Oral surgery
Cellulitis is a flammation of medular bone
Cellulitis is a painful swelling of the soft tissue of the mouth and face resultating from a diffuse spreading of purulent exudate along the facial planes that separate the muscle bundles
Cellulitis is an acute deep suppurative abcess of upper neck and perioral area
Cellilitis is inflammation of hair follicle from infection or trauma or Chemical irritation
What are the causes of cellulitis ?
Inflammation of hair follicles
Chronic of apical infection
Acute of apical infection
Chronic blistering disease
How to spread of pus inside the tissues space ?
By continuity through tissue spaces and planes, by way of the lymphatic system and by way of blood circulation
By way of the lymphatic system by way of the lymphatic System
By way of blood circulation
By direct skin-to-skin contact with the infected areas
Local Signs and Symptoms of cellulitis are :
Pain and swelling
Surface erythema and pus formation
Limitation of motion
All as the above
Systemical signs and symptoms of cellulitis are :
Fever and malaise
Lymphadenopathy and toxic appearance
Elevated white blood cell count
All as the above
Classification of cellulitis based by severity ?
Acute and chronic
Acute, subacute and chronic
Low severity,medium severity and high severity
Odontogenic and nonodontogenic cellulitis
Fascial planes offer anatomic highways for infection to spread superficial to deep planes are :
Surface of gingiva, palatal abscess and maxillary sinus
Surface of gingiva, palatal abscess , maxillary sinus,maxilla and mandible
Surface of gingiva, palatal abscess , maxillary sinus, maxilla and mandible, floor of the mouth
Vestibular region and palatal region
The following are low severity of cellulitis , except…
Abscess of base of upper lip and Subperiosteal abscess,
Vestibular abscess,Intraalveolar and abscess of maxilla&Mandible
Infraorbital abscess,Buccal abscess
Submandibular abscess
Submental, Submandibular,Sublingual,Masseteric,Pterygomandibular,Superficia temporal,Deep temporal are :
Low severity
Medium severity
High severity
Diffuse abscess
The following are high severity of cellulitis , except…
Diffuse cellulitis
Subcutaneous abscess
Ludwig’s angina
Lateral Pharyngeal Space Abscess, Retropharyngeal Abscess
The following are specific signs and symptoms of cellulitis , except…
Redness(erythema) and swellin(edema)
Tenderness and pain
Bleeding
Warmth
The Goals of management of odontogenic infection is/are :
Medical treatment
Incision and drainage
Aspirate the contents
Laser therapy
How many types of localized odontogenic infection ?
Periapical Infections - infection at the apex of an abscessed tooth
Periodontal Infections – soft tissue infection in the periodontal pocket from advanced periodontitis
Pericoronal Infections – soft tissue infection around the crown of the unerupted or partially erupted tooth
All of the above
Spread of pus inside tissues from the site of the initial lesion, inflammation may spread in many ways :
By continuity through tissue spaces and planes
By way of the lymphatic system
By way of blood circulation
All of the above
To drain pus from an abscess,the surgeon should :
Penetrate into abscess cavity and probe with an artery to allow for flow of pus
Cut and eclipse from the abscess surface to allow for a drain
Aspirate the contents
Cut only the mucosa and skin
To drain pus from a submental abscess,the surgeon should :
Cut and eclipse from the abscess surface to allow for a drain
Aspirate the contents
A horizontal incision should be placed 1–3 cm below the lower border of the mandible rather than the top of the swelling (abscess) to exploit gravity to encourage drainage
Cut only the mucosa and skin
To drain pus from a submandibular abscess,the surgeon should :
Cut and eclipse from the abscess surface to allow for a drain
The incision for drainage is performed on the skin, approximately 1 cm beneath and parallel to the inferior border of the mandible
Aspirate the contents
Cut only the mucosa and skin
Treatment of choice to localized infection with pus is :
Antibiotc administration
Establish drainage
Apply col to the area
Advise hot mouth washes
Among of the followinh which is treatment of choice for infection with fluctuation in an afebrile patient ?
Administration of antibiotics
Application of hot packs to the area
Incision and drainage
Antibiotics administration followed by I and D
What is the most important and first step to treat acute infection?
Prescribe antibiotic
Prescribe analgesics
Incision and drainage of pus
All of the above
Which type of abscess that can cause airway obstruction?
Subcutaneous abscess
Ludwig’s Angina
Buccal abscess
Orbital cellulitis
In which case do you need to refer the patient to the hospital?
Localized infection
Ludwig’s Angina
Cavernous sinus thrombosis
Ludwig’s Angina & Cavernous sinus thrombosis
What is a dangerous infection with potentially serious complications ?
Buccal cellulitis
Sumandibular cellulitis
Orbital cellulitis
Sublingual cellulitis
Ludwig`s angina was first described by :
The German physician, Wilhelm Frederick von Ludwig in 1836
Maxwell
Garre in the year 1893
Rene LeFort
The most common cause of cellulitis in face is :
Dental carie
Pericoronitis and impacted teeth
Trauma trauma to the eyelid including bug bites, or a foreign object
Antral infection
A diffuse inflammation of soft tissue that is not circumscribed is an :
Abscess
Granuloma
Swelling
Cellulitis
The most common micro-organisms associated with cellulitis is :
Streptococci
Staphylococci
Actinomyces
Lactobacillus
A corne-shaped space infection involving inner canthus of eye is :
Canine space
Buccal space
Parotid space
Palatal abscess
The incision technique of submandibular cellulitis the incision for drainage is performed on the skin, approximately :
0,5 cm beneath and parallel to the inferior border of the mandible
1 cm beneath and parallel to the inferior border of the mandible
2 cm beneath and parallel to the inferior border of the mandible
3 cm beneath and parallel to the inferior border of the mandible
Surgical drainage for submental abscess is usually performed through a cutaneous Incision. A horizontal incision should be placed :
0,5–1 cm below the lower border of the mandible
1-3 cm below the lower border of the mandible
4 cm1 below the lower border of the mandible
5 cm below the lower border of the mandible
Ludwig's angina was first described by the German physician, Wilhelm Frederick von Ludwig :
In 1836
In 1928
In 1980
In 2000
What is the osteitis ?
Osteitis is an flammatory process within medullary (Trabecular) bone that involves the marrow spaces
Osteitis is a painful swelling of the soft tissue of the mouth and face resultating from a diffuse spreading of purulent exudate along the facial planes that separate the muscle bundles
Osteitis is an acute deep suppurative abcess of upper neck and perioral area
Osteitis is a rare group of blistering autoimmune diseases
The most common local causes of osteitis are :
Apical infection
Localised pathological
Trauma
All as the above
The following are general factors of osteitis , except…
Radiation and fibrous dysplasia
Osteoparosis
Apical infection
Diabetis,syphilis,tuberculosis
Classification of osteitis :
Acute and chronic osteitis
Acute, subacute and chronic osteitis
Low severity,mederate severity and high severity
Close and open osteitis
Purulent exudate ,fistula and sequestra are the signs of :
Acute osteitis
Chronic osteitis
Orbital cellulitis
Sinusitis
Treatment of chronic osteitis :
Incision and drainage
Debridement -the removal of foreign material or devitalized tissue from the vicinity of a wound
Sequestrectomy,Saucerization- an excavation of the tissue of a wound to form a shallow,saucelike depression
Medical treatment
Dry soket is also termed all except :
Localized acute alveolar osteomyelitis
Acute suppurative osteomyelitis
Alveolar osteitis
Alveolalgia
The following are frequency increases with dry socket , except…
Age and smoking
Dental carie
Use of bur
Long surgeries with flap
The following are signs and symptom of dry socket , except…
Increase in acute, throbbing pain after 48 hrs (2-5 days)
Pain may radiate to ear and analgesics ineffective
Sequestrum formation
Fetid odor
The treatment of dry socket :
Curettage the socket and Irrigation with chlorhexidine
Place Alvogyl in the socket
Prescribe strong analgesics
All of the above
Patients who are at high risk for osteomyelitis include those who are :
Poorly nourished and elderly
Obese and those with impaired immune system
Those receiving long-term corticosteroid therapy
All of the above
The following are the signs and symptoms of osteomyelitis , except…
Chill,high fever(40 C),rapid pulse,trismus and general malaise
As the infection progresses, the infected area becomes painful, mobility of teeth , swollen, and extremely tender
Pus,fistula,sequestra(4-6 weeks),fetid odor and trismus
All of the above
Radiographic imaging of osteomyelitis :
Moth eaten r/lucency, I.e. irregular, ,patchy, ragget and poorly outline
Radiopaque sequestrae, I.e. Piece of necrotic bone
Evidence of involucrum surrounding area of destruction
All of the above
The treatment of chronic suppurative osteomyelitis is :
Hyperbaric oxygen therapy
Sequestrectomy,saucerization and hyperbaric oxygen therapy
Sequestrectomy ,with hyperbaric oxygen therapy
Saucerization only
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