Overview of Odontogenic Infection

Prof. Dr. Harmas Yazid Yusuf, drg., Sp.BM(K)

Introduction

Inflammation vs Infection
 Inflamation

Inflammation is a response of vascularized

tissues to infections and damaged tissues that
brings cells and molecules of host defense from
the circulation to the sites where they are
needed, in order to eliminate the offending
agents

Source : c
Inflammatory reactions may be
triggered by a variety of stimuli:
• Infections (bacterial, viral,
fungal, parasitic) and microbial
toxins
• Tissue necrosis elicits
inflammation regardless of the
cause of cell death (ischemia,
trauma, physical and chemical
injury)
• Foreign bodies (splinters, dirt,
sutures)
• Immune reactions (also called
hypersensitivity)
Source : Kumar V, Abbas AK, Aster JC. Robbins basic pathology e-book. Elsevier Health Sciences; 2017 Mar
The steps of the inflammatory
response can be remembered as
the five R:
(1)Recognition of the injurious
agent
(2)Recruitment of leukocytes
(3)Removal of the agent
(4)Regulation (control) of the
response
(5)Resolution (repair).
Hallmarks of acute
inflammation  Cardinal signs
• Rubor (redness)
• Tumor (swelling)
• Calor (heat)
• Dolor (pain)
• Loss of function (functio
laesa)

Source : Kumar V, Abbas AK, Aster JC. Robbins basic pathology e-book. Elsevier Health Sciences; 2017 Mar
Acute vs Chronic

Source : Kumar V, Abbas AK, Aster JC. Robbins basic pathology e-book. Elsevier Health Sciences; 2017 Mar
Source : Kumar V, Abbas AK, Aster JC. Robbins basic pathology e-book. Elsevier Health Sciences; 2017 Mar
8.
 The term “infection” is defined as the
detrimental colonization of a host organism by a
Infection foreign microorganism

And “inflammation” is the term describing the

host’s response to stimuli including those of
infection

Source : Pogrel MA, Kahnberg KE, Andersson L, editors. Essentials of oral and maxillofacial surgery. John Wiley & Sons
How Microorganisms Cause Disease

• Diseases caused by microbes involve interplay between

microbial virulence factors and host responses.

• Infectious agents cause death or dysfunction by directly

interacting with the cell.

• Injury may be due to local or systemic release of microbial

products including endotoxin (LPS), exotoxins or
superantigens.

• Pathogens can induce immune responses that cause tissue

damage. Absence of an immune response may reduce damage
induced by some infections; conversely, immune compromise
can allow uncontrolled expansion of opportunistic agents or
of microorganisms that can directly cause injury.

Source : Kumar V, Abbas AK, Aster JC. Robbins basic pathology e-book. Elsevier Health Sciences; 2017 Mar
 Virulensi
Quantity

Local
Humoral
Celular

Host versus microbe relationship and its effects on host reserve

and susceptibility to infection

Source : Topazian, Richard G., Morton H. Goldberg, and James R. Hupp. Oral and maxillofacial infections. Elsevier Health Sciences, 2002.
 The Interrelationships among the three major components of host defense

HOST DEFENSES

Local Factors Humoral Cellular

Skin and
Immunoglobuli
mucous Complement Lymphocytes Phagocytes
n
membrane

Source : Topazian, Richard G., Morton H. Goldberg, and James R. Hupp. Oral and maxillofacial infections. Elsevier Health Sciences, 2002.
Source : Kumar V, Abbas AK, Aster JC. Robbins basic pathology e-book. Elsevier Health Sciences; 2017 Mar
8.
Odontogenic Infection

Source : Hupp JR, Tucker MR, Ellis E. Contemporary Oral and maxillofacial surgery-E-book. Elsevier Health Sciences;
 Infections Of The Head And Neck Region
MAJORITY

ODONTOGENIC ORIGIN
manifest
with classic signs and symptoms of an infectious disease process
(e.g., pain, swelling, heating, surface erythema, limitation of function).

C • invasive streptococcal infections, streptococcal or

MORBIDITY AND O staphylococcal toxic shock,
MORTALITY M • necrotizing fasciitis
P • descending necrotizing mediastinitis (perhaps the same
• close proximity to vital L process as necrotizing fasciitis, occurring in deeper
anatomic structures I anatomic plane)
• increasing microbial C • internal jugular vein thrombosis
antibiotic resistance A • cavernous sinus thrombosis
• compromised host defense T • carotid artery pseudoaneurysm or rupture
mechanisms, I
O • systemic inflammatory • acute upper airway
N S
response syndrome
L I D E 1 4
obstruction.

James R. Hupp, 2018 from Head, Neck, and Orofacial Infections: An Interdisciplinary Approach
 Principles of Management of Odontogenic Infections
Our Services

01
Determine
02
Evaluate host
03
Determine
04
Support medically
severity defenses the setting of care

05 06
Choose and prescribe
07
Administer antibiotic
08 Reevaluate
Treat surgically
appropriate antibiotic(s) appropriately frequently

James R. Hupp, 2018 from Head, Neck, and Orofacial Infections: An Interdisciplinary Approach
Source : Hupp JR, Tucker MR, Ellis E. Contemporary Oral and maxillofacial surgery-E-book. Elsevier Health Sciences;
Source : Pogrel MA, Kahnberg KE, Andersson L, editors. Essentials of oral and maxillofacial surgery. John Wiley & Sons
Routes of Odontogenic Infection

Source : Balaji, S. M., and Padma Preetha Balaji. Textbook of Oral & Maxillofacial Surgery-E Book. Elsevier Health Sciences, 2018.
Routes of Odontogenic Infection

Source : Hupp JR, Ferneini EM. Head, neck, and orofacial infections. Elsevier; 2016.
Source : Hupp JR, Ferneini EM. Head, neck, and orofacial infections. Elsevier; 2016.
Source : Hupp JR, Ferneini EM. Head, neck, and orofacial infections. Elsevier; 2016.
Conclusion

The treatment of odontogenic infections, remain the

fundamental guiding principles that oral and maxillofacial
surgeons must use in successful management of these cases.
The application of the eight steps must be thorough and the
surgeon’s mind must always remain open to the possibility of
treatment failure, an error in initial diagnosis, antibiotic
resistance, and previously undiagnosed medically
compromising conditions.
 • Kumar V, Abbas AK, Aster JC. 2017. Robbins
basic pathology e-book. Elsevier Health
Sciences
• Hupp JR, Ferneini EM. 2016.Head, neck, and
orofacial infections. Elsevier
Reference • Balaji, S. M., and Padma Preetha Balaji.
2018. Textbook of Oral & Maxillofacial
Surgery-E Book. Elsevier Health Sciences.
• Pogrel MA, Kahnberg KE, Andersson L,
editors. Essentials of oral and maxillofacial
surgery. John Wiley & Sons
thankyou