Odontogenic Infections

Question 1

Are fascia-lined tissue compartments filled with loose, areolar connective tissue that can become inflamed when invaded by microorganism

Answer 1

Facial spaces

Question 2

Six possible fascial space locations

Answer 2

1. Vestibular sace
2. Buccal space
3. Maxillary sinus
4. Submandibular space
5. Sublingal space
6. Palatal abscess

Question 3

Deep fascial space infections associated with any tooth

Answer 3

Vestibular
Buccal
Subcutaneous

Question 4

Deep fascial space infection associated with maxillary teeth

Answer 4

Buccal
Infratemporal
Infraorbital
Maxillary and other paranasal sinuses
Cavernous sinus thrombosis

Question 5

Deep fascial space infections associated with mandibular teeth

Answer 5

Space of the body of the mandible
Perimandibular space
Submandibular
Sublingaul
Submental
Masticator space
Submasseteric
Pterygomandibular
Superficial temporal
Deep temporal

Question 6

Deep fascial space of the neck

Answer 6

Lateral pharyngeal
Retropharyngeal
Pretracheal
Danger space
Prevertebral

Question 7

Low severity - little threat to the airway or vital structure

Answer 7

Vestibular
Buccal
Subperiosteal
Space of the body of the mandible
Infraorbital

Question 8

Moderate severity - hindered access to the airway

Answer 8

Perimandibular space
Submandibular
Sublingual
Submental
Masticator space
Submasseteric
Pterygomandibular
Superficial temporal
Deep temporal

Question 9

High severity - direct threat to the airway or vital structures

Answer 9

Deep neck spaces
Lateral pharyngeal
Retropharyngeal
Pretracheal
Danger space
Mediastinum
Intracranial infections
Cavernous sinus thrombosis
Brain abscess
Necrotizing fasciitis

Question 10

Thin potential space between the levator anguli oris and the levator labii superioris muscles

Results from the infection from the maxillary canine tooth or by extenion of infections from the buccal space

Answer 10

Infraorbital space

Question 11

Swelling of the anterior face obliterates the nasolabial fold

Answer 11

Infraorbital space

Question 12

Bounded by the overlying skin of the face on the lateral aspect and the buccinator muscle on the medial aspect

Answer 12

Buccal space

Question 13

Extension of infection from maxillary teeth through the bone superior to the attachment of the buccinator of the alveolar process of the maxilla

Answer 13

Buccal space

Question 14

What tooth are commonly associated with buccal space infection

Answer 14

Posterior maxillary teeth

Question 15

Bucaal space infections may follow the extension of the buccal fat pad into the?? __ __ __ __

Answer 15

Superficial temporal space
Infratemporal space
Infraorbital space
Periorbital space

Question 16

This space lies posterior to the maxilla

Laterally and superiorly, it is continuous with the deep temporal space

Answer 16

Infra temporal space

Question 17

Infratemporal space contains?

Answer 17

Branches of maxillary artery
Pterygoid venous plexus (importantly the emissary veins)

Question 18

Infratemporal space is the origin of the posterior route by which inections may spread into the ____ sinus

Answer 18

Cavernous sinus

Question 19

The usual cause Infratemporal space infection

Answer 19

Maxillary third molar

Question 20

How many % of cases of maxillary sinusitis are odontogenic?

Answer 20

20%

Question 21

This infection may spread superiorly through the ethmoid sinus or the orbital floor to cause secondary periorbital or orbital infections

Answer 21

Maxillary sinus

Question 22

High mortality rate of odontogenic infection

Answer 22

Cavernous sinus

Question 23

Cavernous sinus ocurs when maxillary odontogenic infections erode into the???? _______ in the infraorbital space or the ______ via the sinuses, they can follow the ______ vein through the superior orbital fissure and extend directly into the cavenous sinue

Answer 23

Infraorbital vein
Inferior ophthalmic vein
Common ophthalmic vein

Question 24

Name of the cavenous sinus infection

Answer 24

Septic cavernous sinus thrombosis

Question 25

An infection erode through the buccal cortical bone but does not perforate the periosteum, it can essentially peel the periosteal layer of soft tissue of the bony surface

Answer 25

Subperiosteal space

Question 26

A swelling that assumes the shape of the underlying mandible, it can appear as if the bone itself has been enlarged

Answer 26

Subperiosteal space

Question 27

The factor that determines whether the infection is submandibular or sublingual is the attachment of the _____ on the ______________

Answer 27

Mylohyoid muscle , mylohyoid ridge of the medial aspect of the mandible

Question 28

Lies between the oral mucosa of the floor of the mouth and the mylohoid muscle

Answer 28

Sublingual space

Question 29

the posterior border off the sublingual space is open, and therefore, it freely communicates with the ___ Space

Answer 29

Submandibular space

Question 30

Lies between the anterior bellies of the right and left digastric muscles and between the mylohyoid muscle and thee overlying fascia

Answer 30

Submental space

Question 31

Submental space involvement is the result of the spread of a _____ space infection

Answer 31

Submandibular space

Question 32

Associated teeth with submental space

Answer 32

Mandibular incisors

Question 33

this infection is rapidly spreading cellulitis that can obstruct the airway and commonly spreads posteriorly to the deep fascial spaces of the neck

Answer 33

Perimandibular spaces (ludwig angina)

Question 34

The infection cannot be called as Ludwig’s angina unless?

Answer 34

All submandibular spaces are involved

Question 35

Spaces involved in ludwig’s angina

Answer 35

Primarily the submandiular, secondary and sublingual and submental spaces

Question 36

Common teeth source infection of ludwig

Answer 36

2nd and 3rd molars

Question 37

Trismus, drolling, and difficulty swallowing and sometimes breathing

Answer 37

Ludwig’s angina

Question 38

Formed by the splitting of the anterior layer of the deep cervical fascia, also called the superficial or the investing layer of the deep cervical fascia, to surround the muscles of mastication

Answer 38

Masticatory space

Question 39

Four compartments of the masticatory space

Answer 39

1. Submasseteric space 2. Pterygomandibular space 3. Superficial temporal space 4. Deep temporal space

Question 40

Infection most commonly as the result of spread from the buccal space of soft tissue infection around the mandibular third molar (pericoronitis)

Answer 40

Submasseteric space

Question 41

When the submasseteric is involved, the masseter muscle also becomes __ and __

Answer 41

Inflamed and swollen

Question 42

What is pericoronitis

Answer 42

Swelling and infection of the gum tissue around the WISDOM TOOTH

Question 43

__ caused by inflammation of the masseter muscle in submasseteric space infection

Answer 43

Trismus

Question 44

Infection spread primarily from the mandibular third molar When this space is involved, little or no facial swelling is observed; however, the patient almost always has significant trismus

Answer 44

Pterygomandibular space

Question 45

Relationship of terygomandiblar space with anesthetic?

Answer 45

It is the area where local anesthetic solution is deposited during IANB

Question 46

Defined as the inflammation of bone and its marrow contents. Infections spread through the bone to a larger extent

Answer 46

Osteomyelitis

Question 47

A serious sequela of Periapical infection that often results in a diffuse spread of infection throughout the medullary spaces, with subsequent necrosis of a variable amount of bone.

Answer 47

Acute osteomyelitis

Question 48

Most frequent cause of acute osteomyelitis of the jaw

Answer 48

Dental infection

Question 49

Most comon bacyeria in acute osteomyelitis Anaerobes such as Bacteriodes, porphyromonas or prevotalla species also predominate

Answer 49

Staphylococcus aureus and staphylococcus albus

Question 50

Supperative infetction with a mixed bacterial flora, much of which forms a biofilm of sequestra of bone

Answer 50

Acute osteomyelitis

Question 51

Clinical features of acute osteomyelitis

Answer 51

Severe pain, trismus, paresthesia of the lips, difficult in eating, increase WBC Pus may exude from the gingival margin

Question 52

Radiographc features ofacute osteomyelitis

Answer 52

Cannot be seen until at least 1-2 weeks Diffuse lytic change in the bone Trabeculae become fuzzy and indistinct

Question 53

Treatment and management of acute osteomyelitis

Answer 53

Debridement, drainage, antimicrobial If large sequestrum, surgical removal

Question 54

May develop in adequately treated acute osteomyelitis or may arise from dental infection without a preceding acute stage. Arises from infection by weakly virulent bacteria

Answer 54

Chronic osteomyelitis

Question 55

Presistent low grade infection is associated with hronic inflammation, activation of osteoclastic bone destruction and granulation tissue formation Sequestra will usually separate spontaneously during months or years may be several centimeters in length

Answer 55

Chronic osteomyelitis

Question 56

Common in children because their bone is better vascularized and produces more reactive bone deposition around the infection A mild bacteria infection entering the bone though a carious tooth in persons who have a high degree of tissue resistance and tissue reactivity Tissue reacts to the infection by proliferation rather than destruction

Answer 56

Chronic focal sclerosing osteomyelitis

Question 57

Term given to a localized area of sclerosis without evidence of infection

Answer 57

Sclerosing osteitis

Question 58

Inflammation or infection causes the periosteum of the surrounding bone to become active and lay down layers of new bone around the cortex as a healing response

Answer 58

Proliferaive periostitis

Question 59

Radiograph feature of proliferative periositits

Answer 59

Onion skinning

Question 60

Two major origins of odontogenic infection

Answer 60

Periapical and periodontal