Spreading type of infection

Into soft tissue intra oral or extra oral swelling or abscess depending on muscle attachments. Spread into adjacent surgical spaces along facial planes cellulitis. More dangerous distant spread

 Maxillary teeth
Molars
PALATAL ABSCESS BUCCAL VESTIBULAR/ SULCULAR ABSCESS FACIAL SWELLING OR ABSESS which may lead to cellilitis.

 Anterior & Premolars.

Palatal abscess. Labial abscess.

Cellulitis from maxillary teeth cause swelling of upper half of face direction towards eye may cause dangerous complication CAVERNOUS SINUS THROMBOSIS.

 Mandibular premolars and molars.

Labial or buccal vestibular / sulcular abscess. Lingual palate perforation depending on mylohyoid muscle infection or pus or exudation may involve submandibular/ sublingual spaces LUDWIGS ANGINA.

 Mandibular anterior teeth.

Incisors or canines.
If pus perforate above mentalis labial abscess. Below insertion of mentalis cause subcutaneous abscess. Most often between two mentalis muscles.

 Usually odontogenic infection remained confined in the peri apical area or periodontal pockets. Peri apical infections may perforate cortex and form local abscess or spread intra medullary chronic infection or focal osteomyelitis.

 But depending on;

The number and virulence of micro organisms, type and severity of mechanical or chemical irritant and defense of the host; Or initial PAI is not completely or adequately treated.
It may lead to spreading type of infection Cellulitis. Or may spread to adjacent facial and cervical or distant spaces

FACIAL SPACES
Fascialined areas-- potential spaces that do not exist in healthy persons. They become filled by pus or exudation during infection. Some contain neurovascular structure compartments. Others filled with loose areolar CT-- Clefts

Primary facial spaces

Primary spaces are adjacent to tooth bearing area & are directly involved by infection.
Primary maxillary spaces.
Canine Buccal Infratemporal.

Primary mandibular spaces.

Submental. Buccal. Submandibular. Sublingual.

Secondary Facial Spaces

Secondary spaces are away or lie more posteriorly tooth bearing area and are lined with a CT fascia which has poor blood supply. Involvement of these spaces produce more complicated infective conditions. They are;

 Masseteric. Pterygomandibular. Superficial & deep temporal. This group is also known as the MASTICATOR SPACE because muscle & fascia of mastication bound them.

Cervical Facial Spaces

Uncommon occurrence. But spread to deep cervical spaces may have life threatening sequelae.
Lateral pharyngeal. Retropharyngeal. Prevertebral.

PRIMARY MAXILLARY SPACES

Primary mandibular spaces 1

 When bilateral submandibular, sublingual & submental spaces become involved --Ludwig's angina. It is a rapidly spreading cellulitis and commonly spread to secondary mandibular spaces. This usually produce life threatening condition.

Cervical Facial Spaces

Principles of management
Determine the severity of infection Evaluate the state of patients host defense mechanism

Determine , whether treated by GDP or refer to specialist Appropriate antibiotic & their proper administration Treat infection surgically Diet & i-v fluids Evaluate pts frequently

MANAGEMENT
Proper diagnosis. Antibiotics. Other Adjuncts. I&D