scholarly journals Retrograde Spread of Buccal Space Infection into Temporal Space with Temporal Muscle Necrosis in a Medically Compromised Patient - A Case Report

2021 ◽  
Vol 10 (37) ◽  
pp. 3301-3305
Author(s):  
Arrvinthan S. U.
Keyword(s):  
Surgical Drainage ◽  
Deep Space ◽  
Temporal Muscle ◽  
Space Infection ◽  
Maxillary Molars ◽  
Temporal Space ◽  
Mandibular Molar ◽  
Patient Reported ◽  
Buccal Space ◽  
Retrograde Spread

Superficial temporal space lies between the temporal fasciae. Abscess in the temporal and infratemporal space is very rare. They develop as a result of the extraction of infected maxillary molars. Temporal space infections or abscesses can be seen in the superficial or deep temporal regions. A 65 - year - old male patient reported with a complaint of painful swelling over the right cheek and restricted mouth opening with a history of extraction of second mandibular molar before four weeks. On examination, an ill-defined diffuse swelling was seen. Treatment was started with IV empirical antibiotics and planned for surgical drainage. Surgical drainage of the abscess in the temporal space was done along with debridement of the necrosed temporalis muscle. Infections of the maxillofacial region are of great significance to general dentists and maxillofacial surgeons. They are of clinical importance as they are commonly encountered, and are also challenging as timely intervention is needed to prevent fatal complications. The infections arising from the tooth are initially confined to the alveolar bone and surrounding periosteum. They spread along the path of the least resistance to the cortical plates. Once the infection penetrates the cortical plates, they reach the muscle plane.1 If the infection perforated is above the muscle attachments, it’s confined to an intraoral abscess. If the cortical plates are perforated below the muscular attachments, extraoral swelling develops. The next barrier is the periosteum which is strong and elastic in nature. Once the periosteum is breached, infections reach the soft tissue planes, the fascia. Most of the infections are confined to a particular space and the surrounding fascia. Based on the toxins produced by the microorganisms, the infection can spread to adjacent spaces and even retrograde. Common deep space infections are Ludwig's angina followed by peritonsillar, submandibular, and parotid abscesses. 2 Infratemporal and temporal space infections are rarely compared to other deep space infections. Many etiological factors form the base for the infections of deep spaces, dental caries, extraction of infected, non-infected tooth maxillary sinusitis, tonsillitis, maxillary sinus fracture, temporomandibular arthroscopy, drug-induced infections. Infections of odontogenic origin, spreading along infratemporal and temporal space are most common with maxillary molars followed by mandibular molars. We report a case of retrograde spread of buccal space infection into temporal space secondary to mandibular tooth extraction.

scholarly journals Retrograde Spread of Buccal Space Infection into Temporal Space with Temporal Muscle Necrosis in a Medically Compromised Patient - A Case Report

2021 ◽  
Vol 10 (37) ◽  
pp. 3301-3305
Author(s):  
Arrvinthan S. U. ◽  
Lokesh Bhanumurthy ◽  
Jimson Samson ◽  
Anandh Balasubramanian
Keyword(s):  
Surgical Drainage ◽  
Deep Space ◽  
Temporal Muscle ◽  
Space Infection ◽  
Maxillary Molars ◽  
Temporal Space ◽  
Mandibular Molar ◽  
Patient Reported ◽  
Buccal Space ◽  
Retrograde Spread

Superficial temporal space lies between the temporal fasciae. Abscess in the temporal and infratemporal space is very rare. They develop as a result of the extraction of infected maxillary molars. Temporal space infections or abscesses can be seen in the superficial or deep temporal regions. A 65 - year - old male patient reported with a complaint of painful swelling over the right cheek and restricted mouth opening with a history of extraction of second mandibular molar before four weeks. On examination, an ill-defined diffuse swelling was seen. Treatment was started with IV empirical antibiotics and planned for surgical drainage. Surgical drainage of the abscess in the temporal space was done along with debridement of the necrosed temporalis muscle. Infections of the maxillofacial region are of great significance to general dentists and maxillofacial surgeons. They are of clinical importance as they are commonly encountered, and are also challenging as timely intervention is needed to prevent fatal complications. The infections arising from the tooth are initially confined to the alveolar bone and surrounding periosteum. They spread along the path of the least resistance to the cortical plates. Once the infection penetrates the cortical plates, they reach the muscle plane.1 If the infection perforated is above the muscle attachments, it’s confined to an intraoral abscess. If the cortical plates are perforated below the muscular attachments, extraoral swelling develops. The next barrier is the periosteum which is strong and elastic in nature. Once the periosteum is breached, infections reach the soft tissue planes, the fascia. Most of the infections are confined to a particular space and the surrounding fascia. Based on the toxins produced by the microorganisms, the infection can spread to adjacent spaces and even retrograde. Common deep space infections are Ludwig's angina followed by peritonsillar, submandibular, and parotid abscesses. 2 Infratemporal and temporal space infections are rarely compared to other deep space infections. Many etiological factors form the base for the infections of deep spaces, dental caries, extraction of infected, non-infected tooth maxillary sinusitis, tonsillitis, maxillary sinus fracture, temporomandibular arthroscopy, drug-induced infections. Infections of odontogenic origin, spreading along infratemporal and temporal space are most common with maxillary molars followed by mandibular molars. We report a case of retrograde spread of buccal space infection into temporal space secondary to mandibular tooth extraction.

scholarly journals A rare case of temporal and infratemporal space abscess secondary to masseteric space infection

2020 ◽  
Vol 6 (2) ◽  
pp. 384
Author(s):  
Mada Lakshmi Narayana ◽  
Urvashi Gaur ◽  
N. Reddy Chaithanya ◽  
Addanki Lakshmi Sravani
Keyword(s):  
Mouth Opening ◽  
Cervical Lymphadenopathy ◽  
Temporal Region ◽  
Parotid Region ◽  
Space Infection ◽  
Maxillary Molars ◽  
Temporal Space ◽  
Mandibular Molar ◽  
Parotid Swelling ◽  
Empirical Antibiotics

Abscess in the temporal and infratemporal space are very rare. They develop as a result of the extraction of infected maxillary molars. Temporal space infections or abscess can be seen in the superficial or deep temporal regions. A 27-year-old lady who had undergone extraction of 2nd mandibular molar five days ago came with complaints of painful swelling over left cheek and restricted mouth opening. On examination, an ill-defined diffuse parotid swelling was seen and treated with empirical antibiotics for which patient didn't respond. On examination, a diffuse hourglass swelling was seen extending from left parotid region to temporal region. CT scan revealed a bulky parotid gland with abscess involving parotid, masticator, infratemporal and temporal scalp region with reactive cervical lymphadenopathy on the left side. Surgical drainage of the abscess was done from the temporal space; subsequently, all other space abscess resolved. On conclusion, masseteric space infection leads to infratemporal and temporal space abscess as they communicate. Drainage of abscess from temporal space is adequate to resolve the abscess from other masticator spaces.

scholarly journals Temporalis space infection secondary to an undiagnosed intra-oral foreign object – a case report

2021 ◽  
Vol 94 (2) ◽  
pp. 260-266
Author(s):  
Anupam Singh ◽  
Sreea Roy ◽  
G Srikanth ◽  
Shruti Gunashekhar ◽  
Komal Smriti
Keyword(s):  
Case Report ◽  
Management Strategy ◽  
Conventional Imaging ◽  
Foreign Object ◽  
Object A ◽  
Space Infection ◽  
Foreign Objects ◽  
Temporal Space ◽  
Wooden Object ◽  
Buccal Space

The penetration of foreign objects is one of the leading causes of maxillofacial infection following trauma. Failure to detect such objects at initial stages can lead to complications like abscess formation, cellulitis, or space infections. Detection is even more complicated if the patient presents to the maxillofacial center after a delay of days or weeks following trauma. Sole reliance on radiographs or CT can be inconclusive as most of these objects are radiolucent and can be difficult to detect even by the experienced radiologists. We report the case of a patient who had an unwitnessed trauma and presented to our center 7 days after the incident, with signs of buccal space infection. Failure to detect the embedded intra-oral wooden object at an earlier stage led to the propagation of infection to superficial temporal space. The management strategy and pitfalls associated with conventional imaging in detecting wooden object are discussed.

scholarly journals Inferior alveolar nerve paraesthesia after overfilling into the mandibular canal, confirmed by cone-beam computed tomography: a case report

2021 ◽  
Vol 24 (2) ◽  
Author(s):  
Claudemir de Souza Júnior ◽  
Ricardo Machado ◽  
Renee Ashley Batts ◽  
Lucas da Fonseca Roberti Garcia
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
Cone Beam Computed Tomography ◽  
Root Canal ◽  
Inferior Alveolar Nerve ◽  
Mandibular Canal ◽  
Cone Beam ◽  
Filling Material ◽  
Mandibular Molar ◽  
Patient Reported

The filling material should be restricted to the root canal, and not extend to the periradicular tissues. Overextension occurs when there is an overflow of gutta-percha and sealer, whereas overfilling refers to the overflow only of sealer beyond the apical foramen. Both may cause several negative clinical consequences. Nevertheless, an accurate diagnosis of where they occurred cannot always be performed by conventional radiographic examination, because of the two-dimensional aspect of the image. This paper describes a clinical case of labiomandibular paraesthesia after overfilling into the mandibular canal (MC), as diagnosed by cone-beam computed tomography (CBCT), later used to perform the treatment planning. A 34-year-old Caucasian female patient sought a private dental clinic complaining of pain in the right mandibular posterior region. After taking the anamnesis and performing clinical and radiographic exams, the patient was diagnosed with pulp necrosis in the second right mandibular molar, and underwent root canal treatment. The final radiography showed overextension or overfilling, probably into the MC. About 2 hours after the procedure, the patient reported paraesthesia of her lower right lip and chin. A CBCT confirmed a small overfilling into the MC. For this reason, vitamin B12 was prescribed as the first treatment option. After 7 days, the patient reported a significant decrease in paraesthesia, and was completely normal after 15 days. This case report shows that CBCT is an effective radiographic diagnostic tool that can be used as an alternative in clinical cases of labiomandibular paraesthesia caused by overextension or overfilling.   Keywords Endodontic treatment; Overfilling; Paraesthesia; Conebeam computed tomography.

scholarly journals Adequacy of molar distalization after second and third molar eruption- a case report

2018 ◽  
Vol 6 (2) ◽  
pp. 50
Author(s):  
Sarath Babu Balina ◽  
Durga Harsha G V ◽  
Padmapriya C V ◽  
Varma DPK ◽  
Goutham C V
Keyword(s):  
Third Molar ◽  
Class Ii ◽  
Class Ii Malocclusion ◽  
Average Growth ◽  
Mini Implants ◽  
Maxillary Molars ◽  
Extraction Therapy ◽  
Patient Reported ◽  
Maxilla And Mandible ◽  
Third Molar Eruption

Adult patients with class II malocclusion can be treated routinely by extraction therapy. In the recent decades there was increasing popularity towards non-extraction treatment. Distalization of maxillary molars is one of the prime treatment modality to correct mild to moderate class II malocclusion cases with esthetically acceptable profile. A 16 years old female patient reported with irregularly placed upper front teeth and was diagnosed as Angle’s Class II malocclusion with orthognathic maxilla and mandible, average growth pattern. Treatment was planned to distalize the entire maxillary arch using mini implants as skeletal anchorage. 4.0 mm of maxillary molars were distalized, class I molar and canine relation were achieved bilaterally within span of 10 months without altering the patient’s existing profile.  

scholarly journals Anchoretic Infection

2012 ◽  
Vol 2012 ◽  
pp. 1-4
Author(s):  
S. Gokkulakrishnan ◽  
Ashish Sharma ◽  
Satish Kumaran ◽  
P. L. Vasundhar
Keyword(s):  
English Literature ◽  
Maxillofacial Surgery ◽  
Mouth Opening ◽  
Unknown Etiology ◽  
Oral And Maxillofacial Surgery ◽  
Basic Principles ◽  
Limited Mouth Opening ◽  
Space Infection ◽  
Temporal Space ◽  
Long Run

Active and passive mouth opening exercises are a very common practice in oral and maxillofacial surgery especially for various conditions causing limited mouth opening like space infections, trauma, and ankylosis. But most of the practitioners do not follow basic principles while advocating these active mouth opening exercises and also take it for granted that it would benefit the patient in the long run. Because of this, the mouth opening physiotherapy by itself can at times lead to unwanted complications. We report a case wherein due to active physiotherapy, the patient had complications leading to persistent temporal space infection which required surgical intervention and hospitalization. This could have been because of hematoma formation during physiotherapy which got infected due to anchoretic infection of unknown etiology and resulted in temporal space infection. Hence, our conclusion is that whenever mouth opening exercises are initiated, it should be done gradually under good antibiotic coverage to avoid any untoward complications and for optimum results. According to the current English literature, such a complication has not been documented before.

scholarly journals Late removal of an upper third molar displaced into the infratemporal space using an intermaxillary fixation screw: a case report

2020 ◽  
Vol 9 (11) ◽  
pp. e129119457
Author(s):  
Eduardo Dallazen ◽  
Vinícius Almeida Carvalho ◽  
Eduardo Hochuli-Vieira ◽  
Cristian Statkievcz ◽  
Cecília Luiz Pereira-Stabile ◽  
...  
Keyword(s):  
Surgical Techniques ◽  
Third Molar ◽  
Mouth Opening ◽  
Mandibular Movement ◽  
Intermaxillary Fixation ◽  
Temporal Space ◽  
Intraoral Approach ◽  
Computer Tomography Scan ◽  
Patient Reported ◽  
Fixation Screw

Teeth displacement during extractions even tough rare are extremely unwanted, especially for infra temporal space. This accident generally necessitate additional treatment for their resolution, being either immediate or late. Several authors discribed surgical techniques for removal displaced teeth into the infratemporal space, varying according to the degree of displacement, being that in some of this cases, is necessary the utilization of complementary tools. This case describes the technique utilized for late removal of tooth 18 (upper right third molar) dislocated into the lower portion of the infratemporal space (confirmed by the Cone Bean Computer tomography Scan), exam was performed after the patient reported pain in the operated region and during mandibular movement too, with an interincisal opening maximum of 20 millimeters. The procedure was realized under local anesthesia by a conservative intraoral approach and aid of intermaxillary fixation screw to facilitate extraction. The patient recovered well, without complications, with remission of pain and restoration of mouth opening.

scholarly journals Dental wear proxy correlation in a long-term feeding experiment on sheep ( Ovis aries )

2021 ◽  
Vol 18 (180) ◽  
pp. 20210139
Author(s):  
Nicole L. Ackermans ◽  
Daniela E. Winkler ◽  
Ellen Schulz-Kornas ◽  
Thomas M. Kaiser ◽  
Louise F. Martin ◽  
...  
Keyword(s):  
Ovis Aries ◽  
Tissue Loss ◽  
Dental Microwear ◽  
Dental Wear ◽  
Tissue Change ◽  
Maxillary Molars ◽  
Tissue Removal ◽  
Mandibular Molar ◽  
Crown Tissue ◽  
Dental Microwear Texture Analysis

Dietary reconstruction in vertebrates often relies on dental wear-based proxies. Although these proxies are widely applied, the contributions of physical and mechanical processes leading to meso- and microwear are still unclear. We tested their correlation using sheep ( Ovis aries , n = 39) fed diets of varying abrasiveness for 17 months as a model. Volumetric crown tissue loss, mesowear change and dental microwear texture analysis (DMTA) were all applied to the same teeth. We hereby correlate: (i) 46 DMTA parameters with each other, for the maxillary molars (M1, M2, M3), and the second mandibular molar (m2); (ii) 10 mesowear variables to each other and to DMTA for M1, M2, M3 and m2; and (iii) volumetric crown tissue loss to mesowear and DMTA for M2. As expected, many DMTA parameters correlated strongly with each other, supporting the application of reduced parameter sets in future studies. Correlation results showed only few DMTA parameters correlated with volumetric tissue change and even less so with mesowear variables, with no correlation between mesowear and volumetric tissue change. These findings caution against interpreting DMTA and mesowear patterns in terms of actual tissue removal until these dental wear processes can be better understood at microscopic and macroscopic levels.

Microbiological Approach in Management of Recurrent Dento - Buccal Space Infection - Report of Three Uncommon Cases

2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Pavithra D ◽  
◽  
Keerthinarayanan . ◽  
Satish Kumar CSC ◽  
Archana B ◽  
...  
Keyword(s):  
Systemic Disease ◽  
Complete Recovery ◽  
Klebsiella Pneumonia ◽  
Odontogenic Infections ◽  
Neck Infection ◽  
Space Infection ◽  
Odontogenic Origin ◽  
Empiric Antibiotic ◽  
Buccal Space ◽  
Relationship Factors

The route of facial infection usually depends on the jaw-tooth relationship factors followed by virulence and type of microorganisms. Staphylococci are frequently associated with abscess formation. However, at times head and neck infection with an odontogenic origin are caused by gram-negative species like Klebsiella pneumonia without any predisposing opportunistic infectious etiology. In this report, we presented 3 rare cases of buccal space infection associated with Klebsiella pneumonia without any predisposing systemic disease. Appropriate diagnosis followed by antibiotics oral cephazolin (500mg BID) and intra-muscular gentamicin (150mg BID) at adequate strength and duration has brought a significant decrease in the progression of the disease that yielded complete recovery after 10days. Thus with odontogenic infections it is appropriate to always begin with the empiric antibiotic regimen with correlation to clinical presentation thinking of the most likely suspected microorganisms, which are usually the normal flora of the region, without forgetting the importance of early surgical intervention to reduce morbidity and complications.

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