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1 MAXILLOFACIAL INFECTIONS
3 Content
3 Maxillofacial infections. Introduction
3 Phlegmons and abscesses of the maxillary region
3 Phlegmons and abscesses of the mandibular region
4 MAXILLOFACIAL INFECTIONS. INTRODUCTION
9 Acute periapical periodontitis. Acute periapical periodontitis, also termed acute apical periodontitis, acute periradicular periodontitis, or symptomatic periapical periodontitis.
9 Chronic periapical periodontitis. Chronic periapical periodontitis, also termed chronic apical periodontitis, chronic periradicular periodontitis, or assymptomatic periapical periodontitis. A periapical granuloma (also termed an apical granuloma or a
57 Lymphadenitis
57 Causes of lymphadenitis
59 Pathophysiology
59 Symptoms of lymphadenitis
60 Diagnosis of lymphadenitis
60 Blood test for lymphadenitis
61 Submandibular lymphadenitis
61 Inguinal lymphadenitis
61 Acute lymphadenitis
61 Subacute lymphadenitis
62 Chronic lymphadenitis
62 Generalized lymphadenitis
62 Lymphadenitis of the face and neck
63 Lymphangitis and lymphadenitis
63 Odontogenic lymphadenitis
64 Treatment of lymphadenitis
65 Prevention of lymphadenitis
65 Prognosis of lymphadenitis
71 PHLEGMONS AND ABSCESSES OF THE MAXILLARY REGION
75 PHLEGMONS AND ABSCESSES OF THE MANDIBULAR REGION
118 Anatomy. The portion of the thorax defined as the mediastinum extends from the posterior aspect of the sternum to the anterior surface of the vertebral bodies and includes the paravertebral sulci when the locations of specific mediastinal masses are
119 Etiology.Risk factors for the development of mediastinitis in this setting include the following
120 Microbiology. Most mediastinitis cases involve gram-positive cocci, with Staphylococcus aureusand Staphylococcus epidermidis accounting for 70-80% of cases (see the image below).Mixed gram-positive and gram-negative infections account for approximate
121 History.Mediastinitis manifests within a spectrum that ranges from the subacute patient to the fulminant critically ill patient who requires immediate intervention in order to prevent death.
121 Physical Examination. Vital signs generally may show tachycardia and fever. In more advanced cases of sepsis, hypotension may be present, and the patient may require large volumes of crystalloid or vasopressor medication for support.
121 Laboratory Studies.A complete blood count (CBC) shows leukocytosis, often with a left shift on the white blood cell (WBC) count differential. The hematocrit value decreases if bleeding has occurred. The platelet count increases in the early stages of
122 Imaging Studies.Delays in the diagnosis of mediastinitis greatly increase morbidity and mortality. The condition is typically recognized because of high clinical awareness in susceptible populations. Occasionally, diagnostic imaging studies, includin
122 Chest radiography. Findings include pneumomediastinum and air-fluid levels within the mediastinum. Air-fluid levels are often best seen on lateral films. Mediastinal widening is not a reliable sign of mediastinitis, especially postoperatively.
122 Computed tomography. CT is more accurate for helping to identify air-fluid levels and pneumomediastinum. A CT scan may demonstrate sternal separation and substernal fluid collections. These examinations can be helpful when the diagnosis is in questio
122 Magnetic resonance imaging. Magnetic resonance imaging (MRI) is poorly suited as a diagnostic modality in persons with mediastinitis. Postoperatively, patients may have sternal wires, vascular clips, metallic valves, and pacing wires that contraindic
123 Approach Considerations. Operative exploration includes reopening the previous sternotomy and debridement of necrotic and infected tissue. The sternum is carefully separated from the ventricle bypass grafts and the aorta so as not to cause bleeding.
123 Medical Therapy.
124 Complications. Systemic sepsis is a major complication of mediastinitis and manifests with tachycardia, hypotension, poor urine output, and other signs of poor systemic perfusion. The aim of early aggressive therapy, both surgical and medical, is to
125 Etiology. Sepsis can be caused by an obvious injury or infection or a more complicated etiology such as perforation, compromise, or rupture of an intra-abdominal or pelvic structure. Other etiologies can include meningitis, head and neck infections,
125 Clinical Presentation.Individuals with sepsis may present with localizing symptoms related to a specific site or source of infection or may present with nonspecific symptoms. Individuals with nonspecific symptoms are usually acutely ill with fever an
126 Nonspecific signs and symptoms
126 Systemic signs and symptoms
127 Management
144 1. Clinical features of periapical periodontitis?
145 9. Histological features of periapical periodontitis?
145 1) granulation tissue
145 10. Radiological features of periapical periodontitis?
145 1) radiolucency around apex
145 2) loss of lamina dura
145 3) widening of PDL space
145 11. What is the purpose of radiograph examination of periodont?
145 12. What tissues of the periodontium can be evaluated radiographically?
146 Task №1. Define Periapical Periodontitis?
146 Task №2. What can Acute Periapical Periodontitis lead to?
146 Task №3.What can Chronic Periapical Periodontitis lead to?
146 Task №4. Management of Periapical Periodontitis?
146 Task №5. What are the components of an Apical Granuloma?
146 Task №6. What tissues of the periodontium can be evaluated radiographically?
153 2. What are sources of infection in the jaw?
153 3. Give the main clinical features of osteomyelitis
153 4. Aerobic bacteria which cause osteomyelitis include
154 6. Anaerobic bacteria which cause osteomyelitis include
156 Task №2. Define osteomyelitis.
156 Task №4.Why does osteomyelitis occur more often in the mandible than in the maxilla?
159 Task №5.What can acute purulent lymphadenitis lead to?
162 TOPIC
170 Тests
174 Task №1. A 27 years old patient complained of pain and swelling of soft tissues in the left submandibular region, an increase in body temperature to 37.3 ºС, malaise, and general weakness. Objectively
175 Which preliminary diagnosis based on the data presented in the condition of the task can be delivered to the patient?What is the treatment plan for the patient in this clinical situation?
175 Task №2. A 39 years old patient, visited adental surgeon with complaints of pain and swelling of the soft tissues of the right side of the face, limiting mouth opening, raising the body temperature to 38.4 C, weakness, nausea, and malaise. Objecti
175 What diagnosis on the basis of the data presented in the condition of the task can be delivered to the patient?What additional methods of examination in the specified clinical situation should the dental surgeon appoint to the patient?What is the tre
175 Task №3. A 19 years old patient visited a dental-surgeon with complaints about the thickening of the lower jaw to the left, which slowly increases. In the history there were periodic pains tooth Number 3.6, there was an edema of soft tissues, someti
176 What diagnosis on the basis of the data presented in the condition of the task can be delivered to the patient?What is the treatment plan for the patient in this clinical situation?
176 Task №4. A 24 years old patient visited a dental-surgeon with complaints about the presence of rounded formation (swelling) in the right submandibular region, which he discovered by accident. Objectively
176 What diagnosis on the basis of the data presented in the condition of the task can be delivered to the patient?What additional methods of examination in the specified clinical situation should the dentist-surgeon appoint to the patient?What is the tr
176 Task №5. The doctor prescribed anti-tuberculosis medications to the patient with cutaneous actinomycosis of the right cheek. Did he do it right?
178 10. Which of the following is NOT a common symptom of a sinus infection? Pain/pressure in the face
179 Answers
191 Maxillofacial infections
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Maxillofacial infections

Авторы: Кабанова А. А., Гончарова А. И., Флерьянович М. С., ... Мовсесян Н. А.
Торосян T. A.
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