The buccal space was involved in 11 29% of 38 patients with mandibular infection. Buccal space the attachment of the buccinator muscle to the base of the alveolar process can control the spread of infection in the region of the mandibular and maxillary molars. Buccal space and submasseteric space infections represented 7. Buccal space infection can spread tofrom the teeth. Infection originating from incisors and canines of the mandible spreads buccally or lingually, due to the thin alveolar bone of the area. This space is filled with adipose tissue termed the buccal fat pad, the parotid duct, the facial artery and vein, lymphatic channels, the minor salivary glands and the branches of the facial and mandibular nerves. Severe soft tissue infections of the head and neck. Here we present a rare case of buccal space infection where in the culture reported. Most frequent causes of this space infection are the dental abscesses, pericornitis of mandibular molars and post surgical infections.
Submandibular space infections 30% were most frequently encountered followed by buccal 20%, submental 15%, and sublingual 10%. Normal lymph nodes were rarely discernible from the facial neurovascular bundles. This space is bounded laterally by the medial surface of the ramus of the mandible, medially by the medial pterygoid muscle, superiorly by the lateral pterygoid muscle, anteriorly by the pterygomandibular raphe, and posteriorly by the parotid gland. Feb 19, 2014 clinical features obliteration of nasolabial fold. Buccal space infection, ask a doctor about diagnosis. Scribd is the worlds largest social reading and publishing site. Role of ultrasound as a diagnostic tool in superficial. Masticator space infection always presents with trismus manifestation and is due to infection of the third molar of the mandible. Dec 19, 2016 buccal space infectioncause infection from maxillary premolars, molars and mandibular premolars if the roots are localized above the buccinator muscle insertion upper jaw or below insertion lower jaw infection spread into the soft tissues of the cheek along anatomical planes toward the infratemporal or pterygopalatine fossa. Computed tomographic assessment in deep space infections of odontogenic origin sankalp verma, ravi prakash sasankoti mohan, anchal singh, udita singh, neha agarwal department of oral medicine, diagnosis and radiology, kothiwal dental college and research centre, moradabad, uttar pradesh, india. This data is comparable with the data of other studies which report involvement of submandibular space infection in 54. There is also potential communication with the pterygomandibular region, infratemporal space, and the parapharyngeal space posteriorly. A diagnosis of a periapical infection with spread to the buccal space was made. The increasing age of most populations and an increasing rate of diseases.
To appraise causative microorganisms responsible for odontogenic space infections and to evaluate sensitivity and resistance to antibiotics used in the treatment. Buccal space associated with temporal space dumb bell shaped appearance. Fascial spaces of head and neck region classifiaction of. Space infections anatomical terms of location tongue. Sources of infections were of odontogenic origin in 92. Aetiopathogenesis and clinical pattern of orofacial. It has been reported that infection in a host in a compromised state is severely intractable 4, 8.
Submental space infection is characterized by a firm midline swelling beneath the chin and is due to infection from the mandibular incisors. Management of fascial space infections in a nigerian teaching. Space between buccinator and superficial fasciaskin. Under general anaesthesia a mucoperiosteal flap was raised. Infection arising from maxillary teeth only spread to the buccal space while from mandibular teeth can spread to any space including the buccal space. The relation of the root apices to the origins of the buccinator muscle determines whether infection exits intraorally into the buccal vestibule or extraorally into the buccal space see fig. Buccal space involvement was always associated with masseter muscle involvement table 2.
Mar 31, 2005 the buccal space is located lateral to the buccinator muscle and deep to the zygomaticus major muscle. Computed tomographic assessment in deep space infections. Cellulitis or abscess in buccal space space between buccinator and superficial fasciaskin. The buccal space is superficial to the buccinator muscle and deep to the platysma muscle and the. Factors contributing to the spread of odontogenic infections. The buccal space, extending from the mandible to the zygomatic arch and from the masseter muscle to the corner of the mouth, is still poorly understood although it plays a pivotal role for various plastic, reconstructive and aesthetic procedures. Research article microbiology and antibiotic sensitivity. Infections of the oral cavity, neck, and head infectious.
Space infection around the face local extension depends on the tooth involved. Pdf acute masticatory disorder is a general term that is used to describe ones inability to masticate. While odontogenic infections are daily encountered in dental and oral and maxillofacial surgery practices, some practitioners may be unfamiliar with the wide range of other infections of diverse etiology, some of them relatively uncommon, or even rare. It is quite likely that infection in a particular fascial space will spread to.
Surgical access to the buccal space infections may be easily accomplished through the intraoral approach. Lateral pharyngeal space was affected the site in a total of 8%, canine space in 5%, mesenteric in 4%, palatal 3%, and pterygoid in 2% sites. Updated anatomy of the buccal space and its implications. Other superficial odontogenic orofacial space infections include the buccal, submental, masticator, canine, and intratemporal spaces see figure 2. Teeth involved in various types of space infections. When the apices are found beneath the mylohyoid muscle second and third molar, the pus spreads towards the submandibular space, resulting in extraoral localization. It is quite likely that infection in a particular fascial space will spread to adjacent ones. The buccal space, also known as the buccinator space, is one of the seven suprahyoid deep compartments of the head and neck gross anatomy the buccal spaces are paired fatcontaining spaces on each side of the face forming cheeks. Buccal mucosa and masticator space anatomy iowa head and. Facial abscess and infection animal anatomy diseases and. Other muscles in the masticator space were less frequently involved in buccal space infection. Less frequently, benign lesions eg, hemangioma and dilated parotid ducts and softtissue malignancies eg, sarcoma manifested as buccal space masses. The buccal mucosa is bordered vertically by the maxillary and mandibular vestibular folds, whereas its anterior and posterior borders are formed by the outer commissure of the lips and the anterior. Aetiopathogenesis and clinical pattern of orofacial infectio ns 17 x spaces related to the maxilla soft tissue space infections related to the ma xilla and middle third of the face include canine fossa abscess, and buccal space infections infection can be localized in a single space.
The parapharyngeal space, also known as the prestyloid parapharyngeal space, is a deep compartment of the head and neck around which most other suprahyoid fascial spaces are arranged. The buccal space may serve as a conduit as there is a lack of fascial compartmentalization in the superior, inferior, and posterior directions, which permits the spread of pathology both to and from the buccal space. However, recurrent buccal space infections can be seen as a complication of crohns disease. Diagnosis and management of odontogenic oral and facial. A ct scan confirmed the infection in the buccal space. Fascial space infections are the most common cause of swellings in the head and neck region. Odontogenic infections and emergencies are a significant part of an oral and maxillofacial surgeons daily practice. In a series of 26 patients with unsuspected buccal space masses, salivary gland tumors were the most common masses. Infection of the buccal space is readily diagnosed because of marked cheek swelling with minimal trismus and systemic symptoms.
The buccal space is superficial to the buccinator muscle and deep to the platysma muscle and the skin. Facial abscess and infection free download as powerpoint presentation. Cellulitis of the buccal space occurs more often in patients buccal space is reported to be the most commonly involved fascial space by dental abscesses, although other sources report it is the submandibular space. Modern understanding of the fascial spaces of the head and neck developed from the landmark research of grodinsky and holyoke in the 1930s. Diagnosis and management of odontogenic oral and facial infections june 1, 2014 by william l. Space infections free download as powerpoint presentation. It is a potential space in the cheek, and is paired on each side. Bacterial infections of the oral mucosa constitute an increasing problem, especially among older people in most countries. Pterygomandibular space infection in this space is manifested. Fascial spaces and spread of dental infection youtube.
Computed tomographic assessment in deep space infections of. Dental infections in emergency medicine clinical presentation. Aetiopathogenesis and clinical pattern of orofacial infectio ns 17 x spaces related to the maxilla soft tissue space infections related to the ma xilla and middle third of the face include canine fossa abscess, and buccal space infections infection can be localized in a single space and can also spread to involve multiple spaces. Updated anatomy of the buccal space and its implications for plastic, reconstructive and aesthetic procedures. Later it may perforate the outer cortical bone and spread in various tissue spaces or discharge onto a free mucous membrane fascial spaces are fascia lined areas that can be eroded or distended by purulent exudate. They can range in severity from a mild buccal space infection to a severe lifethreatening multi space infection.
All dentists should be comfortable with prompt diagnosis and management of these types of infections. A retrospective cohort study li fong low, harshinie audimulam, hui woon lim, kalpana selvaraju, sathesh balasundram department of oral and maxillofacial surgery, hospital sultanah nora ismail batu pahat, johor, malaysia abstract maxillofacial space infection msi is one of the most common conditions. Aetiopathogenesis and clinical pattern of orofacial infections. The spread of odontogenic infections through fascial spaces can result in significant morbidity and risk of mortality if clinical management is inappropriate. Mar 09, 2017 the relative risk of fascial space infection is related to the location of the space in relation to the anatomy of the head and neck. Lowrisk anatomical areas include the region of the facial vestibule of the mandible, the body of the mandible, the buccal vestibule of the mandible, and the palate. Treatment of buccal space infections of odontogenic etiology in a patient with crohns or granulomatous disease may prove to be more challenging. Each space is enveloped by the superficial investing layer of the deep cervical fascia it is located between the buccinator and platysma muscles, therefore it is. Cervicofascial space infections cervicofacial cellulitis perimandibular infections due to the strategic position of the wisdom tooth 3rd molar at the junction of a number of different fascial spaces, any infection in this area must be taken seriously as an infection here can easily spread along the fascial planes and compromise the airway. The buccal space also termed the buccinator space is a fascial space of the head and neck sometimes also termed fascial spaces or tissue spaces. Updated anatomy of the buccal space and its implications for. Therefore periapical infections tend the perforate through the thinner labial plate most commonly into the vestibular space fig. The teeth involved in various types of space infections or space infections caused due to teeth. Infection of the inner lining of the cheek due to infection of the structures associated with the cheek eg.
Buccal space and submasseteric space infection represented 7. Dentoalveolar infections can be defined as pusproducing or pyogenic infections associated with the teeth and surrounding supporting structures, such as the periodontium and the alveolar bone. Other terms for these conditions include periapical abscess, apical abscess, chronic periapical dental infection, dental pyogenic infection, periapical periodontitis. Buccal space infection pdf into these spaces, which are. Muscular, ductal and neural tissues, an odontogenic infection or a cyst. Role of ultrasound as a diagnostic tool in superficial facial space infections m khaja khalid nawaz postgraduate student, department of oral and maxillofacial surgery, rajah muthiah dental college and hospital, annamalai university, chidambaram, tamil nadu, india infections. Fascial spaces of the head and neck pocket dentistry. Apr 22, 2017 this video highlights important fascial spaces and how dental infection can spread through them to mediastinum. Buccal space infections these arise primarily from mandibular or maxillary bicuspid or molar teeth, the apices of which lie outside of the buccinator muscle attachments.
Pdf management of odontogenic buccal space infection in. Case example of buccal fat flap palate reconstruction anatomy of the buccal mucosa. Management of odontogenic buccal space infection in patient with. If you have any doubts feel free to contact me or comment in the post, thanks for visiting. Pattern of odontogenic fascial space infections among a. Primary mandibular submental, sublingual, buccal, submandibular. Fascial infections derived from maxillary odontogenic. Management of odontogenic space infection with microbiology study.
Pterygomandibular abscess,anatomic location,etiology, clinical presentation and treatment anatomic location. Infections involving fascial spaces of the head and neck may give varying signs and symptoms depending upon the spaces involved. The infratemporal space is the inferior portion of the deep temporal space. The buccal space also termed the buccinator space is a fascial space of the head and neck sometimes also termed fascial tissue spaces or tissue spaces. Buccal mucosa and masticator space anatomy return to. Infections originating in either maxillary or mandibular teeth can spread into the buccal space, usually maxillary molars most commonly and premolars or mandibular premolars. Buccal space infection can be onl y a cause and the. Nocardia in buccal space abscess an oral manifestation.
Masticator space buccal space canine space parotid space submandibular space submental space vestibular space ludwigs angina not including deep head and neck infection considered in extensive infections. Buccal mucosa graft for urethral reconstruction return to. Buccal space infection is typically indicated by cheek edema and is due to infection. Pretreatment frontal view of patient with buccal space abscess with obliteration of. Pdf on jan 1, 2018, kalim ansari and others published management. Case report third molar tooth and buccal space infection. Shahriari and others published oral and maxillofacial infections.
Ct and mr imaging of the buccal space and buccal space masses. Original article aerobic microbiology and culture sensitivity. For example, ludwigs angina constitutes an infection that has spread to involve the submental and bilateral submandibular and sublingual spaces which could cause impingement and embarrassment of the airway figs. Odontogenic infections pdf free pdf epub medical books.
Submasseteric infections occupy the potential space between the lateral border of the mandible and the masseter muscle. Jan 04, 2018 buccal space infection is typically indicated by cheek edema and is due to infection of posterior teeth, usually premolar or molar. Bacterial infections of the oral mucosa request pdf. Pterygomandibular abscess free pdf epub medical books. Antimicrobial therapy and surgical management of odontogenic. Oct 08, 2010 a periapical xray of the carious revealed periapical rarefaction at the apex of the distal root. Dental abscess which penetrate the lingual cortical. Despite being rare, facial and neck fasciae spaces involved by infections from. Thirty patients referred to the oral and maxillofacial surgery department of modern dental college and research centre, indore over a period of two and a half years may 2008november 2010 with specific complaints of infectious symptoms diagnosed as orofacial space infection of odontogenic origin irrespective of their age and sex formed the study group.
Deep temporal space by extending superiodeep temporal space by extending superioposteriorly. Trismus difficulty opening the mouth is a sign that the muscles of mastication the muscles that move the jaw are involved. Jun 04, 2016 the buccal space may serve as a conduit as there is a lack of fascial compartmentalization in the superior, inferior, and posterior directions, which permits the spread of pathology both to and from the buccal space. Mcqs on odontogenic infections oral and maxillofacial. There is no real boundary between the buccal space and the submandibular space inferiorly. Infection can be mild buccal space infection or severe life threatening multi space infection. In some cases the nerve blocks which are giving lead to space infection as seen in pterygomandibular space and retrozygomatic space when the needle pierces the surrounding muscle and enters the space leading to infection. Buccal space infection pdf buccal space infection pdf buccal space infection pdf download. Teeth involved in various types of space infections space.
This video highlights important fascial spaces and how dental infection can spread through them to mediastinum. A case of 19yearold female patient is presented to show the involvement of medical assistance to treat buccal space infection which. Manisalisalivary duct fistula and recurrent buccal space infection. Infections in the buccal space and buccinator space are usually localised on the lateral side of the mandible. Infections of the oral cavity, neck, and head infectious disease. Odontogenic infections chapter 3 onur gonul, sertac aktop. A case of buccal abscess from an impacted wisdom tooth in an. Role of ultrasound as a diagnostic tool in superficial facial.
Odontogenic source maxillary second and third molars most common. Patient was followed up for a month and he was symptom free tablefig6. It consists largely of fat, neurovascular structures, and, in. Granulomatous lesions and ulcerations of the buccal mucosa can develop into true buccal space infections. Infection in this space has a dramatic appearance and may cause trismus. Buccal space associated with temporal space dumb bell shaped appearance due to lack of swelling over zygomatic arch. The buccal space is part of the subcutaneous space, which is continuous from.
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