2. Objectives
By the end of 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 infection is
an acute or chronic infection
originating from a tooth related
pathology.
Periapical
PericoronalPeriodontal
7. What will it depend 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
connective tissue degradation
• Hyaluronidase (Produced by aerobes; causes
cellulitis and lowers the pH)
• Collagenase (Produced by anaerobes; cause
liquefactive necrosis; pus)
9. Spread of infection takes the path of least
resistance in the tissues.
In the connective
tissue spaces
(potential)
Between the bone
and periosteum
Spaces between
the muscle layers
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
o Vestibular/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
o Vestibular
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
o Vestibular
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
o Vestibular
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 of Odontogenic
Infections
• Maxillary Sinus
• Orbit
• Danger space
• Mediastinum
Direct Spread
• Cavernous Sinus
• Endocardium
• Joints
Haematogenous Spread
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 end of 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