Académique Documents
Professionnel Documents
Culture Documents
Overview
Odontogenic Microbiology
Progression of infection
Infections Assessment
Fascial spaces
Treatment/antibiotics
Microorganisms Causing
Microbiology Odontogenic Infections
Organism Percentage
Polymicrobial Aerobic 25%
Gram-positive cocci 85
Mixed aerobic/ anaerobic Streptococcus spp. 90
Aerobic cellulitis
Aerobic-cellulitis St
Streptococcus
t (G
(Group D) spp. 2
Anaerobic-abscess Staphylococcus spp. 6
Eikenella spp. 2
Gram-negative cocci (Neisseria spp.) 2
Gram-positive rods (Corynebacterium spp.) 3
Gram-negative rods (Haemophilus spp.) 6
Miscellaneous and undifferentiated 4
Excerpted from Contemporary Oral and Maxillofacial Surgery, Third Edition, 1998
Microorganisms Causing
Odontogenic Infections Progression
Anaerobic 75%
Gram-positive cocci 30
Streptococcus spp. 33 Periapical/periodontal
Peptostreptoccus spp. 65
Gram-negative cocci (Viellonella spp.) 4
Spread through least resistance
Gram positive rods
Gram-positive 14 Role of muscle attachments
Eubacterium spp.
Lactobacillus spp.
Actinomyces spp.
Clostridia spp.
Gram-negative rods 50
Bacteroides spp. 75
Fusobacterium spp. 25
Miscellaneous 6
Excerpted from Contemporary Oral and Maxillofacial Surgery, Third Edition, 1998
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Differences Between
Cellulitis and Abscess
Characteristic Cellulitis Abscess
Duration Acute Chronic
Pain Severe/generalized Localized
Size Large Small
Localization Diffuse borders Well circumscribed
Palpation Doughy to indurated Fluctuant
Presence of pus No Yes
Degree of seriousness Greater Less
Bacteria Aerobic Anaerobic
Excerpted from Contemporary Oral and Maxillofacial Surgery, Third Edition, 1998
Assessment Assessment
History Physical exam
Onset, duration, rapidity Vital signs
Previous treatment malaise
Medically compromised temp
tachycardia
Abcess vs. cellulitis
Radiographs
Fascial Spaces
Potential spaces
Bounded by muscle attachments;
bone
Spread to secondary neck spaces
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Vestibule Vestibule
Maxillary Spaces:
Canine Spaces
Usual source: canine
Boundaries: lev anguli oris; lev
labi superioris
Loss of nasolabial fold
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Maxillary Spaces:
Infratemporal Space
Usual source: maxillary third molar
Boundaries: skull base, lateral
pterygoid plate, continuous with
temporal space
Mandibular Spaces:
Buccal Space
Usual source: mandibular molar,
premolar
Boundaries: skin,
skin buccinator
muscle
Mandibular Spaces:
Submental Space
Usual source: mandibular incisors
Boundaries: skin, mylohold
muscle ant belly of digastrics
muscle,
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Mandibular Spaces:
Ludwigs Angina
Bilateral submandibular,
sublingual, submental spaces
Treat aggressively,
aggressively potential
airway compromise
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Mandibular Spaces:
Pterygomandibular Spaces
Usual source: mandibular molar,
premolar
Boundaries: medial mandible,
mandible
medial pterygoid
Trismus
Mandibular Spaces:
Masticator Space
Masseteric, Pterygomandibular,
Temporal spaces
Communicate
Non-specific
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Thank You
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