Temporal abscess after third molar extraction in the mandible
ABSTRACT Dental infections resulting before or after third molar removal are complications in which the maxillofacial surgeon may have to initiate an earlier management. The severe dental infections resulting before or after this procedure is one of the few life-threatening complications in which the maxillofacial surgeon may have to initiate an earlier management. Infections involving the temporal space are rare and infrequently reported. Infections in this space have also been observed secondary to maxillary sinusitis, maxillary sinus fracture, temporomandibular arthroscopy, and drug injection, although more commonly associated to third molar infections.
A 22-year-old man had undergone extraction of tooth 38 secondary to pericoronaritis by a general dentist. Physical examination of his face demonstrated severe trismus, pain, and swelling in temporal region. A CT scan showed an inflammatory area into the temporal space. He was started on IV cephalosporin, but the clinical course of the patient was not satisfactory. Incision and drainage were performed from an extraoral and intraoral approach. After discharged, the antibiotic was switched to clindamycin IO 600 mg.
The retromaxillary and temporal infections are quite common after maxillary molar extractions but not after mandibular third molar, the spread mechanism of ascension must be involved with the virulence of microorganisms, but more studies are necessary to clarify this occurrence.
- Journal of Oral and Maxillofacial Surgery 07/2000; 58(6):682-5. DOI:10.1016/S0278-2391(00)90169-1 · 1.28 Impact Factor
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ABSTRACT: Propagation of odontogenic masticator space abscesses is insufficiently understood. The purpose was to analyse pathways of spread in 30 patients with odontogenic masticator space abscess. The imaging findings in 30 patients (CT in 30, MR in 16 patients) were retrospectively analysed. CT and MR imaging depicted a masticator space abscess within: medial pterygoid muscle in 13 patients (43.3%), lateral masseter and/or pterygoid muscle in 14 (46.7%) and superficial temporal muscle in 3 patients (10%). In the lateral masticator space intra-spatial abscess extension occurred in 7 of 14 patients (50%). The sub-masseteric space provided a pathway in seven (70%). Extra-spatial extension involved the submandibular space only in 3 of 14 patients (21.4%). Medial masticator space abscesses exhibited extra-spatial spread only. Extension affected the parapharyngeal space and/or soft palate in 7 of 13 lesions (53.8%). MR imaging in comparison to CT increased the number of abscess locations from 18 to 23 (27.8%) and regions affected by a cellular infiltrate from 12 to 16 (33.3%). The sub-masseteric space served as a previously underestimated pathway for intra-spatial propagation of lateral masticator abscesses. Medial masticator space abscesses tend to display early extra-spatial parapharyngeal space and/or soft palate extension.European Radiology 05/2008; 18(9):1972-9. DOI:10.1007/s00330-008-0946-5 · 4.34 Impact Factor
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ABSTRACT: Dental infections are associated with a range of serious complications. The orofacial region provides potential spaces in the tissue that infections of dental origin can occupy. We describe the subtemporal extension of a dental infection, the late development of cranial osteomyelitis, and its surgical management.British Journal of Oral and Maxillofacial Surgery 06/2008; 46(8):673-4. DOI:10.1016/j.bjoms.2008.03.025 · 1.13 Impact Factor