1、Infection in Oral & Maxillofacial Region,Yu Chuang-Qi,Pandect,Infection- in oral & maxillofacial region,Infection Conception Trait Anatomy Arising Route Mutation Influence factors Diagnosis Principles Treatment Principles,Pandect,Infection-conception,Infectious agent(bacteria),Host,Inflammatory reac
2、tion,Elimination the infectious pathogen,Repair tissue injury,Hypersensitivity Autoimmune disease,Beneficial,Harmful,protective and defensive,Trait of anatomy,Oral and nasal cavity Tooth Space Blood and Lymphoid system Bacteria,Trait of anatomy,Oral and nasal cavity Maxillary sinus(上颌窦),Bacteria-Exi
3、st,Alveolar boneSoft tissueFascial space,Trait of anatomy,Tooth,CariesPulpitisApical infection,Trait of anatomy,Fascial space(间隙)-loose connective tissue Among skin, maxillary and muscle,Purulent- spreading way Do not exist in healthy state Become filling during infection,Trait of anatomy,Blood and
4、lymphoid systemBeneficial AbundanceHarmful,Dangerous triangle Lacking valves Cavernous sinus,Cavernous sinus thrombosis,Encephalic infection,Trait of pathogenic bacterium,Varied Numerous,Streptococcus hemolyticus(溶血性链球菌) Staphylococcus aureus(金黄色葡萄球菌) Escherichia coli(大肠杆菌) Anaerobe(厌氧菌),SterileSimp
5、le Complex,Flora(菌丛),Route of infection,Odontogenic infection Adenogenous(腺源性) infection Traumatic infection Hematogenous(血源性) infection Iatrogenic(医源性) infection,Odontogenic infection,Periapical infectionPericoronitis(冠周炎),Periapical infection,Pathways of Periapical infection,Pericoronitis (冠周炎),Lo
6、wer third molar,Infection-Arising,Host- defense system Microbe-virulence quantity Local circumstance,Balance Imbalance,Scale,Mutation,Influence factors Changing directions,Influence factors,Host- defense system Microbe-virulence quantity Treatment strategy,Changing directions,Localization and recove
7、ry Acute chronic Diffusion,Blood system-Septicemia lymphoid system-Lymphadenopathy,From submandible space infection to chest region,How to diagnose?,Local Signs and Symptoms Systemical Signs and Symptoms,Signs and Symptoms,Local Signs and Symptoms,Pain Swelling Surface erythema Pus formation Limitat
8、ion of motion,Locally,Systemical Signs and Symptoms,Fever Lymphadenopathy Malaise Toxic appearance Elevated white blood cell count,How to treat?,Acute stage Chronic stage,Acute stage,Host Antibiotic therapy Surgical drainage and incision,Host,Migration of white blood cell Production of antibodies,Mo
9、st important factor - final outcome The infections- cured by the host, not by antibiotics,Critical Principles,Defense Mechanisms,Principles for choosing appropriate antibiotic,causative organism(致病菌) sensitivity specific, narrow-spectrum antibiotic least toxic antibiotic drug history(success, allerg
10、ic and toxic),Antibiotic era,Principles of antibiotic administration,Proper dose Proper time interval Proper route of administration(oral, parenteral) Combination antibiotic therapy,Surgical drainage and incision,How to judge the pus formation? Purposes of surgical drainage and incision Principles o
11、f surgical drainage and incision,How to judge the pus formation?,Three stagesInoculationCellulitisAbscess,Duration- 5 daysPalpation-FluctuantAppearance-ReddenedNeedle aspirationB-ultrasoundCT,Characteristic,Fluctuant examination,Purposes of surgical drainage & incision,Rid the body of toxic purulent
12、 material Decompress the tissues Allowing better perfusion of blood containing antibiotics and defensive elements Increased oxygenation of the infected area,Infection in masseteric space,Infection in multi-space,Ludwigs angina,Principles of surgical drainage & incision,Place the incision in an esthe
13、tically acceptable Place the incision in a dependent position to encourage drainage by gravity Dissect bluntly through deeper tissues and explore all portions of the abscess Place a drain and stabilize it with sutures,Principles of surgical drainage & incision,Lesion tooth-Impacted tooth Osteomyelitis,Chronic stage,Surgical removal of the focus(病灶),Conclusion,The trait of Infection Odontogenic infection mutation of infectious Diagnosis of the infection Diagnosis of the abscess formation The principles of the treatment,Infection in oral & maxillo-facial region,Thank you,
