Routes of Spread of Dental Infection

Infection , supporting structure jaws

:- 1. Blood stream
2. Lymphatic vessels
3. Direct spread loose connective tissue
Direct Spread of Dental Infection
:- 1. alveolar bone
2. attachment maxilla mandible
(muscles of facial expression, mylohyoid muscle)
3.
4. floor nasal cavity maxillary sinus
Facial Muscles Related to Roof Apexes
Upper teeth
I : Sup. Incisive bundle
C,P : Quadratus labii superioris
Lavator anguli oris
M : Buccinator
Lower teeth
I,C : Inf. Incisive bundle
Mentalis
P : Depresser labii inferioris
Depresser anguli oris
M : Buccinator

Dental Infection
Relation of Mylohyoid Muscle Attachment to
Root Apexes of Lower Teeth
Potential Sites of Localization of Dental Infection
Oral vestibule
Nasal cavity
Maxillary sinus
Palate
Infection FACIAL SPACES
Upper Jaw
Lower Jaw
Oral vestibule
Infection FACIAL SPACES
Fascial Space
Boundaries of Facial Space :-
-Fascial layers or planes
-Muscles
-Bone
-Skin
-Mucous membrane
Contents of Fascial Space :-
-Nerves
-Blood vessels
-Lymphatic vessel, Lymph nodes
-Salivary glands
-Loose connective tissue
Infection
Fascial space Fascial space
:
- fascial plane
- blood vessels,
lymphatic vessels nerves
Fascial Spaces Related to
Dental Infection of Upper Jaw
Fascial Spaces Related to
Dental Infection of Lower Jaw
Boundaries: Flooor canine fossa
Roof Quadratus labii superioris, skin
Superior Origin of quadratus labii superioris
Inferior Orbicularis oris1
Canine Space
Contents: Levator anguli oris,Infraorbital nerve and vessels
Canine Space
Buccal Space
Boundaries : Lat. Skin, superficial fascia
Med. Buccinator
Sup. Zygomatic arch
Inf. Mandible
Ant. Zygomaticus major, depressor anguli oris
Post. Masseter
Buccal Space
Contents : Parotid duct
Buccal nerve of V3
Buccal branch of VII
Facial vessels
Buccal fat pad
Zygomaticotemporal(Retrozygomatic)Space
Boundaries: Ant. - maxilla, Zygomatic bone
Lat. - Insertion of Temporalis muscle
Zygomaticotemporal(Retrozygomatic)Space
Contents : Posterior suprerior alveolar nerve
and vessles buccal fat pad
Temporal Space
Superficial temporal space
Boundaries : Lat.-temporal fascia
Med.-Temporalis
Contents : Middle temporal vessel
Temporal Space
Deep temporal space
Boundaries : Lat. temporalis
Mid.- fascia deep surface
temporalis
Contents : Deeptemporal nerve and vessel
Submental Space
Boundaries : Lat. - Ant. Belly of digastric
Ant. Symphysis menti
Post. Hyoid bone
Roof Investing fascia
Floor Mylohyoid muscle
Contents : Submental lymph node and vessels
ant. Jugular veins
Sublingual Space
Boundaries : Roof Mucosa of floor of mouth
Floor Mylohyoid muscle
Med. Medial raphe of tongue,
genioglossus,geniohyoid,
styloglossus
Ant., Lat. Body of mandible
Post. Hyoid bone
Contents : Sublingual,Submandibular gland
Submandibular duct
Lingual nerve and vessels
Submandibular ganglion
Hypoglossal nerve
Submandibular Space
Boundaries : Ant.med. Ant. Belly of digastric
Post.med. Post. Belly of digastric, stylohyoid muscle
Sup.lat. Mandible
Floor Mylohyoid, hyoglossus,styloglossus
Roof Investing fascia
Contents : Submandibular salivary gland (superficial past)
Submandibular lymph nodes
Facial vessels
Hypoglossal nerve
Marginal mandibular branch of nerve VII
Submasseteric Apace
Boundaries : Lat. Superficial part of masseter
Med. Deep part of masseter
Ant. Mucosa of retromolar triangle of mandible
Post. Parotideomasseteric fascia
Pterygomandibular Space
Boundaries : Lat. - Mandibular ramus
Med. Med. Pterygoid muscle
Sup. Lat. Pterygoid muscle
Post. Parotid gland and its fascia
Ant. Buccinator, superior constrictor of
pharynx, pterygomandibular raphe,
buccopharyngeal fascia
Contents : Lingual nerve and vessels
Inf. Alveolar nerve and vessels
Maxillary vessels
Pterygoid venous plexus
Sphenomandibular ligament
Lateral Pharyngeal (parapharyngeal) Space
Boundaries : Med. Sup. Constrictor of pharynx
Lat. Med. Pterygoid muscle and
deep part of parotid gland
Post. Styoid process and its muscles,
carotid sheath
Ant. Pterygomandibular raphe
Sup. Base of skall
Inf. hyoid bone limit investing fascia
post. Belly of digastric and stylohyoid
Contents : Int. carotid a.
Int. jugular v.
Deep cervical lymph nodes
Nerve IX, X, XI, XII
Sympathetic chain
Pretracheal and Retropharyngeal Space
Boundaries : Ant. Strap muscles
Post. Trachea
Sup. Hyoid bone, thyroid cartilage
Inf. Superior mediastinum
Pretracheal Space
Retropharyngeal Space
Boundaries : Lat. Carotid sheaths
Ant. Constrictor muscles of pharynx,
buccopharyngeal fascia
Post. Prevertebral muscles and fascia
Sup. Base of skull
Inf. Posterior mediastinum
Pretracheal and Retropharyngeal Spaces
Retropharyngeal Space
Contents : Retropharyngeal lymph node
Pretracheal Space
Contents : Pretracheal lymph node
Communications
Infection fascial space
Fascial space
fascial plenes spaces
connective tissue ,
Cavernous Sinus
Infection teeth Periodontium
Superior mediastinum
Posterior mediastinum
Upper Canine
Canine space
Buccal space
Pterygomandibular space
Submandibular
space
Lateral pharyngeal
space
Retropharyngeal space
Superior mediastinum
Upper Molars
Buccal space
Retrozygomatic space
Temporal space
Ptergomandibular space
Submandibular space
Lateral pharyngeal space
Retropharyngeal space
Superior mediastinum
Lower
premolars
Sublingual space
Buccal space
Lower 1
st
+2
nd
molars
Submandibular space
Pterygomandibular space
Lower 3
rd
molar
Lateral pharyngeal space
Retropharyngeal space
Superior mediastinum