Clinical Correlation: Odontogenic Infections

Question 1

Odontogenic infection involves extension through

Answer 1

enamel → dentin → pulp of tooth

Question 2

Once the infection gets to the apex of the root, it eventually perforates through ___, which creates a

Answer 2

buccal or lingual cortex of jaw

subperiosteal abscess

Question 3

Infections go through what kinds of pathways?

Answer 3

pathway of least resistance

Question 4

if an infection is in the lateral pharyngeal & retropharyngeal, what can it lead to?

Answer 4

airway compromise due to swelling & hard to breathe

Question 5

If an infection is in the maxillary, what can it lead to?

Answer 5

cavernous sinus thrombosis, postseptal orbital infection, intracranial infection

Question 6

If an infection is in the pretracheal/danger space, what can it lead to?

Answer 6

Infection in the mediastinum

Question 7

Once infection spreads to ___, it can go into chest

Answer 7

Prevertebral

Question 8

What are the low severity primary spaces?

Answer 8

Vestibular, infraorbital, buccal, palatal

Question 9

What are the moderate severity spaces?

Answer 9

Submandibular, sublingual, submental, masticator

Question 10

What are the high severity spaces?

Answer 10

Lateral pharyngeal, pretracheal, danger space, mediastinum, intracranial

Question 11

Masticator spaces refers to

Answer 11

ANY space below the muscles of mastication

Question 12

What are the 4 masticator spaces?

Answer 12

• Pterygomandibular
• (sub)masseteric
• Superficial temporal space
• Deep temporal space

Question 13

Examples of maxillary spaces

Answer 13

canine space, intraorbital, & periorbital

Question 14

Where is the buccal space located? Can it be from maxillary, mandibular or both?

Answer 14

Located lateral to buccinator muscle

Can be from maxillary or mandibular tooth

Question 15

Where is the sublingual space located?

Answer 15

Below tongue, medial to mandible, & above (superior) mylohyoid

Question 16

You may be able to drain ___ space intraorally, but it’s mostly done extraorally

Answer 16

Sublingual space

Question 17

Where is the submandibular space located?

Answer 17

Below (inferior) mylohyoid, deep to platysma

Question 18

Sign of infection in submandibular/sublingual space?

Answer 18

inferior border of mandible often not palpable

Question 19

Which tooth is mostly affected in the submandibular/sublingual space? why?

Answer 19

3rd molar b/c their root apex is inferior to the mylohyoid line

2nd molar is sometimes associated

Question 20

Effects of submandibular/sublingual space infection

Answer 20

firm swelling down to neck, possible voice changes, & possible trismus

Question 21

You almost always have some trismus w/ ___. You may not have it w/

Answer 21

masticator infections

submandibular space infection

Question 22

Location of submental spaces

Answer 22

Below mylohyoid, in between anterior digastric muscle

Question 23

Location of para/retropharyngeal spaces.
Is this space located in primary or secondary spaces?

Answer 23

Lateral pharyngeal (below), retropharyngeal included

Secondary, but can be primary

Question 24

Uvula deviation is an effect of an infection in the ___ space

Answer 24

para/retropharyngeal spaces

Question 25

Ludwig’s Angina involves what spaces? What’s it caused by?

Answer 25

Bilateral submandibular, sublingual, & submental spaces

Due to aggressive forms of bacteria

Question 26

What’s the greatest concern in ludwig’s angina?

Answer 26

airway compromise

Question 27

What’s the real cure for odontogenic infection?

Answer 27

Surgery (some sort of procedure)

Question 28

You need ___ drainage in odontogenic infections?

Answer 28

Dependent
- use gravity to your advantage

Question 29

In subperiosteal abscesses, you do what for treatment?

Answer 29

dissect to bone

Question 30

What is a critical source control in the treatment of odontogenic infections?

Answer 30

Remove tooth

Question 31

In a submandibular approach, how large must the incision be & where?

Answer 31

> 1.5 cm below inferior border of mandible

Question 32

Common warning signs of odontogenic infection

Answer 32

Posturing (ex: tripoding), difficulty swallowing, airway deviation