Spread Of Oral Infections Oral Pathology Essay Question And Answers

Spread Of Oral Infections Important Notes

  1. Ludwig’s angina
    • Ludwig’s angina is an overwhelming diffuse, suppurative cellulitis, which simultaneously involves the submandibular, sublingual, and submental space.
    • It produces a rapidly spreading, large, diffuse, and broad-like aggressive swelling; which involves the upper part of the neck and floor of the mouth bilaterally with brawny induration, swelling causes elevation of the tongue.
    • The enlarged tongue may protrude outside the mouth and the condition is called woody tongue.
    • Bull neck
    • Complications
      • Cavernous sinus thrombosis,
      • Meningitis,
      • Brain abscess and
      • Suppurative encephalitis, etc.
      • Death due to asphyxia
  2. Focal Infection
    • Metastases of microorganisms or their toxins from a localized site of infection to any distant part of the body with subsequent injury are called “focal infections.”
  3. Focus of Infection
    • A circumscribed area of tissue, which is infected by exogenous pathogenic organisms and is usually located near the skin or mucosal surface is called a focus of infection.
  4. Cellulitis
    • It is a diffuse inflammation of soft tissues that tends to spread through tissue spaces and along fascial planes
    • Causative organisms – streptococci and anaerobes
    • Clinical features
      • The patient is moderately ill with increased temperature and leukocytosis
      • Swelling is painful, diffuse, firm, and brawny
      • The overlying skin is inflamed
      • Regional lymphadenitis is present
      • Treatment
        • Administration of antibiotics
  5. Spread of infection
    Spread Of Oral Infections Spread Of Infections
  6. Maxillary sinusitis
    • It is an acute or chronic inflammation of sinusitis
    • Features
      • Moderate to severe pain in the sinus region
      • Discharge of pus into the nose with fetid breath
    • Water’s view is a radiographical technique used for it
    • Clouding of the maxillary sinus is seen over radiograph
  7. Cavernous sinus thrombosis
    • It is characterized by the formation of septic thrombi within the cavernous sinus and its numerous communicating branches
    • Sources of infection
      • External source
        • Infection from face
      • Internal source
        • Periapical abscess
        • Otitis media
        • Fracture of skull
        • Meningitis
        • Septicaemia
    • Clinical features
      • Tachycardia, tachypnoea
      • Stiffness of neck
      • Photophobia
      • Increased lacrimation
      • Proptosis
      • Chemosis
      • Dilatation of pupil
      • Paralysis of extraocular muscles
      • Fixation of eyeball
      • Complete paralysis of 3rd, 4rd and 6th cranial nerves

Spread Of Oral Infections Oral Pathology

Spread Of Oral Infections Short Question And Answers

Question 1. Describe in detail chronic osteomyelitis affecting the jaw.

Chronic Osteomyelitis

It is defined as the inflammation of bone and bone marrow along with the surrounding periosteum

Chronic Osteomyelitis: Osteomyelitis persisting for more than one month is known as chronic osteomyelitis

Chronic Osteomyelitis Causative Organism:

  • Staphylococci
  • Streptococci
  • Bacteroids
  • Actinomyces

Chronic Osteomyelitis Pathogenesis:

Spread Of Oral Infections Chronic Osteomyelitis Pathogenesis

Chronic Osteomyelitis Clinical Features:

  • Age- before 20 years of age
  • Site- Mandibular first molar is commonly affected
  • Fever, tachycardia
  • Mild and vague pain
  • Insidious in nature
  • jaw swelling
  • Mobility of teeth
  • Sinus tract formation
  • Purulent discharge
  • Anesthesia and paraesthesia of lip
  • The affected tooth is carious

Chronic Osteomyelitis Radiographic Features:

  • The moth-eaten appearance of lesion
  • Ill-defined radiolucency with ragged borders
  • Radiolucency with multiple radiopaque foci within it represents sequestra
  • A dense zone of radiopacity with faint radiolucency at the margin

Chronic Osteomyelitis Histopathology:

  • Accumulation of exudates and pus within medical spaces
  • Presence of inflammatory cells like lymphocytes, plasma cells, and macrophages
  • Formation of irregular bony trabeculae
  • Presence of sequestrum

Chronic OsteomyelitisTreatment:

  • Antibiotics- penicillin, metronidazole, clindamycin for 2-4 months
  • Sequestromy
  • cauterization of bone
  • decortication
  • Hyperbaric oxygen therapy

Read And Learn More: Oral Pathology Questions and Answers

Question 2. Ludwig’s angina

Ludwig’s angina

  • Ludwig’s angina was described by Wilhelm Fredrich Von Ludwig in 1836
  • It is rapidly spreading cellulitis invoking simultaneously submandibular, sublingual, and sub-mental spaces

Ludwig’s angina Etiology:

  • Odontogenic infections
  • Traumatic injuries
  • Infective conditions
  • Pathologic conditions

Ludwig’s angina Predisposing Factors:

  • Diabetes mellitus
  • HIV infection
  • Oral transplant
  • Aplastic anemia

Ludwig’s angina Pathogenesis

Spread Of Oral Infections Ludwig's Angina Pathogenesis

Ludwig’s angina Clinical Features:

  • Rapidly spreading, large, diffuse, and broad-like aggressive swelling
  • Elevation of tongue leading to open mouth appearance
  • Swollen area of the neck is firm, painful, and non fluctuant
  • Swelling is bilateral
  • Massive swelling in the neck above the hyoid bone results in bull neck
  • High fever with chills
  • Rapid pulse
  • Dysphagia
  • Sore throat
  • Hoarseness of voice
  • Stridor
  • Drooling of saliva

Ludwig’s angina Treatment:

  • High dose of antibiotics
  • Incision and drainage
  • Tracheostomy in case of airway obstruction

Question 3. Capillary and cavernous haemangiomas

Capillary and cavernous haemangiomas

Hemangiomas are relatively common benign proliferative lesions of vascular tissue origin

Capillary Haemangioma:

  • They begin as endothelial cell neoplasms that are absent at birth
  • Common in females
  • They exhibit two phases of growth
  • Proliferative phase
  • Occurs from 8-18 months
  • Characterized by the increased number of endothelial and mast cells
  • Involution phase
  • Characterized by slow regression of haemangioma
  • Decrease in endothelial and mast cell activity
  • Vascular spaces are lined with endothelial cells

Capillary Haemangioma Types:

  • Salmon’s patch
  • Port-wine stain
  • Strawberry angioma

Cavernous Haemangioma:

  • Occurs in areas of abundant venous space like lip, cheek, tongue, posterior triangle of neck
  • Age-3rd-5th decade of life
  • Swelling is compressible, bluish, warm and nontender
  • Associated with arteriovenous communication
  • Characterized by large, irregularly shaped, dilated, endothelial lining sinuses
  • Contains large aggregates of erythrocytes

Capillary Haemangioma Treatment

  • Injection of boiling water or hypertonic saline
  • Excision

Capillary Haemangioma Complications:

  • Ulceration
  • Bleeding
  • Infection
  • High-output cardiac failure

Question 4. Focal infection

Focal infection

Focal infection is a localized or general infection caused by the dissemination of micro-organisms or toxic products from a focus of infection

Focal infection Mechanism:

  • Spread of pathogenic micro-organisms from their primary site of infection to the distant part of the body via blood vessels or lymphatics
  • Spread of toxins liberated by the pathogenic microbes to distant organs either via blood vessels or lymphatics

Focal infection Significance:

  • It causes a great number of systemic diseases like
    • Arthritis
    • Valvular heart diseases
    • Gastrointestinal diseases
    • Ocular diseases
    • Skin diseases
    • Renal diseases

Question 5. Cellulitis

Cellulitis Definition: It is an acute, edematous, purulent inflammatory process that spreads diffusely through different tissue spaces

Cellulitis Sources of Infections:

  • Periapical abscess
  • Pericoronitis
  • Periodontal abscess
  • Osteomyelitis
  • Infected post-extraction wound
  • Gunshot injuries
  • Oral soft tissue infections
  • Blood borne infections

Cellulitis Clinical Features:

  • Large, diffuse, painful swelling over the face or neck
  • The overlying skin appears purplish
  • Fever, chills
  • Leukocytosis
  • Regional lymphadenopathy
  • Pus discharging sinuses

Cellulitis Complications:

  • Trismus
  • Dyspnoea
  • Dysphagia

Question 2 Spaces involved in Ludwig’s Angina

Spaces involved in Ludwig’s Angina

  • Spaces involved in Ludwig’s angina are
  • Submandibular spaces
  • Sub-lingual spaces
  • Sub-mental spaces

Question 3. Definitions: Focus of infection, focal infection

The focus of Infection:

  • Circumscribed area of tissue, which is infected by exogenous pathogenic organisms and is usually located near the skin or mucosal surface is called the focus of infection

Focal Infection:

  • It is a localized or general infection caused by the dissemination of micro-organisms or toxic products from a focus of infection


Spread Of Oral Infections Viva Voce

  1. 2nd and 3rd molars are the most common teeth for the source of infection.
  2. Submasseteric space is situated between the masseter muscle and the lateral surface of mandibular vaunts
  3. Canine space is between the anterior surface of the maxillary anti overly log levator muscle of the upper Up
  4. A tracheostomy is done to ease airway obstruction in Ludwig’s angina
  5. Cellulitis is a diffuse inflammation of soft tissues
  6. Pterygomandibular space lies between the inter not pterygoid muscle and ramus of the mandible
  7. Rheumatic fever occurs due to hypersensitization of tissues to hemolytic streptococci
  8. Subacute bacterial endocarditis is more often related to dental infection



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