and supportive care. The document also briefly covers abscesses of the parotid space.
Ludwig's angina is an acute, potentially life-threatening infection of the submandibular space that causes severe swelling and difficulty opening the mouth or swallowing. It usually stems from dental infections. Clinical features include bilateral swelling of the submandibular region, elevated tongue, and difficulty speaking or swallowing. Management involves securing the airway through tracheostomy or intubation, administering IV antibiotics, and incising and draining any abscesses through bilateral submandibular and submental incisions. Early diagnosis, antibiotic treatment, and surgical drainage are crucial for successful treatment.
1) The document discusses different types of abscesses that can occur in the pharynx and neck region, including peritonsillar abscesses, parapharyngeal abscesses, and submandibular space abscesses (Ludwig's angina).
2) It describes the anatomy, etiology, clinical features, investigations, treatment, and complications of each type of abscess. Recurrent tonsillitis and dental infections are common causes.
3) Symptoms include pain, difficulty swallowing, trismus, and in severe cases, airway obstruction. Treatment involves antibiotics, analgesics, and sometimes surgical drainage or tracheostomy.
Spread of Oral Infection (2009)
Copyright 2009 by Department of Oral Medicine
University of Dental Medicine, Yangon
Feel free to request to take it down this slide if you are copyright owner.
1. The document describes various fascial spaces of the head and neck region, including the buccal space, submandibular space, sublingual space, and others.
2. Causes of infections in these spaces include odontogenic sources from infected or necrotic teeth, trauma, systemic diseases like diabetes, and more. Infections can spread between spaces through direct continuity, lymphatics, or veins.
3. Specific spaces like the buccal space, submandibular space, and sublingual space are described in more detail, including their boundaries, contents, blood supply, and clinical signs of infection within each space.
The document summarizes the anatomy of the deep neck spaces. It describes the layers of cervical fascia that divide the neck into compartments containing specific structures. Key points include:
- There are 3 layers of deep cervical fascia that invest the neck muscles and organs.
- The spaces include the masticator space containing the muscles of mastication, parotid space containing the parotid gland, and parapharyngeal space containing nerves and vessels.
- Infections can spread between spaces through connections in the fascial planes, potentially reaching the mediastinum through the retropharyngeal and danger spaces.
- Specific infections like peritonsillar and parapharyngeal abs
Similar to Fascial spaces of the jaws and its management (20)
This document discusses staging of oral malignancies. It begins with an introduction about oral cancer prevalence and challenges with late detection. It then covers the TNM staging system and STNMP classification system used to stage oral cancers. Different staging criteria are provided for various oral cancer sites. The conclusion emphasizes that early diagnosis is important for prognosis and outlines how staging helps clinicians determine operability and treatment plans.
Surgical approaches to the facial skeletonAbhishek Roy
This document discusses surgical approaches to different areas of the face and skull. It begins by outlining general principles for facial incisions, including considerations like scar visibility and proximity to vital structures. It then describes specific approaches for different regions, such as the periorbital area (coronal, subciliary incisions), mandible (transoral, transfacial, TMJ approaches), nasal skeleton, and others. For each approach, it discusses preparation, incision placement, planes of dissection, and closure. Throughout, it emphasizes the importance of adequate exposure while avoiding injury to nerves, vessels and ensuring good cosmetic outcomes due to the face's aesthetic significance.
This document discusses midface fractures, including:
- The Le Fort classification system divides midface fractures into 3 types based on the fracture lines. Le Fort I involves the maxilla, Le Fort II is a pyramidal fracture, and Le Fort III is a craniofacial disjunction.
- Common causes of midface fractures are motor vehicle accidents, assaults, and falls. Maxillary bones and the zygomatic bone are frequently involved.
- Clinical features of a Le Fort I fracture include swelling of the upper lip and palate, a "cracked pot" sound from tapping teeth, and mobility of the maxilla. Le Fort II fractures result in "moon face" swelling and "raccoon
Internal derangement of the temporomandibular joint (TMJ) refers to an abnormal positioning of the articular disc within the joint that interferes with smooth movement. Common causes include trauma, microtrauma from grinding or clenching, and degenerative joint disease. Non-surgical treatments include splint therapy, medications, acupuncture, and physical therapy techniques like ultrasound or TENS. Surgical procedures are considered when non-surgical options fail to provide adequate relief of symptoms like pain and restricted opening.
This document discusses various giant cell lesions of the jaws. It defines giant cells and describes their origin from monocytes/macrophages. Giant cell lesions are classified as inflammatory/reactive, aneurysmal bone cyst, metabolic like hyperparathyroidism, or neoplastic like central giant cell tumor. Central giant cell granuloma is described in detail with regards to etiology, clinical features, radiographic appearance, histology, and treatment involving intralesional steroids, calcitonin or surgery. Other giant cell lesions discussed include peripheral giant cell granuloma, aneurysmal bone cyst, traumatic bone cyst, osteoid osteoma/osteoblastoma, cherubism, and brown tumor of hyperparathyroidism
Benign odontogenic and non odontogenic tumoursAbhishek Roy
This document provides information on various benign odontogenic tumors of the jaws. It begins by classifying these tumors into three categories based on their histological composition. It then discusses specific tumor types in more detail, including their clinical features, radiographic appearance, histology, treatment and prognosis. The tumors covered include ameloblastoma (solid/multicystic, unicystic and peripheral subtypes), calcifying epithelial odontogenic tumor, and adenomatoid odontogenic tumor. For each tumor, the summary highlights their defining characteristics and typical presentation.
The document discusses the venous and lymphatic drainage of the head and face. It describes the major veins of the head and face, including the facial vein, maxillary vein, superficial temporal vein, and occipital vein. It notes that the facial vein has no valves and connects to the cavernous sinus through two routes, making infections of the facial vein dangerous as they could spread to the intracranial venous sinuses. The document also provides an overview of the lymphatic system and notes the major lymph nodes of the head and neck.
The document discusses various types of biopsies used to diagnose oral lesions. It describes incisional, excisional, scalpel, punch, frozen section, brush and fine needle aspiration biopsies. For each type it provides details on the procedure, advantages, and disadvantages. The goal of a biopsy is to obtain a tissue sample for histopathological examination to establish a diagnosis and guide treatment. Proper biopsy technique is important for collecting representative samples and making an accurate diagnosis.
Antibiotics, analgesics and emergency drugsAbhishek Roy
This document discusses antibiotics, analgesics, and emergency drugs. It begins by describing different classes of antibiotics including their chemical structures, mechanisms of action, and examples. Specific antibiotics discussed in detail include sulfonamides, quinolones, beta-lactams like penicillins and cephalosporins, tetracyclines, and chloramphenicol. The document also briefly covers analgesics and classifications and examples of opioids and non-opioids. It concludes with a short section on emergency drugs that can be injected or are non-injectable.
The document discusses pain and its pathways in the human body. It defines pain and describes its characteristics and theories. It discusses the neurochemistry and types of pain receptors. The main pain pathway described is the lateral spinothalamic tract, which carries pain and temperature sensations from the periphery to the thalamus and somatosensory cortex via the dorsal horn and spinal cord. It relays information via three orders of neurons and can be modulated in the substantia gelatinosa of the spinal cord.
General anesthesia and its complicationsAbhishek Roy
General anesthesia refers to the reversible loss of sensation and consciousness achieved through a combination of inhaled and intravenous drugs. It involves stages including analgesia, delirium, and surgical anesthesia. Complications may include respiratory depression, arrhythmias, nausea, and emergence delirium. Anesthesia is induced and maintained using inhalational agents like nitrous oxide, halothane, and sevoflurane or intravenous drugs like propofol and ketamine. Premedication, reversal agents, and conscious sedation techniques help optimize anesthesia outcomes and safety.
This document discusses exodontia, or tooth extraction. It begins by defining exodontia as the painless removal of a tooth or root with minimal trauma. It then lists the common indications for extraction such as dental caries, periodontal disease, and impacted teeth. The document describes various factors that can complicate extractions as well as different types of dental elevators, forceps, and flap designs that are used for extractions. It concludes by discussing potential immediate and delayed complications following tooth extraction.
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...Donc Test
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by Stamler, Verified Chapters 1 - 33, Complete Newest Version Community Health Nursing A Canadian Perspective, 5th Edition by Stamler, Verified Chapters 1 - 33, Complete Newest Version Community Health Nursing A Canadian Perspective, 5th Edition by Stamler Community Health Nursing A Canadian Perspective, 5th Edition TEST BANK by Stamler Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Pdf Chapters Download Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Pdf Download Stuvia Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Study Guide Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Ebook Download Stuvia Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Questions and Answers Quizlet Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Studocu Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Quizlet Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Pdf Chapters Download Community Health Nursing A Canadian Perspective, 5th Edition Pdf Download Course Hero Community Health Nursing A Canadian Perspective, 5th Edition Answers Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Ebook Download Course hero Community Health Nursing A Canadian Perspective, 5th Edition Questions and Answers Community Health Nursing A Canadian Perspective, 5th Edition Studocu Community Health Nursing A Canadian Perspective, 5th Edition Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Pdf Chapters Download Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Pdf Download Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Study Guide Questions and Answers Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Ebook Download Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Questions Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Studocu Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Stuvia
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
3. Introduction
Fascia is defined as layers of fibrous connective tissue underlying the skin and
surrounding muscles, bones, vessels, nerves and organs
Fascial spaces are potential spaces that exist between the fasciae and underlying
organs and other tissues.
Infection of orofacial & neck region, particularly those of odontogenic origin, have
been one of the most common diseases in human being
9. Content
It is the region between anterior surface of maxilla and overlying levator muscles
of upper lip
Contains angular artery, vein and infraorbital nerve
Etiology - Maxillary canine & 1st premolar infection
- sometimes mesiobuccal root of first molars
10. Clinical Features
Swelling of cheek, lower eyelid & upper lip
Drooping of angle of mouth
Nasolabial fold obliterated
Oedema of lower eyelid
12. Boundaries
Anteromedially : buccinator muscle
Posteromedially : masseter overlying the anterior border of ramus of mandible
Laterally : by forward extension of deep fascia from the capsule of parotid gland
and by platysma muscle.
Inferiorly : limited by the attachment of the deep fascia to the mandible and by
depressor anguli oris.
Superiorly : the zygomatic process of the maxilla and the zygomaticus major and
minor muscles.
14. Clinical Features
Obliteration of nasolabial fold
Angle of the mouth shifted to opposite side
Swelling in the cheek extending to corner of mouth
Buccal space associated with temporal space : dumb-bell shaped appearance due
to lack of swelling over zygomatic arch
41. Clinical Features
Absence of extra-oral swelling
Severe trismus
Difficulty in swallowing
Anterior bulging of half of soft palate & tonsillar pillars with deviation of uvula to
unaffected side
42. Spread of Infection
Superiorly to infratemporal space
Medially to lateral pharyngeal space
To submandibular space
44. Boundaries
Superficial temporal-
o Laterally: temporalis fascia
o Medially: temporalis muscle
Deep temporal-
o Laterally: temporalis muscle
o Medially: temporal bone & greater wing of sphenoid
45. Clinical Features
Superficial temporal - Swelling limited by outline of temporalis fascia
Trismus
Severe pain
Deep temporal - less swelling, difficult to diagnose and trismus
Etiology - From infratemporal or Pterygomandibular space
48. Boundaries
Shape of an inverted cone or pyramid, the base is
at sphenoid bone and the apex at hyoid bone
Anteriorly : Pterygomandibular raphe
Posteriorly : extends to prevertebral fascia
Laterally : fascia covering medial pterygoid muscle,
parotid & mandible
Medially : buccopharyngeal fascia on lateral
surface of superior constrictor muscle
Styloid process divides the space into anterior
muscular and posterior vascular compartment
50. Clinical Features
Anterior compartment:
o Trismus
o Induration & swelling at angle of jaw
o Fever
o Pharyngeal bulging
Posterior compartment:
o Posterior tonsillar pillar deviation
o Neurological involvement
o Thrombosis of internal jugular vein
o Erosion of carotid vessels may occur
53. Boundaries
Posteromedial to lateral pharyngeal space and anterior to the prevertebral space
Anterior : posterior pharyngeal wall
Posterior : prevertebral fascia
Superior : skull base
Inferior : mediastinum
Laterally : lateral pharyngeal space
54. Clinical Features
Stiffness of neck
Dyspnea
Dysphagia
Bulging of posterior pharyngeal wall
Etiology - Nasal & pharyngeal infections
Spread from odontogenic infections
57. Boundaries
Formed by superficial layer of deep cervical fascia
surrounding the parotid gland
Gland is strongly attached to fascial covering and
there is very little loose connective tissue
Etiology – Blood borne infections
Retrograde infections through
Stenson’s Duct
Rare spread from submassetric,
Pterygomandibular or lateral
pharyngeal space
58. Clinical Features
Swelling from zygomatic arch to lower border of mandible superoinferiorly
Anterior border of mandible to retromolar region anteroposteriorly
Lobule of ear may be everted
Severe pain while mastication leads to less consumption and dehydration
Possible escape of pus from duct during milking of parotid gland
60. Causative Organisms
Usually caused by endogenous bacteria
Most odontogenic infections due to mixed flora
Streptococcus species(alpha haemolytic) are usually the etiologic organisms if
aerobic bacteria present
Anaerobes - prevotella, bacteroids, fusobacterium are also involved
61. Factors affecting spread of infection
Microbial factors-
o Level of virulence
o No. of organisms introduced
Host factors-
o General state of health
o Integrity of surface defence
o Level of immunity
o Capacity for inflammatory & immune response
o Impact of medical intervention
Combination of both factors.
62. Routes of spread
Direct spread
o a) Spread into superficial soft tissues as-
Abscess - pathological thick walled cavity filled with pus
Cellulitis – diffuse erythematous subcutaneous / submucous inflammation of soft
tissues
o b) Spread into adjacent fascial spaces.
o c) Into deep medullary spaces of bone- osteomyelitis
Indirect spread
o a) Lymphatic routes to regional nodes.
o b) Hematogenous route to other organs such as brain
63.
64.
65.
66.
67.
68. Investigations
Routine laboratory investigations.
Special laboratory investigations.
Radiological examination
o IOPA
o OPG
o Lateral oblique view mandible
o A-P & Lateral view of neck for soft tissues can be useful in detecting
retropharyngeal space infection
o Ultrasound of swelling
o CT scan, MRI help in diagnosing extension of infection beyond maxillofacial
region
70. Goals of management
o Airway protection
o Surgical drainage
o Identification of etiologic bacteria
o Selection of appropriate antibiotic therapy
o Medical & supportive therapy
71. Antibiotic Therapy
Parenteral penicillin
Metronidazole in combination with penicillin can be used in
severe infections
Clindamycin for penicillin-allergic patients
Cephalosporins
Antibiotics do not substitute for incision and drainage in
cases of significant odontogenic infections.
Causes for clinical failure include inadequate drainage or
antibiotic resistance
72. Surgical Management
Incision & drainage helps-
o To get rid of toxic purulent material
o To decompress oedematous tissues
o To allow better perfusion of blood, containing antibiotics and defensive elements
o To increase oxygenation of infected area
Removal of the cause; such as infected tooth, a segment of necrotic bone, a
foreign body should be done at the time of I & D procedure
73. Hilton’s method
Stab incision is made over a point in the most fluctuant area along the
skin creases, through skin & subcutaneous tissue
If pus is not encountered, further deepening of surgical site is achieved
with sinus forceps
Closed forceps are pushed through the tough deep fascia and advanced
towards the pus collection
Abscess cavity is entered and forceps opened in a direction parallel to
vital structures
Pus flows along side of the beaks
Explore the entire cavity for additional loculi
74.
75.
76. Hilton’s method
Placement of drain : A corrugated rubber drain is inserted into the depth of the
cavity and fixed with the help of suture
Drain left for at least 24 hours
Dressing : Dressing is applied over the site of incision taken extraorally without
pressure
77. Drainage
Canine, Sublingual and Vestibular abscesses are drained intraorally
Massetric, Pterygomandibular, Buccal and Lateral Pharyngeal space
abscesses can be drained with combination of intraoral and extraoral
drainage
Temporal, Submandibular, Submental, Retropharyngeal and Parotid space
abscesses may mandate extraoral incision and drainage
78. Supportive Therapy
Administration of antibiotics
Hydration of patient by I/V route
Soft or liquid diet rich of high proteins
Analgesics & NSAIDs
Antiseptic mouthwashes
Complete bed rest
80. Definition
It is a firm, acute, toxic cellulitis of the submandibular, sublingual spaces bilaterally
and of the submental space
Described by WILHELM FREDREICH VON LUIDWIG IN 1836
81. Etiology
Periapical, pericoronal or periodontal infection of a lower third molar
Traumatic injuries and infected lesions
Infective conditions such as osteomyelitis may manifest as Ludwig's angina
Cysts or tumors in third molar region
82. Pathology
Infection from lower third molar reaches the submandibular spaces
From here infection spreads along the submandibular salivary glands above the
mylohyoid muscle to reach the sublingual space
84. Extraoral Features
Hard to firm brown indurated swelling skin over the swelling appears erythematous
and stretched
Swelling is tender with local rise in temperature
Difficulty in closing the mouth
Drooling of saliva
Respiratory distress
86. Management
Airway maintenance- tracheostomy and cricothyroidectomy is advisable
Parenteral antibiotics - amoxicillin + metronidazole
Surgical decompression (under LA) - decompression improves vascularity and
potentiates the action of antibiotics
Bilateral submandibular incision with a midline submental incision
Pus should be drained
Hydration of the patient – it is necessary to put the patient on IV fluids
Removal of cause - the offending tooth is removed
88. Conclusion
Misdiagnosis of such conditions can prove extremely deleterious to the patient
Proper knowledge of fascial spaces is very important for correct diagnosis and
definitive treatment plan