1. Infection in the oral and maxillofacial region can arise due to a balance between the host's defense system, microbial virulence and quantity, and local circumstances. Common routes of infection include odontogenic, traumatic, hematogenous, and iatrogenic causes. 2. Diagnosis involves identifying local signs like pain, swelling and pus formation as well as systemic symptoms such as fever and lymphadenopathy. Imaging may also be used. 3. Treatment of acute infections focuses on supporting the host's defense system with antibiotics and surgical drainage or incision of abscesses when pus has formed. For chronic infections, surgical removal of the infection source is often needed in addition to antibiotics and drainage.

1. Infection in Oral & Maxillofacial Region

2. Infection--- in oral & maxillofacial region Infection Conception Trait Anatomy Arising Route Mutation Influence factors Diagnosis Principles Treatment Principles

3. Infection---conception Infectious agent(bacteria) Host Inflammatory reaction Elimination the infectious pathogen Repair tissue injury Hypersensitivity Autoimmune disease Beneficial Harmful protective and defensive

4. Anatomy Oral and nasal cavity Tooth Space Blood and Lymphoid system Bacteria

5. Anatomy Oral and nasal cavity Maxillary sinus Bacteria---Exist Temperature + Moisture (Beneficial) Reproduction + Developing

6. Anatomy Alveolar bone Soft tissue Fascial space Tooth Caries Pulpitis Apical infection

7. Anatomy Fascial space-loose connective tissue Among skin, maxillary and muscle Purulent--- spreading way Do not exist in healthy state Become filling during infection

8. Anatomy Blood and lymphoid system Beneficial Abundance Harmful Dangerous triangle Lacking valves Cavernous sinus Cavernous sinus thrombosis Encephalic infection

9. Trait of pathogenic bacterium Varied Numerous Streptococcus hemolyticus Staphylococcus aureus Escherichia coli Anaerobe Sterile Simple Complex Flora

10. Route of infection Odontogenic infection Traumatic infection Hematogenous infection Iatrogenic infection

11. Odontogenic infection Periapical infection Pericoronitis

12. Periapical infection Acute-chronic Periapical infection Fistular Cellulitis Intraoral soft tissue abscess Osteomyelitis Septicemia Deep fascial space infection Ascending facial-cerebral infection

13. Pathways of Periapical infection

14. Pericoronitis Lower third molar

15. Infection---Arising Host--- defense system Microbe---virulence quantity Local circumstance Balance Imbalance Scale

16. Mutation Influence factors Changing directions

17. Influence factors Host--- defense system Microbe---virulence quantity Treatment strategy

18. Changing directions Localization and recovery Acute chronic Diffusion Blood system---Septicemia lymphoid system---Lymphadenopathy From submandible space infection to chest region

19. How to diagnose? Local Signs and Symptoms Systemical Signs and Symptoms Signs and Symptoms

20. Local Signs and Symptoms Pain Swelling Surface erythema Pus formation Limitation of motion Locally

21. Systemical Signs and Symptoms Fever Lymphadenopathy Malaise Toxic appearance Elevated white blood cell count

22. How to treat? Acute stage Chronic stage

23. Acute stage Host Antibiotic therapy Surgical drainage and incision

24. Host Migration of white blood cell Production of antibodies Most important factor --- final outcome The infections--- cured by the host, not by antibiotics Critical Principles Defense Mechanisms

25. Principles for choosing appropriate antibiotic causative organism sensitivity specific, narrow-spectrum antibiotic least toxic antibiotic drug history(success, allergic and toxic) Antibiotic era

26. Principles of antibiotic administration Proper dose Proper time interval Proper route of administration(oral, parenteral) Combination antibiotic therapy

27. Surgical drainage and incision How to judge the pus formation? Purposes of surgical drainage and incision Principles of surgical drainage and incision

28. How to judge the pus formation? Three stages Inoculation Cellulitis Abscess Duration--- >5 days Palpation---Fluctuant Appearance---Reddened Needle aspiration B-ultrasound CT Characteristic

29. Fluctuant examination

30. Purposes of surgical drainage & incision Rid the body of toxic purulent material Decompress the tissues Allowing better perfusion of blood containing antibiotics and defensive elements Increased oxygenation of the infected area

31. Infection in masseteric space

32. Infection in multi-space Ludwig’s angina

33. Principles of surgical drainage & incision Place the incision in an esthetically acceptable Place the incision in a dependent position to encourage drainage by gravity Dissect bluntly through deeper tissues and explore all portions of the abscess Place a drain and stabilize it with sutures

34. Principles of surgical drainage & incision

35. Lesion tooth---Impacted tooth Osteomyelitis Chronic stage Surgical removal of the focus

36. Conclusion The trait of Infection Odontogenic infection mutation of infectious Diagnosis of the infection Diagnosis of the abscess formation The principles of the treatment Infection in oral & maxillo-facial region

37. Thank you