Infection Conception Trait Anatomy Arising Route Mutation Influence factors Diagnosis Principles Treatment Principles

Infectious agent(bacteria)Infectious agent(bacteria) HostHost

Inflammatory reactionInflammatory reaction

Elimination the infectious pathogenElimination the infectious pathogen Repair tissue injury Repair tissue injury

Hypersensitivity Autoimmune diseaseHypersensitivity Autoimmune disease

Beneficial

Harmful

protective and defensive

Oral and nasal cavity Tooth Space Blood and Lymphoid system Bacteria

Oral and nasal cavity Maxillary sinus

Temperature + Moisture

(Beneficial)

Reproduction + Developing

Bacteria---Exist

Alveolar bone

Soft tissue

Facial space

Alveolar bone

Soft tissue

Facial space

TootToot

hhCaries

Pulpitis

Apical infection

Caries

Pulpitis

Apical infection

Fascial space ---loose connective tissue

Among skin, maxillary and muscle

•Purulent--- spreading way

•Do not exist in healthy state

•Become filling during infection

Blood and lymphoid system

Beneficial

Abundance Harmful

Blood and lymphoid system

Beneficial

Abundance Harmful

Dangerous triangle

•Lacking valves

•Cavernous sinus

Dangerous triangle

•Lacking valves

•Cavernous sinus

Cavernous sinus thrombosisCavernous sinus thrombosis

Encephalic infectionEncephalic infection

Varied Numerous

Streptococcus hemolyticus Staphylococcus aureus Escherichia coli Anaerobe

• Sterile

• Simple

• Complex

• Sterile

• Simple

• Complex

Micro Micro

FloraFlora

Odontogenic infection

Adenogenous infection

Traumatic infection

Hematogenous infection

Iatrogenic infection

• Periapical infection

• Pericoronitis

• Periapical infection

• Pericoronitis

Acute-chronic

Periapical infection

Acute-chronic

Periapical infection

FistularFistular

CellulitisCellulitis

Intraoral soft tissue abscessIntraoral soft tissue abscess

OsteomyelitisOsteomyelitis

SepticemiaSepticemia

Deep fascial space infection

Deep fascial space infection

Ascending facial-cerebral infectionAscending facial-cerebral infection

Lower third molar Lower third molar

Local Signs and Symptoms

Systemical Signs and Symptoms

Pain Swelling Surface erythema Pus formation Limitation of motion

LocallyLocally

Fever Lymphadenopathy Malaise Toxic appearance Elevated white blood cell count

Acute stage Chronic stage

Host Antibiotic therapy Surgical drainage and incision

Migration of white blood cell Production of antibodies

Most important factor --- final outcome The infections--- cured by the host, not by antibiotics

Critical PrinciplesCritical Principles

Defense MechanismsDefense Mechanisms

causative organism sensitivity specific, narrow-spectrum antibiotic least toxic antibiotic drug history(success, allergic and toxic)

Antibiotic eraAntibiotic era

Proper dose Proper time interval Proper route of administration(oral, parenteral) Combination antibiotic therapy

How to judge the pus formation? Purposes of surgical drainage and incision Principles of surgical drainage and incision

Three stages

Inoculation

Cellulitis

Abscess

Duration--- >5 days Palpation---Fluctuant Appearance---Reddened Needle aspiration B-ultrasound CT

CharacteristicCharacteristic

Rid the body of toxic purulent material Decompress the tissues Allowing better perfusion of blood containing antibiotics

and defensive elements Increased oxygenation of the infected area

Ludwig’s anginaLudwig’s angina

Place the incision in an esthetically acceptable Place the incision in a dependent position to

encourage drainage by gravity Dissect bluntly through deeper tissues and explore all

portions of the abscess Place a drain and stabilize it with sutures

Principles of surgical drainage Principles of surgical drainage & incision& incision

Principles of surgical drainage Principles of surgical drainage & incision& incision

Lesion tooth---Impacted toothLesion tooth---Impacted tooth

OsteomyelitisOsteomyelitis

Chronic stage Chronic stage Chronic stage Chronic stage

Surgical removal of the focusSurgical removal of the focus

The trait of Infection Odontogenic infection mutation of infectious Diagnosis of the infection Diagnosis of the abscess formation The principles of the treatment

Infection in oral & maxillo-facial region