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Odontogenic infections
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.
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Odontogenic infections
- 1. Odontogenic Infections Dr. Rida F.Waseem BDS, Demonstrator Department of Oral Surgery IOD, CMH
- 2. Objectives By the endof this lecture the students should be able to: • Describe the sequelae of odontogenic infections. • Describe the spread of odontogenic infections to primary, secondary and distant spaces. • Diagnose a patient with odontogenic infections.
- 3. An odontogenic infectionis an acute or chronic infection originating from a tooth related pathology. Periapical PericoronalPeriodontal
- 4.
- 5.
- 6. 1) Localized SoftTissue Abscess or 2) Diffused widespread Cellulitis
- 7. What will itdepend on? Number of Microorganisms Virulence of Microorganisms Host Defense In a healthy patient spread is localized and drained to the buccal or lingual cortex In an immune compromised patient spread is diffused and spreads to the bone osteomyelitis
- 8. Enzymes responsible for connectivetissue degradation • Hyaluronidase (Produced by aerobes; causes cellulitis and lowers the pH) • Collagenase (Produced by anaerobes; cause liquefactive necrosis; pus)
- 9. Spread of infectiontakes the path of least resistance in the tissues. In the connective tissue spaces (potential) Between the bone and periosteum Spaces between the muscle layers
- 10. Fascial Spaces Primary Secondary •Vestibular •Buccal •Canine •Infratemporal Maxillary •Vestibular •Submental •Submandibular •Sublingual Mandibular Massetricspace Superficial and Deep temporal spaces Pterygomandibular space Carotid sheath space Lateral pharyngeal space Retropharyngeal Space
- 11. Spaces Primary • Maxillary o Vestibular/Palatal oBuccal o Canine o Infratemporal • Mandibular o Vestibular o Submental o Submandibular o Sublingual
- 12. Spaces Primary • Maxillary o Vestibular/Palatal oBuccal o Canine o Infratemporal • Mandibular o Vestibular o Submental o Submandibular o Sublingual
- 13. Spaces Primary • Maxillary o Vestibular/Palatal oBuccal o Canine o Infratemporal • Mandibular o Vestibular o Submental o Submandibular o Sublingual
- 14. Spaces Primary • Maxillary o Vestibular/Palatal oBuccal o Canine o Infratemporal • Mandibular o Vestibular o Submental o Submandibular o Sublingual
- 15. Spaces Primary • Maxillary o Vestibular/Palatal oBuccal o Canine o Infratemporal • Mandibular o Vestibular o Submental o Submandibular o Sublingual
- 16. Spaces Primary • Maxillary o Vestibular/Palatal oBuccal o Canine o Infratemporal • Mandibular o Vestibular o Submental o Submandibular o Sublingual
- 17. Spaces Primary • Maxillary o Vestibular/Palatal oBuccal o Canine o Infratemporal • Mandibular o Vestibular o Submental o Submandibular o Sublingual
- 18. Spaces Primary • Maxillary o Vestibular/Palatal oBuccal o Canine o Infratemporal • Mandibular o Vestibular o Submental o Submandibular o Sublingual
- 19. Spaces Primary • Maxillary o Vestibular/Palatal oBuccal o Canine o Infratemporal • Mandibular o Vestibular o Submental o Submandibular o Sublingual
- 20. Spaces Primary • Maxillary o Vestibular/Palatal oBuccal o Canine o Infratemporal • Mandibular o Vestibular o Submental o Submandibular o Sublingual
- 21. Spaces Primary • Maxillary o Vestibular/Palatal oBuccal o Canine o Infratemporal • Mandibular o Vestibular o Submental o Submandibular o Sublingual
- 22. Spaces Primary • Maxillary o Vestibular/Palatal oBuccal o Canine o Infratemporal • Mandibular o Vestibular o Submental o Submandibular o Sublingual
- 23. Spaces Primary • Maxillary o Vestibular/Palatal oBuccal o Canine o Infratemporal • Mandibular o Vestibular o Submental o Submandibular o Sublingual
- 24.
- 25.
- 26. Spaces Secondary • Massetric space •Superficial and Deep temporal spaces • Pterygomandibular space • Carotid sheath space • Lateral pharyngeal space • Retropharyngeal Space
- 27. Spaces Secondary • Massetric space •Superficial and Deep temporal spaces • Pterygomandibular space • Carotid sheath space • Lateral pharyngeal space • Retropharyngeal Space
- 28. Spaces Secondary • Massetric space •Superficial and Deep temporal spaces • Pterygomandibular space • Carotid sheath space • Lateral pharyngeal space • Retropharyngeal Space
- 29. Spaces Secondary • Massetric space •Pterygomandibular space • Superficial and Deep temporal space • Carotid sheath space • Lateral pharyngeal space • Retropharyngeal Space
- 30. Fascial Spaces Primary Secondary •Vestibular/Palatal •Buccal •Canine •Infratemporal Maxillary •Vestibular •Submental •Submandibular •Sublingual Mandibular Massetric space Superficial and Deep temporal spaces Pterygomandibular space Carotid sheath space Lateral pharyngeal space Retropharyngeal Space
- 31. Spaces Primary Secondary • Maxillary oVestibular/Palatal o Buccal o Canine o Infratemporal • Mandibular o Vestibular o Submental o Submandibular o Sublingual • Massetric space • Pterygomandibular space • Superficial and Deep temporal spaces • Carotid sheath space • Lateral pharyngeal space • Retropharyngeal
- 32. Spaces Primary Secondary • Maxillary oVestibular o Buccal o Canine o Infratemporal • Mandibular o Submental o Submandibular o Sublingual • Massetric space • Pterygomandibular space • Superficial and Deep temporal spaces • Carotid sheath space • Lateral pharyngeal space • Retropharyngeal
- 33. Spaces Primary Secondary • Maxillary oVestibular o Buccal o Canine o Infratemporal • Mandibular o Submental o Submandibular o Sublingual • Massetric space • Pterygomandibular space • Superficial and Deep temporal spaces • Carotid sheath space • Lateral pharyngeal space • Retropharyngeal
- 34. Spaces Primary Secondary • Maxillary oVestibular o Buccal o Canine o Infratemporal • Mandibular o Submental o Submandibular o Sublingual • Massetric space • Pterygomandibular space • Superficial and Deep temporal spaces • Carotid sheath space • Lateral pharyngeal space • Retropharyngeal
- 35. Distant Spread ofOdontogenic Infections • Maxillary Sinus • Orbit • Danger space • Mediastinum Direct Spread • Cavernous Sinus • Endocardium • Joints Haematogenous Spread
- 36.
- 37. Prophylaxis Against Infectious Endocarditis-60min before Situation Agent Adults Children Oral Amoxicillin 2g 50mg/kg Parenteral Ampicillin 2g IM/IV 50mg/kg IM/IV Cefazolin/ceftriaxo ne 1g IM/IV 50mg/kg IM/IV Penicillin allergy, Oral Clindamycin Azithromyci/Clarit hromycin 600mg 500mg 20mg/kg 15mg/kg Penicillin allergy, Parentral Clindamycin 600mg IM/IV 20mg/kg IM/IV
- 38. Clinical Features Swelling (IOand/or EO) Redness Fever and malaise Trismus Lymphadenopathy Dehydration Dyspnea Dysphagia
- 39.
- 40. Treatment Options Medical Surgical •Empirical Oral antibiotics/IV antibiotics • Pain medication • Hydration • Nutrition • Control any systemic disease • Remove the dental cause (RCT/debridement/extr action) • Incision and drainage(IO/EO) • Follow up
- 41. Objectives By the endof this lecture the students should be able to: • Describe the sequelae of odontogenic infections. • Describe the spread of odontogenic infections to primary, secondary and distant spaces. • Diagnose a patient with odontogenic infections
- 42.