??? ??????? Chapter 6 Infection in Oral and Maxillofacial Regions

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??? ???????Chapter 6 Infection in Oral and
Maxillofacial Regions
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??? ??( Conspectus)

• ????(Basic concept)
• ??(Infection)
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  ????????????????????

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??(Infection) Invasion by and
multiplication of pathogenic micro-organisms in a
bodily part or tissue, which may produce
subsequent tissue injury and progress to overt
disease through a variety of cellular or toxic
mechanisms.(??????) ??(Inflammation) A
localized protective reaction of tissue to
irritation, injury, or infection, characterized
by pain, redness, swelling, and sometimes loss of
function. (??????)
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?????(Dangerous triangular zone)
?????????,?????????,??????????( from nanal root
to bilateral oral angles )??????????????,????????
? .
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???????????????? Pathways and Pathogens of
Infection in Oral and Maxillofacial Regions

• (?)??????????
• ???(Dental genetic)
• ???(Adenoid genetic)
• ???(Injury genetic)
• ???(Hemal genetic)
• ???(Iatrogenic)

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Pathogenic microorganisms
Tooth
Periodontium
Pulp
Root apex

Alveolus
Maxillary / Mandible
Cellular spaces in oral and maxillofacial regions
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Progression of Odontogenic Infections
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Fascial Space Infections
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Progression of Odontogenic Infections
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Progression of Odontogenic Infections
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(?)???(Pathogens)

• ???(Aerobic bacteria)
• ???????(Staphylococci aureus)
• ??????(Haemolytic chain cocci)
• ????(Escherichia coli ,E coli)
• ???(Anaerobic bacteria)
• ????(Bacteroides)
• ????(Fusobacteria)
• ?????(Peptostreptococci )

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??????????????Clinical Features of Infection in
Oral and Maxillofacial Region

• (?)????(local symptoms)
• ???(acute phase)
• ?????????,?????????????????????????????(ab
  scess)??????
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• ??????????????,???(pus)?????
• ???????(staphylococci aureus)??????
• ???(chain cocci)?????????
• ????(aeruginosus bacillus )???????????
• ????(combining bacteria)???????????

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????????
Heat Redness
Swelling Pain Loss Of Func.

• ??? (chronic phase)
• ????,???????????????????????????????

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Progression of Odontogenic Infections

• Periapical
• Periodontal
• Soft tissue involvement
• Determined by perforation of the cortical bone in
  relation to the muscle attachments
• Cellulitis- acute, painful, diffuse borders
• Abscess- chronic, localized pain, fluctuant.

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(?)????(systemic symptoms)
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??????????????,??????????????????,??????,??????,??
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???????????? Diagnosis of Infection in Oral and
Maxillofacial Region

• (?)????(clinical examination)
• ????,????????????????????????????
• ?????,
• ??????????(fluctuance)
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  ??????
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(No Transcript)
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• (?)?????(laboratory examination)
• ????????????,???????? ?,????
• ??????,??????(drug sensitivity test
  )?????????????
• X?????????????????????????????????????

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Microbiologic Considerations

• Identification of bacteria
• Representative specimen collected
• Examine specimen
• Submit for culture and sensitivity
• Gram Stain

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????????????Treatment of Infection in Oral and
Maxillofacial Region

• (?)????(local treatment)
• ??????,??????,??????,???????(Furuncle)
  ??(carbuncle)?

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Surgical Treatment

• Provide drainage
• Remove the cause of infection
• Pulpectomy
• Extraction
• Remove foreign body
• Debride non-viable bone
• Culture and sensitivity

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Surgical Treatment
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• (?)????(operative treatment)
• ???????(Abscess incision drainage)
• ???????(Purpose of incision drainage)
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• ???????(Indication of incision drainage)
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• ???????(Demands of incision drainage)
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• ???????????,??????????????,???????????????????????
  ??????,???????,???????
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?.??(drains)??? ?????????????,?????????
??????????12?,??????13??????????????????
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• ????
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• ?????,????????,?????????????

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• (?)????(General treatment)
• ??????(antibacterial therapy)
• ????????
• ???????(the infection is of bacterial origin)
• ???????????????????(there is significant regional
  lymph node or systemic reactions, ie. body
  temperature is raised)
• ??????(spread is significant)
• ??????(appropriate local treatment has not been
  succesful)
• ???????(resistance is reduced)

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• ????????

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Principles of Antibiotic Therapy

• Administer the antibiotic properly
• Proper route of administration
• Proper dose
• Proper time interval
• Adequate period of administration

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