Spread of Infection Flashcards
(37 cards)
How does infection spread into the buccal space from upper teeth?
Infection can spread from the apex following an acute apical abscess and can go through bone buccally (above insertion of buccinator)-
Why is palatal spread of infection less likely in uppers?
Bone is more dense (infection tends to spread via path of least resistance)
-> extreme pain- due to stretching of the tissue
When is palatal spread more likely?
If palatal root or lateral incisor (as root can be quite palatally placed)
What occurs if infection perforates below the insertion of buccinator from upper tooth?
It drains into the mouth
-> Gives bad taste and a bursting bubble (abscess)
What occurs if infection from upper tooth spreads upwards?
Maxillary sinusitis
How does infection spread into the sublingual space from lower teeth?
lingually above the insertion of mylohyoid
What happens if infection perforates mylohyoid muscle?
It can spread into submandibular space
What can happen when infection passes buccally in lower teeth?
It can:
Go above buccinator attachment- into mouth
Below- into buccal space
In lower jaw where does infection anteriorly and posteriorly tend to spread?
Anterior- labially
Posterior- lingually
-> bone is thinner
How does the mylohyoid line dictate the space in which infection is likely to spread?
Infection spread depends on the location of tooth i.e 7 roots are below the mylohyoid line so typically spreads to submandibular space
What is the significance in terms of infection spread of the mylohyoid being open at the back?
Sublingual infections can spread into submandibular space (VV)
Why is the space surrounding the ptergyoid plates and muscles a hotspot for infection spread?
There is little resistance and neighbouring spaces all communicate
What is the name for the space surrounding the pterygoid muscles and plates?
Masticatory space- misleading as there isn’t one space
What is the effect of infection in pterygoid muscle region?
Trismus due to muscle spasm
What occurs when infection spreads into lateral pharyngeal space? Why is it worrying?
Bulge in pharynx
-> This space contains many important nerves and vessels
Where can infection spread from lateral pharyngeal space and what can it cause?
Retropharyngeal space (behind pharynx) or into pre-vertebral space
-> It then can spread into base of skull (infection of brain) or superior/inferior mediastinum (can cause pressure on heart)
What is the route of infection from tooth to CS thrombosis?
Infection from lower tooth spreads back into lateral pharyngeal space or infratemporal space and reach pterygoid Venus plexus which communicates with veins reaching the cavernous sinus (no valves to stop infection)
Infection from upper tooth can spread into infraorbital space and get into veins (valveless) and reach cavernous sinus
What is the treatment for CS thrombosis?
Drainage
How does different bacteria affect spread?
Spread can be worse with more virulent bacteria
How can infection in buccal space be identified?
Swelling of face
Inability to close eye
How can an infection with infraorbital spread be identified?
Loss of nasolabial fold
-> If this is not affected, it may suggest it is only buccal space that is affected (but every patient is unique and has different anatomy)
What tooth is most likely to give infraorbital spread?
Canine
What happens if infections are left untreated?
They can spread further:
Upper infections tend not to spread down (apart from buccal space which can go to lateral pharyngeal space)
Lower infection tends to spread back more easily (apart from anteriors which tend to go to mental/submental space)
Where does infection tend to spread from different regions in upper jaw?
Upper Anterior Teeth
Lip
Nasolabial region
Lower eyelid
Upper Lateral Incisor
Palate (Less common)
Upper Premolars and Molars
Cheek
Infra-temporal Region
Maxillary Antrum (Very rare)
Palate (Less common)
