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Routes of Spread of Dental Infection
Infection , supporting structure jaws
:- 1. Blood stream2. Lymphatic vessels3. Direct spread loose
connective tissue
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Direct Spread of Dental Infection
:- 1. alveolar bone2. attachment maxilla mandible
(muscles of facial expression, mylohyoid muscle)3. 4. floor
nasal cavity maxillary sinus
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Facial Muscles Related to Roof Apexes
Upper teethI : Sup. Incisive bundle
C,P : Quadratus labii superiorisLavator anguli oris
M : Buccinator
Lower teethI,C : Inf. Incisive bundle
MentalisP : Depresser labii inferioris
Depresser anguli orisM : Buccinator
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Dental Infection
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Relation of Mylohyoid Muscle Attachment toRoot Apexes of Lower
Teeth
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Potential Sites of Localization of Dental Infection
Oral vestibuleNasal cavityMaxillary sinusPalate
Infection FACIAL SPACES
Upper Jaw
Lower Jaw Oral vestibule
Infection FACIAL SPACES
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Fascial Space
Boundaries of Facial Space :-
-Fascial layers or planes-Muscles-Bone-Skin-Mucous membrane
Contents of Fascial Space :-
-Nerves-Blood vessels-Lymphatic vessel, Lymph nodes-Salivary
glands-Loose connective tissue
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Infection Fascial space Fascial space :
- fascial plane- blood vessels,
lymphatic vessels nerves
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Fascial Spaces Related to Dental Infection of Upper Jaw
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Fascial Spaces Related to Dental Infection of Lower Jaw
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Boundaries: Flooor canine fossaRoof Quadratus labii superioris,
skinSuperior Origin of quadratus labii superiorisInferior
Orbicularis oris1
Canine Space
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Contents: Levator anguli oris,Infraorbital nerve and vessels
Canine Space
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Buccal Space
Boundaries : Lat. Skin, superficial fascia Med. BuccinatorSup.
Zygomatic archInf. MandibleAnt. Zygomaticus major, depressor anguli
orisPost. Masseter
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Buccal Space
Contents : Parotid ductBuccal nerve of V3Buccal branch of
VIIFacial vesselsBuccal fat pad
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Zygomaticotemporal(Retrozygomatic)Space
Boundaries: Ant. - maxilla, Zygomatic boneLat. - Insertion of
Temporalis muscle
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Zygomaticotemporal(Retrozygomatic)Space
Contents : Posterior suprerior alveolar nerveand vessles buccal
fat pad
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Temporal Space
Superficial temporal space
Boundaries : Lat.-temporal fasciaMed.-Temporalis
Contents : Middle temporal vessel
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Temporal Space
Deep temporal spaceBoundaries : Lat. temporalis
Mid.- fascia deep surface temporalis
Contents : Deeptemporal nerve and vessel
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Submental Space
Boundaries : Lat. - Ant. Belly of digastricAnt. Symphysis
mentiPost. Hyoid boneRoof Investing fasciaFloor Mylohyoid
muscle
Contents : Submental lymph node and vessels ant. Jugular
veins
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Sublingual Space
Boundaries : Roof Mucosa of floor of mouthFloor Mylohyoid
muscleMed. Medial raphe of tongue,
genioglossus,geniohyoid,styloglossus
Ant., Lat. Body of mandiblePost. Hyoid bone
Contents : Sublingual,Submandibular glandSubmandibular
ductLingual nerve and vesselsSubmandibular ganglionHypoglossal
nerve
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Submandibular Space
Boundaries : Ant.med. Ant. Belly of digastricPost.med. Post.
Belly of digastric, stylohyoid muscleSup.lat. MandibleFloor
Mylohyoid, hyoglossus,styloglossusRoof Investing fascia
Contents : Submandibular salivary gland (superficial
past)Submandibular lymph nodesFacial vesselsHypoglossal
nerveMarginal mandibular branch of nerve VII
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Submasseteric Apace
Boundaries : Lat. Superficial part of masseterMed. Deep part of
masseterAnt. Mucosa of retromolar triangle of mandiblePost.
Parotideomasseteric fascia
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Pterygomandibular Space
Boundaries : Lat. - Mandibular ramusMed. Med. Pterygoid
muscleSup. Lat. Pterygoid musclePost. Parotid gland and its
fascia
Ant. Buccinator, superior constrictor ofpharynx,
pterygomandibular raphe,buccopharyngeal fascia
Contents : Lingual nerve and vesselsInf. Alveolar nerve and
vesselsMaxillary vesselsPterygoid venous plexusSphenomandibular
ligament
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Lateral Pharyngeal (parapharyngeal) Space
Boundaries : Med. Sup. Constrictor of pharynxLat. Med. Pterygoid
muscle and
deep part of parotid glandPost. Styoid process and its
muscles,
carotid sheathAnt. Pterygomandibular rapheSup. Base of skall
Inf. hyoid bone limit investing fascia post. Belly of digastric
and stylohyoid
Contents : Int. carotid a.Int. jugular v.Deep cervical lymph
nodesNerve IX, X, XI, XIISympathetic chain
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Pretracheal and Retropharyngeal Space
Boundaries : Ant. Strap musclesPost. Trachea
Sup. Hyoid bone, thyroid cartilageInf. Superior mediastinum
Pretracheal Space
Retropharyngeal Space
Boundaries : Lat. Carotid sheathsAnt. Constrictor muscles of
pharynx,
buccopharyngeal fasciaPost. Prevertebral muscles and fasciaSup.
Base of skull
Inf. Posterior mediastinum
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Pretracheal and Retropharyngeal Spaces
Retropharyngeal Space
Contents : Retropharyngeal lymph node
Pretracheal Space
Contents : Pretracheal lymph node
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Communications
Infection fascial space
Fascial space
fascial plenes spaces connective tissue ,
Cavernous Sinus
Infection teeth PeriodontiumSuperior mediastinumPosterior
mediastinum
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Upper Canine
Canine space Buccal space
Pterygomandibular space
Submandibularspace
Lateral pharyngealspace
Retropharyngeal space
Superior mediastinum
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Upper Molars
Buccal space
Retrozygomatic space
Temporal spacePtergomandibular space
Submandibular space Lateral pharyngeal space
Retropharyngeal space
Superior mediastinum
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Lowerpremolars Sublingual space
Buccal space
Lower 1st+2ndmolars
Submandibular space
Pterygomandibular space
Lower 3 rdmolar Lateral pharyngeal space
Retropharyngeal space
Superior mediastinum
