| normal residents of the oral cavity | bacterial taxa, several fungal species, few protozoal genera and many viruses |
| defined as the pathological state of disease caused by the invasion of pathogenic microorganisms within the body | Infection |
| Occurrence of infectious disease is determined by the | interaction of the host, the organism and the environment |
| A large proportion of infections of the _______ region are of odontogenic origin | head and neck |
| The routes by which the infection can spread are | lymphatic system, blood stream, directly through tissues |
| Factors affecting the ability of the infection to spread depend on | type and virulence of the organism, general health of the patient, anatomical site of the initial infection |
| Spread of Infection from Maxillary Teeth | maxillary sinus, canine fossa, palatal space, infratemporal fossa, buccal space, and vestibular space |
| spread of cavernous sinus thrombosis from | infratemporal fossa, canine fossa |
| Spread of Infection from Mandibular Teeth | vestibular and buccal space, pterygomandibular space, sublingual space, submandibular space, and submental space |
| submandibular spaces | sublingual, submental, and submandibular spaces |
| inflammation of bone caused by an infecting organism. | OSTEOMYELITIS |
| localized inflammation of bone; spread to marrow, cortex, periosteum and soft tissue | ACUTE OSTEOMYELITIS |
| ACUTE OSTEOMYELITIS (ETIOLOGY): Acute inflammation of the bone and bone marrow of the mandible and maxilla results most often from extension of a | periapical abscess |
| ACUTE OSTEOMYELITIS (ETIOLOGY): The second most common cause of acute osteomyelitis is ____ | physical injury |
| ACUTE OSTEOMYELITIS (ETIOLOGY): bacteria | staphylococci and streptococci |
| ACUTE OSTEOMYELITIS (ETIOLOGY): It can occur in normal daily activities such as conduction oral hygiene and after minor medical procedure. | bacteremia |
| ACUTE OSTEOMYELITIS: primary feature of this inflammatory process | Pain |
| ACUTE OSTEOMYELITIS: Other signs and symptoms of acute infection are commonly present | Pyrexia, painful lymphadenopathy, leukocytosis |
| ACUTE OSTEOMYELITIS: Paresthesia of the lower lip occasionally occurs with mandibular involvement. In the development of a clinical differential diagnosis, the presence of this symptom should also suggest malignant _______. | mandibular neoplasms |
| True or False: Acute osteomyelitis cannot be seen radiographically | True |
| ACUTE OSTEOMYELITIS(histology):occupies the marrow spaces | purulent exudate |
| ACUTE OSTEOMYELITIS(histology):Bony trabeculae show reduced _______ and increased ________ | osteoblastic activity; osteoclastic resorption |
| ACUTE OSTEOMYELITIS(histology):If an area of bone necrosis occurs (sequestrum), osteocytes are lost and the marrow undergoes _____. | liquefaction |
| ACUTE OSTEOMYELITIS(Treatment): most frequently used antibiotic for the treatment of osteomyelitis caused by MRSA. | Vancomycin |
| ACUTE OSTEOMYELITIS(Treatment): glycopeptide that must be administered intravenously and has a serum half-life of 6 hours | Vancomycin |
| ACUTE OSTEOMYELITIS(Treatment): Surgery | sequestrectomy; excision with autologous bone replacement |
| It is a suppurative infection, but suppuration is generally limited and may cease in quiescent periods | CHRONIC OSTEOMYELITIS |
| A defensive response that leads to production of granulation tissue which subsequently forms dense scar tissue in an attempt to wall off the infected area | CHRONIC OSTEOMYELITIS |
| sequelae of acute osteomyelitis | CHRONIC OSTEOMYELITIS |
| It is an unusual reaction of bone to infection, tissue reacts to infection by proliferation rather than destruction. | CHRONIC FOCAL SCLEROSING OSTEOMYELITIS |
| other name for CHRONIC FOCAL SCLEROSING OSTEOMYELITIS | Condensing Osteitis |
| usually the tooth involved in Condensing Osteitis | Mandibular first molars |
| Condensing Osteitis is usually found through | routine radiographic examination |
| Radiographic Features: Well circumscribed radiopaque mass of sclerotic bone surrounding and extending below the apex of the root | CHRONIC FOCAL SCLEROSING OSTEOMYELITIS |
| Radiographic Features: Radiopacity stands in distinct contrast to the trabeculation of normal bone | CHRONIC FOCAL SCLEROSING OSTEOMYELITIS |
| CHRONIC FOCAL SCLEROSING OSTEOMYELITIS: PDL | Widened |
| CHRONIC FOCAL SCLEROSING OSTEOMYELITIS(Histologic Features): dense, irregular bone with some intermingled | fibrous tissue |
| CHRONIC FOCAL SCLEROSING OSTEOMYELITIS(Histologic Features): Dense mass of bony trabeculae with little _____ tissue. | interstitial marrow |
| CHRONIC FOCAL SCLEROSING OSTEOMYELITIS(Histologic Features): If the interstitial soft tissue is present then it is generally _________ with a small number of only lymphocytes. | fibrotic and infiltrated |
| CHRONIC FOCAL SCLEROSING OSTEOMYELITIS: treatment | treated endodontically or can be extracted |
| CHRONIC FOCAL SCLEROSING OSTEOMYELITIS: The dense area of bone is sometimes not removed ( can be recognized on radiograph even after years which is called a _____). | bone scar |
| Inflammatory disease characterized by recurrent episodes of intense pain in the mandible | CHRONIC DIFFUSE SCLEROSING OSTEOMYELITIS |
| Analogous focal form and also represents a proliferative reaction of bone to low grade infection | CHRONIC DIFFUSE SCLEROSING OSTEOMYELITIS |
| CHRONIC DIFFUSE SCLEROSING OSTEOMYELITIS portal of entry | diffuse periodontal disease |
| CHRONIC DIFFUSE SCLEROSING OSTEOMYELITIS: common in what age | older |
| CHRONIC DIFFUSE SCLEROSING OSTEOMYELITIS: Specifically seen in association with | edentulous mandibular jaw or edentulous area |
| CHRONIC DIFFUSE SCLEROSING OSTEOMYELITIS: radiographic appearance from diffuse, patchy sclerosis of the bone | Cotton wool appearance |
| CHRONIC DIFFUSE SCLEROSING OSTEOMYELITIS: diffused/ well defined | diffused |
| CHRONIC DIFFUSE SCLEROSING OSTEOMYELITIS(histological features): Dense, irregular trabeculae of bone, some of which are boarded by an active layer of _____. | osteoblast |
| CHRONIC DIFFUSE SCLEROSING OSTEOMYELITIS(histological features):Focal areas of _____ activities are often seen | osteoclastic |
| CHRONIC DIFFUSE SCLEROSING OSTEOMYELITIS (histological features): Bone in some lesions shows a _______due to the repeated periods of resorption followed by repair. | Mosaic Pattern |
| CHRONIC DIFFUSE SCLEROSING OSTEOMYELITIS: treatment that stops inflammation | NSAIDs, TNF inhibitors |
| CHRONIC DIFFUSE SCLEROSING OSTEOMYELITIS: treatment that prevents loss of bone density | bisphosphonates |
| is a diffuse inflammation of soft tissues which is not circumscribed or confined to one area in contrast to the abscess, it tends to spread through tissue spaces and along fascial planes | CELLULITIS (PHLEGMON) |
| It occurs as a result of infection by microorganisms that produce significant amounts of streptokinase, hyaluronidase, fibrinolysins, the universal intercellular cement substance, and fibrin. | CELLULITIS (PHLEGMON) |
| Potent producers of hyaluronidase; common causative organism in cases of cellulitis. | Streptococci |
| Anaerobic Microbes (____) that destroy collagen. | Prevotella and Porphyromonas |
| Cellulitis of face and neck are most commonly cause of | apical abscess or osteomyelitis or periodontal infection; Tooth extraction (infected); Jaw fracture |
| CELLULITIS(clinical features):Painful swelling of the soft tissues involved that are _____ and ______ | firm and brawny |
| Clinical Features: The skin is inflamed, has an orange peel appearance and is even purplish sometimes, if the superficial tissue spaces are involved. | CELLULITIS (PHLEGMON) |
| CELLULITIS: usually present | Regional lymphadenitis |
| CELLULITIS(MAXILLA): There is a perforation of ______ above the buccinator | outer cortical plate |
| CELLULITIS(MAXILLA): There is swelling on the _____ of the face | upper half |
| CELLULITIS(MAXILLA): extends towards the | eye |
| CELLULITIS(MANDIBULAR): A perforation below the | buccinator |
| CELLULITIS(MANDIBULAR): Shows a swelling on the _____ of the face | lower half |
| CELLULITIS(HISTOLOGIC):CELLS | polymorphonuclear leukocytes, lymphocytes, serous fluid and fibrin |
| CELLULITIS: WHAT NOT TO DO | not to massage the affected area with any medication |
| LUDWIG’S ANGINA is named after the german physicist | Wilhelm Friedrich von Ludwig |
| an acute, potentially life threatening, toxic cellulitis, beginning usually in the submandibular space and secondarily involving the sublingual and submental spaces as well | LUDWIG’S ANGINA |
| LUDWIG’S ANGINA: involvement of a _______, either periapical or periodontal | mandibular molar |
| LUDWIG’S ANGINA is a sequelae of | submandibular gland sialadenitis, oral soft tissue lacerations, intaoral and perioral piercing |
| LUDWIG’S ANGINA(location): rapidly developing board-like swelling | floor of the mouth and consequent elevation of the tongue. |
| LUDWIG’S ANGINA: swelling involves the | neck, and edema of the glottis |
| LUDWIG’S ANGINA(histopathology): | Streptococci, Fusiform bacilli and spiral forms, various staphylococci, diphtheroids |
| LUDWIG’S ANGINA: treatment | maintenance of airway, antibiotic therapy, extraction, surgical drainage, tracheotomy |
| A serious condition consisting in the formation of a thrombus in the cavernous sinus or its communicating branches. It can sometimes originate from an upper anterior tooth, the sinuses or nose | CAVERNOUS SINUS THROMBOSIS |
| CAVERNOUS SINUS THROMBOSIS: etiology | Infections of the head, face, and intraoral structures above the maxilla |
| routes by which the infection may reach the cavernous sinus:_____________ carry infection from the face and lip | Facial and angular veins |
| routes by which the infection may reach the cavernous sinus: Dental infection is carried by way of the _____ | pterygoid plexus. |
| CAVERNOUS SINUS THROMBOSIS(clinical features): oedema of the eyelid is associated with _____ | pulsatile exophthalmos |
| CAVERNOUS SINUS THROMBOSIS: Treatment | antibiotics, anticoagulants, surgery |
| infection or inflammation of the paranasal sinuses or the hollow spaces within the bones of the head surrounding the nose. | Sinusitis |
| ACUTE MAXILLARY SINUSITIS is also known as | rhinosinusitis |
| ACUTE MAXILLARY SINUSITIS: bacteria | S. pneumoniae, H. influenzae, and Moraxella catarrhalis |
| ACUTE MAXILLARY SINUSITIS: patients may feel numbness in _______________ | maxillary molars and premolars |
| ACUTE MAXILLARY SINUSITIS(Symptoms): A sense of fullness or tension around the affected sinus, aggravated on stooping or coughing | Local |
| ACUTE MAXILLARY SINUSITIS(Symptoms): Rise of temperature, pulse rate and other symptoms of generalized toxemia. | Generalized |
| ACUTE MAXILLARY SINUSITIS(Examinations): Anterior Rhinoscopy shows congestion and swelling of the | nasal mucosa |
| ACUTE MAXILLARY SINUSITIS(Examinations): Posterior Rhinoscopy shows ____________- sticking to the boundaries of the post | generalized congestion and discharge |
| A small bulb placed in patient’s mouth in a dark room lits the skull and sinuses | Tran-illumination Test |
| Ultrasonic examination of sinus to differentiate fluid or mucosal thickening from a solid growth. | Sinogram |
| Physical examination of sinus by a fibroptic sinoscope | Sinoscopy |
| Imaging studies are indicated for refractory or recurrent sinusitis | CT Scan |
| Used to access soft tissues changes and to evaluate the extent of sinus tumor. | MRI Scan |
| ACUTE MAXILLARY SINUSITIS(histopathology): | squamous metaplasia of the specialized ciliated columnar epithelium |
| ACUTE MAXILLARY SINUSITIS(treatment): | antibiotics, nasal sprays, decongestants |
| Sinusitis of more than three months duration | CHRONIC MAXILLARY SINUSITIS |
| dystrophic calcification | antrolith |
| CHRONIC MAXILLARY SINUSITIS: histopathology | polyps |
| hyperplastic granulation tissue with lymphocytic and sometimes plasma cell infiltration | polyps |
