Ficha de revisão: Comprehensive Odontogenic Infection Management

📋 Course Outline

1. General treatment principles for odontogenic infections
2. Odontological treatment methods for odontogenic infections
3. Principles and general guidelines of pharmacological antibiotherapy
4. Antibiotic administration routes, dosing, and combination strategies
5. Antibiotic prophylaxis indications and protocols for high-risk cardiac and systemic conditions
6. Antibiotic prophylaxis regimens for standard and allergic patients
7. Surgical treatment techniques: debridement and drainage of abscesses
8. Anatomical considerations and incision techniques for intraoral and extraoral approaches
9. Drainage methods and timing of surgical interventions in odontogenic infections
10. Classification and selection of antibiotics for odontogenic infections
11. Complementary pharmacological treatments including analgesics and anti-inflammatories
12. Supportive care measures in managing odontogenic infections

📖 1. General treatment principles for odontogenic infections

🔑 Key Concepts & Definitions

• ABSCESS : A localized collection of pus that is not definitively resorbed and requires surgical drainage to eliminate the exudate and prevent progression.
• PERIODONTITIS : An infection stage characterized by inflammation treated by causal dental procedures combined with pharmacological therapy.
• Pluri-spacial affection : The involvement of multiple anatomical spaces in an infection, indicating secondary dissemination and requiring comprehensive treatment.
• ODONTOGENIC INFECTION III : General treatment rules.

📝 Essential Points

• Treatment varies according to infection stage: periodontitis, cellulitis, or abscess.
• Treatment depends on infection topography: intraoral or extraoral.
• The importance of the anatomical space involved influences treatment approach.
• Presence of pluri-spacial affection or secondary dissemination necessitates more comprehensive management.
• Immunological status of the patient affects treatment decisions and prognosis.
• There is no standarized treatment for odontogenic infections, it will depend on: - Stage of infection (periodontitis, cellulitis or abscess).
• SURGICAL TREATMENT SPECIFIC TREATMENT ACCORDING TO THE CLINICAL STAGE TREATMENT OF PERIODONTITIS 1.

💡 Key Takeaway

Treatment of odontogenic infections must be individualized based on infection stage, location, extent, and patient immune status.

📖 2. Odontological treatment methods for odontogenic infections

🔑 Key Concepts & Definitions

• Effect" : The change produced by a treatment, such as oxygen entering the chamber which alters the environment to eliminate anaerobic bacteria and relieve pain.
• TREATMENT OF ODONTOGENIC INFECTION : A therapeutic approach combining odontological, pharmacological, and surgical treatments aimed at eliminating the infection source and controlling its spread.
• Chamber opening : It is performed in the stage of acute apical periodontitis.
• Conventional extraction : When there is no possibility of conservative treatment.

📝 Essential Points

• Conventional extraction is indicated when conservative treatment is impossible or infection tends to become chronic.
• Dental treatment is the first therapeutic action in odontogenic infections, often preceding medical treatment.
• Serious infections, increase the spectrum of action of an empirical treatment.

💡 Key Takeaway

Dental interventions target the infection source and are essential initial steps in managing odontogenic infections.

📖 3. Principles and general guidelines of pharmacological antibiotherapy

🔑 Key Concepts & Definitions

• General principles of antibiotherapy : Guidelines for antibiotic selection and use based on efficacy in eliminating pathogens, safety with non-toxic therapeutic doses, minimal tissue toxicity, and acceptable cost.
• PHARMACOLOGICAL TREATMENT b)GENERAL PRINCIPLES : Core concepts emphasizing the use of specific, narrow-spectrum antibiotics with proven success, appropriate dosing to achieve therapeutic levels, and treatment duration aligned with clinical remission.

📝 Essential Points

• Identification of the causative organism and antibiotic sensitivity is essential before antibiotic use.
• Prefer specific, narrow-spectrum, less toxic, bactericidal antibiotics with proven success.
• Adjust antibiotic dose to avoid resistance and toxicity.
• To be effective ATB has to reach the infected tissue and must remain there long enough and at a concentration that is assumed to be effective.
• The antimicrobial has a toxic potential in front of the patient itself so it is necessary to adjust the dose properly since a low dose in addition to being ineffective will promote the appearance of resistance while if it is disproportionately high it will not achieve greater benefits, but it will increase the risk of adverse reactions due to toxicity.

💡 Key Takeaway

Identification of the causative organism and antibiotic sensitivity is essential before antibiotic use.

📖 4. Antibiotic administration routes, dosing, and combination strategies

🔑 Key Concepts & Definitions

• Oral : A route of antibiotic administration that is the most physiological and provides fewer adverse reactions, but has variable absorption.
• Parenteral : Severe cases and immunosuppressed patients.
• PHARMACOLOGICAL TREATMENT TERATOGENICITY : FDA (Food and Drug Administration) classification, North American of 1990.

📝 Essential Points

• Parenteral route is preferred in severe or immunosuppressed patients for guaranteed therapeutic levels.
• Intramuscular administration is less comfortable and requires multiple daily injections.
• Dosing aims to maintain effective plasma and tissue concentrations without toxicity.
• Treatment initiation can use double doses to rapidly achieve therapeutic levels.
• ATB ADMINISTRATION Routes of administration: - Oral: The most physiological and the one that provides less adverse reactions.

💡 Key Takeaway

Optimizing antibiotic delivery and dosing maximizes efficacy while minimizing toxicity and resistance.

📖 5. Antibiotic prophylaxis indications and protocols for high-risk cardiac and systemic conditions

🔑 Key Concepts & Definitions

• Fetal risk : The potential for adverse effects on the fetus caused by medication or treatment during pregnancy.

📝 Essential Points

• Antibiotic prophylaxis is indicated for patients with cardiac valve prosthesis, previous endocarditis, certain congenital heart diseases, and cardiac transplant recipients with valvulopathy.
• Prophylaxis aims to prevent local and distant infections in these high-risk patients.

💡 Key Takeaway

Antibiotic prophylaxis is critical to prevent infective complications in patients with specific high-risk cardiac and systemic conditions.

📖 6. Antibiotic prophylaxis regimens for standard and allergic patients

🔑 Key Concepts & Definitions

• Corticosteroids : Antiedema BUT decreases the defenses and enables the spread of the infection.

📝 Essential Points

• Standard oral prophylaxis involves Amoxicillin 2 g taken 30-60 minutes before surgery, with children dosed at 50 mg/kg.
• Standard parenteral prophylaxis involves Ampicillin 2 g IM/IV or Cefazolin/Ceftriaxone 1 g IM/IV 30-60 minutes before surgery, with children dosed at 50 mg/kg.
• Allergic patients should receive oral Cephalexin 2 g, Clindamycin 600 mg, or Azithromycin/Clarithromycin 500 mg 30-60 minutes before surgery, with dose adjustments for children.
• Allergic patients requiring parenteral prophylaxis should receive Clindamycin 600 mg IM/IV or Cefazolin/Ceftriaxone 1 g IM/IV 30-60 minutes before surgery, with dose adjustments for children.

💡 Key Takeaway

Prophylactic antibiotic regimens must be tailored to patient allergy status to ensure safety and efficacy.

📖 7. Surgical treatment techniques: debridement and drainage of abscesses

🔑 Key Concepts & Definitions

• ABSCESS : A pathological tissue collection characterized by pus and necrotic material that requires both surgical and pharmacological treatment.
• Goals : To eliminate pathogenic microorganisms directly, remove harmful substances such as pus and bacterial toxins, improve oxygenation, reduce pain, and prevent progression to compromised anatomical spaces.
• Debridement" : "Prophylactic debridement": Severe diffuse cellulitis, do not wait to mature stage because there is vital commitment.
• Dental treatment : 2.- Dental treatment: exodoncia.

📝 Essential Points

• Debridement involves incision and surgical disruption of fibrous bands within abscesses to eliminate pathogens, improve oxygenation, and remove pus and necrotic tissue.
• Indications for debridement include mature abscesses, severe diffuse cellulitis, residual abscesses, and antibiotic abscesses.
• Drainage maintains wound opening to allow continuous pus evacuation and oxygenation, using soft rubber drains sutured in place.
• Drainage is indicated for large abscesses, deep space infections, and diffuse cellulitis.
• • Indications: - Big abscesses.

💡 Key Takeaway

Debridement involves incision and surgical disruption of fibrous bands within abscesses to eliminate pathogens, improve oxygenation, and remove pus and necrotic tissue.

📖 8. Anatomical considerations and incision techniques for intraoral and extraoral approaches

🔑 Key Concepts & Definitions

• Vestibular : The mucous membrane area inside the mouth where incisions are made parallel to the occlusal surfaces of the teeth, specifically in the lower and upper vestibular regions.
• ESTHETICAL : The requirement that incisions be placed in areas accepted for appearance, such as intrabucal sites or following natural skin folds and Langer's lines, to minimize visible scarring.
• Anatomical structures to avoid : Critical nerves, vessels, glands, and ducts that must be preserved during incisions, including the mental nerve, infraorbital nerve, angular vessels, sublingual gland, Wharton's duct, lingual nerve, sublingual vein, branches of the facial nerve, Stensen's duct, facial artery and vein, and parotid gland.

📝 Essential Points

• Intraoral incisions are made parallel to occlusal surfaces or mucosal folds, avoiding nerves and vessels such as mental nerve, infraorbital nerve, palatine vessels, and sublingual structures.
• Extraoral incisions follow Langer's lines and avoid facial nerve branches, arteries, veins, and Stensen's duct.
• Incisions must be sufficient, functional, and esthetically acceptable to prevent infection perpetuation and scarring.
• In the mucous membrane incisions are made parallel to the occlusal surface of the teeth, 1 to 2 cm in length, with due regard for underlying structures such as the mental nerve.
• EXTRAORAL INCISIONS: Incisions through the skin should avoid the branches of the facial nerve.

💡 Key Takeaway

Precise anatomical knowledge guides safe and effective incision placement for surgical access.

📖 9. Drainage methods and timing of surgical interventions in odontogenic infections

🔑 Key Concepts & Definitions

• Blunt dissection : A surgical technique involving the insertion of closed forceps or scissors into a wound and then forcibly opening them inside to separate soft tissue planes, minimizing the risk of injury to nerves and vessels.

📝 Essential Points

• Blunt dissection with closed forceps opened inside the wound separates tissue planes, minimizing nerve and vessel injury.
• Drainage devices such as Penrose drains or glove fingers are sutured in place for 24-48 hours or longer until suppuration ceases.
• Immediate drainage is required once pus is localized, with culture and sensitivity testing performed.
• Antibacterial drugs should be started promptly in acute infections with high temperature.
• Causal dental treatment should be deferred until the acute phase subsides unless the general condition allows earlier intervention.
• Timing The decision when to perform various procedures is of great importance and requires considerable experience:
  • In acute infection with a high temperature, immediate treatment with intravenous antibacterial drugs should be commenced.
• Dental treatment: exodoncia.

💡 Key Takeaway

Timely surgical drainage combined with appropriate antibiotic therapy is critical for resolving odontogenic infections.

📖 10. Classification and selection of antibiotics for odontogenic infections

🔑 Key Concepts & Definitions

• Ineffective : Describes an incision that is too small to allow adequate drainage of an abscess, thus failing to relieve infection.
• First-choice antibiotics : Narrow-spectrum agents including natural penicillins, aminopenicillins, and macrolides, selected for their proven efficacy and safety in odontogenic infections.
• Third-choice antibiotics : Broad-spectrum or reserve antibiotics including aminoglycosides, isoxazolic penicillins, cephalosporins, vancomycin, tetracycline, chloramphenicol, quinolones, and oxazolidinones, reserved for serious or resistant infections.
• Second-choice antibiotics : MACROLIDES -Erythromycin: Pantomycin® -Spiramycin: Rovamycine® -Clarithromycin: Klacid® -Azithromycin: Zitromax® PHARMACOLOGICAL TREATMENT SECOND CHOICE ANTIBIOTICS METRONIDAZOL - Flagyl® PENICILLIN + BETA-LACTAMASES INHIBITORS - Augmentine® LINCOSAMIDES -Clindamycin: Dalacin® c)PRACTIC ANTIBIOTHERAPY IN THE O.

📝 Essential Points

• Antibiotic selection should prioritize narrow-spectrum agents with proven efficacy and safety.
• First-choice antibiotics include natural penicillins, aminopenicillins, and macrolides
• We must adjust the spectrum of action to the maximum and leave those broad-spectrum antibiotics for really serious situations.

💡 Key Takeaway

Antibiotic selection should prioritize narrow-spectrum agents with proven efficacy and safety.

📖 11. Complementary pharmacological treatments including analgesics and anti-inflammatories

🔑 Key Concepts & Definitions

• Pharmacological treatment (antibiotherapy : The use of antibiotics, analgesics, and anti-inflammatory drugs administered rationally and matched with antibiotic therapy to manage infection symptoms effectively.
• Facial artery : A blood vessel in the face that must be avoided during extraoral surgical incisions to prevent vascular injury.

📝 Essential Points

• NSAIDs such as ibuprofen are used to reduce inflammation and pain during acute infection.
• Pure analgesics include paracetamol, minor opiates like codeine, and acetylsalicylic acid derivatives.
• Corticosteroids at high doses would be indicated in severe processes especially if an involvement of the upper respiratory tract is intuited.
• ( Prednisone)
• Pure painkillers - Paracetamol -Minor opiate: Eg Codeine.

💡 Key Takeaway

NSAIDs such as ibuprofen are used to reduce inflammation and pain during acute infection.

📖 12. Supportive care measures in managing odontogenic infections

🔑 Key Concepts & Definitions

• Medical rest : A supportive care measure intended to alleviate the effects of infection by reducing physical stress and supporting the patient's defenses during recovery.
• Saline rinses : The practice of rinsing the mouth with saline solution every hour in cases of buccal phlegmon to aid in cleaning while avoiding germicidal mouthwashes that disrupt the normal oral flora.
• Odontogenic infections : Infections originating from dental or periodontal sources that require both supportive care to improve the patient's general condition and specific treatments such as drainage and antibiotics.

📝 Essential Points

• Medical rest helps patient recovery during infection.
• Fluid and electrolyte replacement is essential to counteract dehydration from fever and poor intake.
• Local heat application improves blood supply and natural defenses but may increase edema.
• Saline rinses every hour are recommended for buccal phlegmon; germicidal mouthwashes are discouraged to preserve normal flora.
• Improving oral hygiene supports infection control and healing.
• Applying heat to improve local blood supply with the natural defenses, but increases edema.

💡 Key Takeaway

Supportive care optimizes patient condition and enhances the effectiveness of specific treatments in odontogenic infections.

🧩 Additional Source Details

1. Study this source detail: INFECTION III: General treatment rules. Antibiotherapy and prophylaxis. TREATMENT OF ODONTOGENIC INFECTION : - Odontological treatment - Pharmacologycal treatment - Surgical treatment ODONTOGENIC INFECTION : As a general (Source: "INFECTION III: General treatment rules. Antibiotherapy and prophylaxis. TREATMENT OF ODONTOGENIC INFECTION : - Odontological treatment - Pharmacologycal treatment - Surgical treatment ODONTOGENIC INFECTION : As a general therapeutic option, dental treatment will be the first action, followed by a medical treatment that can be resolutive in many")
2. Study this source detail: but that in others will have to be supplemented with drainage. This approach will be based on the diagnosis and clinical status of the patient, since sometimes if the general situation is compromised, it will be necessar (Source: "but that in others will have to be supplemented with drainage. This approach will be based on the diagnosis and clinical status of the patient, since sometimes if the general situation is compromised, it will be necessary to refer the patient to a hospital environment. There is no standarized treatment for odontogenic infections, it will depend on: -")
3. Study this source detail: - Importance of the space involved in the infection - Pluri-spacial affection. - Secundary dissemination. - Immunological status of the patient. In general rules: - PERIODONTITIS: Dental treatment (causal) + pharmacologi (Source: "- Importance of the space involved in the infection - Pluri-spacial affection. - Secundary dissemination. - Immunological status of the patient. In general rules: - PERIODONTITIS: Dental treatment (causal) + pharmacological. - CELLULITIS / PHLEGMON: Pharmacological treatment. - ABSCESS: Surgical treatment + pharmacological. TREATMENT OF ODONTOGENIC")
4. Study this source detail: TREATMENT 1.- CHAMBER OPENING - It is performed in the stage of acute apical periodontitis. - The change of environment by the entrance of oxygen causes the annulment of the habitat of anaerobic germs that maintain and c (Source: "TREATMENT 1.- CHAMBER OPENING - It is performed in the stage of acute apical periodontitis. - The change of environment by the entrance of oxygen causes the annulment of the habitat of anaerobic germs that maintain and chronify the infection. - Immediate relief of pain from decompression. 2.- CONVENTIONAL EXTRACTION - When there is no possibility of")
5. Study this source detail: of the patient or the severity requires it. ODONTOLOGICAL TREATMENT 1. Antibiotics 2. Complementary treatment PHARMACOLOGICAL TREATMENT a) Principles for the use of therapeutic antibiotics b) General principles of antibi (Source: "of the patient or the severity requires it. ODONTOLOGICAL TREATMENT 1. Antibiotics 2. Complementary treatment PHARMACOLOGICAL TREATMENT a) Principles for the use of therapeutic antibiotics b) General principles of antibiotherapy c) Practic antibiotherapy in Odontogenic infections (O.I) a)PRINCIPLES FOR THE USE OF THERAPEUTIC ANTIBIOTICS")
6. Study this source detail: sensitivity. 3. Use of specific, narrow-spectrum antibiotics. 4. Use of less toxic antibiotic. 5. Patient drug history. 6. Use of bacteriocidal ( kill bacteria) rather than bacteriostatic drugs ( interfere with their rep (Source: "sensitivity. 3. Use of specific, narrow-spectrum antibiotics. 4. Use of less toxic antibiotic. 5. Patient drug history. 6. Use of bacteriocidal ( kill bacteria) rather than bacteriostatic drugs ( interfere with their reproduction). 7. Use of antibiotics with a proven history of success. 8. Cost of antibiotics. b)GENERAL PRINCIPLES OF ANTIBIOTHERAPY 1. THE")
7. Study this source detail: microorganisms -Safety: Non-toxic therapeutic doses. -Low toxicity: Minimal damage of tissues. -Acceptable cost: Generic use. PHARMACOLOGICAL TREATMENT 2. ATB ADMINISTRATION Routes of administration: - Oral: The most phy (Source: "microorganisms -Safety: Non-toxic therapeutic doses. -Low toxicity: Minimal damage of tissues. -Acceptable cost: Generic use. PHARMACOLOGICAL TREATMENT 2. ATB ADMINISTRATION Routes of administration: - Oral: The most physiological and the one that provides less adverse reactions. But the intestinal absorption presents individual variations and also the")
8. Study this source detail: plasma and tissue levels are guaranteed. It also allows the administration of other drugs as supportive therapy. - Intramuscular: Uncomfortable (minimum 2 injections per day). PHARMACOLOGICAL TREATMENT b)GENERAL PRINCIPL (Source: "plasma and tissue levels are guaranteed. It also allows the administration of other drugs as supportive therapy. - Intramuscular: Uncomfortable (minimum 2 injections per day). PHARMACOLOGICAL TREATMENT b)GENERAL PRINCIPLES OF ANTIBIOTHERAPY 3. DOSE Objective 1: Plasma and tissue concentrations should be maintained at non- exaggerated but effective")
9. Study this source detail: have a half-life of 1 to 2 hours but dosing is usually every 6 to 8 hours. "Post-antibiotic effect": Some cells of the immune system, such as neutrophils, macrophages and fibroblasts, store the antibiotic inside and rele (Source: "have a half-life of 1 to 2 hours but dosing is usually every 6 to 8 hours. "Post-antibiotic effect": Some cells of the immune system, such as neutrophils, macrophages and fibroblasts, store the antibiotic inside and release it - "targeted release" - in the presence of pathogens. Persistence of effects in the physical absence of the antibiotic.")
10. Study this source detail: end of the treatment must be abrupt. The initiation can be with double doses to achieve sufficient therapeutic levels. Every antibiotic has two doses: - Hard dose - Soft dose Example: Amoxicillin 500 mg - 1 g. We give th (Source: "end of the treatment must be abrupt. The initiation can be with double doses to achieve sufficient therapeutic levels. Every antibiotic has two doses: - Hard dose - Soft dose Example: Amoxicillin 500 mg - 1 g. We give the "hard" for the first day and severe cases and the "soft" for mild and moderate cases. Remove the treatment when there is clinical")
11. Study this source detail: ANTIBIOTHERAPY PHARMACOLOGICAL TREATMENT ATB in all cases they must be effective in eliminating or inactivating pathogenic microorganisms. To be effective ATB has to reach the infected tissue and must remain there long e (Source: "ANTIBIOTHERAPY PHARMACOLOGICAL TREATMENT ATB in all cases they must be effective in eliminating or inactivating pathogenic microorganisms. To be effective ATB has to reach the infected tissue and must remain there long enough and at a concentration that is assumed to be effective. Therefore we must know some parameters that will allow us to strategically")
12. Study this source detail: normal, by the characteristics of the patient or by the severity of the infection. The antimicrobial has a toxic potential in front of the patient itself so it is necessary to adjust the dose properly since a low dose in (Source: "normal, by the characteristics of the patient or by the severity of the infection. The antimicrobial has a toxic potential in front of the patient itself so it is necessary to adjust the dose properly since a low dose in addition to being ineffective will promote the appearance of resistance while if it is disproportionately high it will not achieve")
13. Study this source detail: the spectrum of action to the maximum and leave those broad-spectrum antibiotics for really serious situations. 4. ANTIBIOTIC COMBINATIONS Indications: 1.- Several pathogenic germs with different susceptibility. 2.- Seri (Source: "the spectrum of action to the maximum and leave those broad-spectrum antibiotics for really serious situations. 4. ANTIBIOTIC COMBINATIONS Indications: 1.- Several pathogenic germs with different susceptibility. 2.- Serious infections, increase the spectrum of action of an empirical treatment. 3.- Immunodeficiencies. Example 1: Amoxicillin + clavulanic")
14. Study this source detail: 2: Spiramycin + Metronidazole: Synergistic action. In cases of odontogenic infections these are accepted associations, the rest are considered at risk for the ecological balance of endogenous flora. 5. ALLERGIC REACTIONS (Source: "2: Spiramycin + Metronidazole: Synergistic action. In cases of odontogenic infections these are accepted associations, the rest are considered at risk for the ecological balance of endogenous flora. 5. ALLERGIC REACTIONS b)GENERAL PRINCIPLES OF ANTIBIOTHERAPY PHARMACOLOGICAL TREATMENT SPECIAL PHYSIOLOGICAL SITUATIONS CHILDHOOD •Adapt the dose to body")
15. Study this source detail: from adults. •Tetracyclines not allowed up to 8 years. PHARMACOLOGICAL TREATMENT SPECIAL PHYSIOLOGICAL SITUATIONS ELDERLY •Slight renal and hepatic insufficiency - decreased excretion - decrease dose. •Decreased intestin (Source: "from adults. •Tetracyclines not allowed up to 8 years. PHARMACOLOGICAL TREATMENT SPECIAL PHYSIOLOGICAL SITUATIONS ELDERLY •Slight renal and hepatic insufficiency - decreased excretion - decrease dose. •Decreased intestinal absorption by oral route. Reduce total dose 2/3 parts of normal and / or extend dosage if given parenterally. PHARMACOLOGICAL")
16. Study this source detail: so their use implies the possibility of adverse effects on the fetus. Antibiotics such as penicillin, cephalosporins, erythromycin, and spiramycin may be given during pregnancy. •Decreased intestinal absorption. •Increas (Source: "so their use implies the possibility of adverse effects on the fetus. Antibiotics such as penicillin, cephalosporins, erythromycin, and spiramycin may be given during pregnancy. •Decreased intestinal absorption. •Increased excretion (50% increase in glomerular filtration). LACTANCY •All ATB used systemically is excreted in breast milk, causing")
17. Study this source detail: be administered for safety as in pregnancy. PHARMACOLOGICAL TREATMENT TERATOGENICITY: FDA (Food and Drug Administration) classification, North American of 1990. A- Controlled studies in women show no risk to the fetus du (Source: "be administered for safety as in pregnancy. PHARMACOLOGICAL TREATMENT TERATOGENICITY: FDA (Food and Drug Administration) classification, North American of 1990. A- Controlled studies in women show no risk to the fetus during the first trimester and the possibility of fetal damage appears remote.. B- Animal studies do not indicate risk to the fetus and")
18. Study this source detail: the fetus,In well controlled studies with pregnant women, no fetal risk has been demonstrated. E.g. .: Penicillin, clavulanic acid, clindamycin C-Animal studies have shown that the drug cause teratogenic or embriocydal e (Source: "the fetus,In well controlled studies with pregnant women, no fetal risk has been demonstrated. E.g. .: Penicillin, clavulanic acid, clindamycin C-Animal studies have shown that the drug cause teratogenic or embriocydal effect, but there are no control studies in woman. D-There is positive evidence of fetal risk in humans, but, in certain cases (for example,")
19. Study this source detail: ineffective), the benefits can make the medication acceptable despite its risks. E.g.: Tetracyclines X- Totally unjustified its use in pregnant women. c) PRACTIC ANTIBIOTHERAPY IN THE O.I FIRST CHOICE ANTIBIOTICS NATURAL (Source: "ineffective), the benefits can make the medication acceptable despite its risks. E.g.: Tetracyclines X- Totally unjustified its use in pregnant women. c) PRACTIC ANTIBIOTHERAPY IN THE O.I FIRST CHOICE ANTIBIOTICS NATURAL PENICILLINS -Penicillin G -Penicillin V AMINOPENICILLINS -Ampicillin -Amoxicillin: Clamoxyl®, Ardine® ... MACROLIDES -Erythromycin:")
20. Study this source detail: TREATMENT SECOND CHOICE ANTIBIOTICS METRONIDAZOL - Flagyl® PENICILLIN + BETA-LACTAMASES INHIBITORS - Augmentine® LINCOSAMIDES -Clindamycin: Dalacin® c)PRACTIC ANTIBIOTHERAPY IN THE O.I PHARMACOLOGICAL TREATMENT THIRD CHO (Source: "TREATMENT SECOND CHOICE ANTIBIOTICS METRONIDAZOL - Flagyl® PENICILLIN + BETA-LACTAMASES INHIBITORS - Augmentine® LINCOSAMIDES -Clindamycin: Dalacin® c)PRACTIC ANTIBIOTHERAPY IN THE O.I PHARMACOLOGICAL TREATMENT THIRD CHOICE ANTIBIOTICS AMINOGLYCOSILADES ISOXAZOLIC PENICILLINS CEFALOSPORINS VANCOMICIN TETRACYCLINE CLORANFENICOL QUINOLONES OXAZOLIDINONES")
21. Study this source detail: treatment: In general, any of the acute infectious processes is accompanied of inflammation, pain and sometimes temperature rise. The use of analgesics, non-steroidal anti-inflammatories and antithermal usually done duri (Source: "treatment: In general, any of the acute infectious processes is accompanied of inflammation, pain and sometimes temperature rise. The use of analgesics, non-steroidal anti-inflammatories and antithermal usually done during the first days until the antibiotic acquires ability to counteract the corresponding symptoms. PHARMACOLOGICAL TREATMENT 2.")
22. Study this source detail: -Corticosteroids: Antiedema BUT decreases the defenses and enables the spread of the infection. Corticosteroids at high doses would be indicated in severe processes especially if an involvement of the upper respiratory t (Source: "-Corticosteroids: Antiedema BUT decreases the defenses and enables the spread of the infection. Corticosteroids at high doses would be indicated in severe processes especially if an involvement of the upper respiratory tract is intuited. ( Prednisone) •Pure painkillers - Paracetamol -Minor opiate: Eg Codeine. -Acetylsalicylic acid derivatives RATIONAL")
23. Study this source detail: TREATMENT Supportive care Intended to alleviate the effects of infection on the general condition of the patient and to improve his defenses. When the pain is important the patient eats little and the fever favors dehydr (Source: "TREATMENT Supportive care Intended to alleviate the effects of infection on the general condition of the patient and to improve his defenses. When the pain is important the patient eats little and the fever favors dehydration. -Medical rest -Replacement of fluids and electrolytes. Fluid requirements are increased if the temperature is raised, so")
24. Study this source detail: but increases edema. -Saline rinses if buccal phlegmon every hour. It is not advisable to use mouthwashes containing germicides as it would cause greater imbalance of the flora, so it is better use other substances that (Source: "but increases edema. -Saline rinses if buccal phlegmon every hour. It is not advisable to use mouthwashes containing germicides as it would cause greater imbalance of the flora, so it is better use other substances that allow the repopulation of the normal flora. - Improve the oral cavity hygiene 2. COMPLEMENTARY TREATMENT PHARMACOLOGICAL TREATMENT")
25. Study this source detail: inside certain pathological tissue, such as abscesses. Goals: -Eliminate pathogenic microorganisms directly. -Improve oxygenation. -Eliminate harmful substances (pus, bacterial toxins, tissue fragments ...). -Reduce pain (Source: "inside certain pathological tissue, such as abscesses. Goals: -Eliminate pathogenic microorganisms directly. -Improve oxygenation. -Eliminate harmful substances (pus, bacterial toxins, tissue fragments ...). -Reduce pain. -Direct elimination of the exudate, eliminating the risk of progression to compromised anatomical spaces. Indications of debridement:")
26. Study this source detail: cellulitis, do not wait to mature stage because there is vital commitment. Due to the debridement we cause a change of medium (oxigen) causing a remision of the clinica in 24 h - Residual Abscess: Localized microorganism (Source: "cellulitis, do not wait to mature stage because there is vital commitment. Due to the debridement we cause a change of medium (oxigen) causing a remision of the clinica in 24 h - Residual Abscess: Localized microorganisms in the flanges and necrotic tissue of an abscess that spontaneously opened but did not achieve complete drainage. - Antibiotic abscess:")
27. Study this source detail: as a foreign body. The abscess is not definitely resorbed. SURGICAL TREATMENT SPECIFIC TREATMENT ACCORDING TO THE CLINICAL STAGE TREATMENT OF PERIODONTITIS 1.- Dental treatment: endodontics or exodoncia. 2.- Pharmacologi (Source: "as a foreign body. The abscess is not definitely resorbed. SURGICAL TREATMENT SPECIFIC TREATMENT ACCORDING TO THE CLINICAL STAGE TREATMENT OF PERIODONTITIS 1.- Dental treatment: endodontics or exodoncia. 2.- Pharmacological treatment (antibiotherapy). If there is repercussion of the general condition, administer ATB and wait 24-48 hours to perform the")
28. Study this source detail: treatment. 3.- Prophylactic debridement. If there is no general toxic impact, an exodontics can be performed as long as it is done with antibiotic coverage. We must ensure that the concentration of the antibiotic is maxi (Source: "treatment. 3.- Prophylactic debridement. If there is no general toxic impact, an exodontics can be performed as long as it is done with antibiotic coverage. We must ensure that the concentration of the antibiotic is maximum at the time of surgery. If there is a clear general impact in addition to initiating supportive therapy, a change in antibiotic")
29. Study this source detail: dental tto until the clinical features have cooled. In case the cellulite does not yield in 2 or 3 days or it acquires alarming characteristics, prophylactic debridement will be indicated. SPECIFIC TREATMENT ACCORDING TO (Source: "dental tto until the clinical features have cooled. In case the cellulite does not yield in 2 or 3 days or it acquires alarming characteristics, prophylactic debridement will be indicated. SPECIFIC TREATMENT ACCORDING TO THE CLINICAL STAGE ABSCESS TREATMENT 1.- Surgical debridement. 2.- Dental treatment: exodoncia. SPECIFIC TREATMENT ACCORDING TO THE")
30. Study this source detail: erythematosus IMMUNOSUPPRESSION: By disease, drugs, transplanted or radiotherapy DIABETES: I. MALNUTRITION HEMOPHILYA GRAFT OSTEOARTICULAR PROSTHESIS: Less than 2 years implantation or previous infection in the prosthesi (Source: "erythematosus IMMUNOSUPPRESSION: By disease, drugs, transplanted or radiotherapy DIABETES: I. MALNUTRITION HEMOPHILYA GRAFT OSTEOARTICULAR PROSTHESIS: Less than 2 years implantation or previous infection in the prosthesis. OTHER NON-CONTROLLED ASSOCIATED PATHOLOGIES: Renal or hepatic impairment Gutiérrez JL, Bagan JV, Bascones A, Llamas R, Llena J, Morales")
31. Study this source detail: procedimientos dentales. Med Oral Patol Oral Cir Bucal. 2006 .11(2): 188-205 INDICATIONS OF ANTIBIOTIC PROPHYLAXIS FOR LOCAL INFECTION CARDIAC CONDITIONS ASSOCIATED WITH HIGH RISK OF BACTERIAL ENDOCARDITIS 1.- Cardiac va (Source: "procedimientos dentales. Med Oral Patol Oral Cir Bucal. 2006 .11(2): 188-205 INDICATIONS OF ANTIBIOTIC PROPHYLAXIS FOR LOCAL INFECTION CARDIAC CONDITIONS ASSOCIATED WITH HIGH RISK OF BACTERIAL ENDOCARDITIS 1.- Cardiac valve prosthesis. 2.- Previous endocarditis. 3.- Congenital heart disease : - Unrepaired cyanotic , including shunts and palliative ducts. -")
32. Study this source detail: surgery or catheter 6 months ago (endothelialization of the prosthesis occurs the first 6 months). - CHD repaired with residual defects at the site or adjacent to the site of a prosthesis or prosthetic device (which inhi (Source: "surgery or catheter 6 months ago (endothelialization of the prosthesis occurs the first 6 months). - CHD repaired with residual defects at the site or adjacent to the site of a prosthesis or prosthetic device (which inhibit endothelialization). 4.- Cardiac transplant receptors who develop cardiac valvulopathy. INDICATIONS OF ANTIBIOTIC PROPHYLAXIS FOR")
33. Study this source detail: surgery (children 50 mg/kg). B) Parenteral: Ampicillin 2 g i.m./v. 30-60 minutes before surgery (children 50 mg/kg). Cefazolin / Ceftriaxone 1 g i.m / i.v 30-60 minutes before surgery (children 50 mg/kg). ALLERGIC PATIEN (Source: "surgery (children 50 mg/kg). B) Parenteral: Ampicillin 2 g i.m./v. 30-60 minutes before surgery (children 50 mg/kg). Cefazolin / Ceftriaxone 1 g i.m / i.v 30-60 minutes before surgery (children 50 mg/kg). ALLERGIC PATIENT: A) Oral : Cephalexin 2 g 30-60 minutes before surgery (children 50 mg/kg). Clindamycin 600 mg 30-60 minutes before surgery (children 20")
34. Study this source detail: B) Parenteral : Clindamycin 600 mg i.m./i.v 30-60 minutes before surgery (children 20 mg/kg). Cefazolin / Ceftriaxone 1 g i.m / i.v 30-60 minutes before surgery (children 50 mg/kg) ANTIBIOTIC PROPHYLAXIS ODONTOGENIC INFE (Source: "B) Parenteral : Clindamycin 600 mg i.m./i.v 30-60 minutes before surgery (children 20 mg/kg). Cefazolin / Ceftriaxone 1 g i.m / i.v 30-60 minutes before surgery (children 50 mg/kg) ANTIBIOTIC PROPHYLAXIS ODONTOGENIC INFECTION IV: Surgical treatment of the odontogenic infection Surgical treatment: Debridement Drainage of intraoral abscesses may be")
35. Study this source detail: general anaesthesia may be required). The blade of the scalpel is inserted parallel to the gingival margin, directly into the abscess to the full depth in its long axis. This should be followed immediately by a flow of p (Source: "general anaesthesia may be required). The blade of the scalpel is inserted parallel to the gingival margin, directly into the abscess to the full depth in its long axis. This should be followed immediately by a flow of pus. Debridement: As pus tends to track downwards under gravity, it is usual to make the incision at the lowest (most dependent)")
36. Study this source detail: dissection using scissors or a curved haemostat. This involves pushing the end of the instrument into the wound with the tips together, then forcibly opening the instrument to develop a plane of dissection. This is repea (Source: "dissection using scissors or a curved haemostat. This involves pushing the end of the instrument into the wound with the tips together, then forcibly opening the instrument to develop a plane of dissection. This is repeated until the abscess cavity is reached. Blunt dissection minimizes the risk of injury to nerves and vessels. DEBRIDEMENT To introduce a")
37. Study this source detail: directions of the cavity of the abscess in order to break the septa that constitute the different anatomical structures, basically the aponeurosis and the superficial muscles. Goals: •Exit of purulent and necrotic materi (Source: "directions of the cavity of the abscess in order to break the septa that constitute the different anatomical structures, basically the aponeurosis and the superficial muscles. Goals: •Exit of purulent and necrotic material. •Pain relief. •Oxygenation and alteration of the ecosystem. SELECTION OF THE ANESTHESIA INFILTRATIVE ANESTHESIA: - Superficial")
38. Study this source detail: in deep planes (subcutaneous and submucosal) for proper debridement. E.V SEDATION FOR SHORT TERM INCISION GENERAL CHARACTERISTICS The correct incision for debridement must meet 4 REQUIREMENTS: - Knowledge of local ANATOM (Source: "in deep planes (subcutaneous and submucosal) for proper debridement. E.V SEDATION FOR SHORT TERM INCISION GENERAL CHARACTERISTICS The correct incision for debridement must meet 4 REQUIREMENTS: - Knowledge of local ANATOMY of the area to be incised. - SUFFICIENT: We must avoid closing the abscess and perpetuating the infection. Wide incisions for drainage")
39. Study this source detail: the most decline area. Avoid areas where the abscess drains spontaneously (thin and not vital skin) to avoid cutaneous necrosis and scarring fibrosis. - ESTHETICAL: The election area is intrabucal . Extrabucal follow lan (Source: "the most decline area. Avoid areas where the abscess drains spontaneously (thin and not vital skin) to avoid cutaneous necrosis and scarring fibrosis. - ESTHETICAL: The election area is intrabucal . Extrabucal follow langer lines. Incision placed in esthetically accepted area. – Parallel to the skin folds or shadow of mandible. Natural folds of head and")
40. Study this source detail: of the tooth. Caution with the nobles structures. In the mucous membrane incisions are made parallel to the occlusal surface of the teeth, 1 to 2 cm in length, with due regard for underlying structures such as the mental (Source: "of the tooth. Caution with the nobles structures. In the mucous membrane incisions are made parallel to the occlusal surface of the teeth, 1 to 2 cm in length, with due regard for underlying structures such as the mental nerve. Smaller incisions are ineffective. - Palate and sublingual: Medial incisions, NEVER TRANSVERSAL, to avoid anatomical content. On")
41. Study this source detail: EXTRAORAL INCISIONS: Incisions through the skin should avoid the branches of the facial nerve. Where the abscess is deep and a free discharge is not obtained through a simple skin incision, Hilton’s method of blunt disse (Source: "EXTRAORAL INCISIONS: Incisions through the skin should avoid the branches of the facial nerve. Where the abscess is deep and a free discharge is not obtained through a simple skin incision, Hilton’s method of blunt dissection is performed. This involves inserting closed forceps into the wound, and then opening slowly but firmly to separate the soft tissue")
42. Study this source detail: blind. This procedure is repeated until the abscess is reached and pus discharged. In dental infections, an area of rough cortical bone can be felt on the mandible or maxilla where the periosteum has been raised. A drain (Source: "blind. This procedure is repeated until the abscess is reached and pus discharged. In dental infections, an area of rough cortical bone can be felt on the mandible or maxilla where the periosteum has been raised. A drain is placed to allow drainage to continue for the required duration EXTRABUCAL INCISIONS: Flows to the mandibular basilar and following")
43. Study this source detail: incision: To access deep spaces when the intrabuccal route is impossible due to trismus. 3.- High submaxillary incision. 4.- Low submaxillary incision. 5.- Horizontal and median submental incision. 6.- Oblique temporal i (Source: "incision: To access deep spaces when the intrabuccal route is impossible due to trismus. 3.- High submaxillary incision. 4.- Low submaxillary incision. 5.- Horizontal and median submental incision. 6.- Oblique temporal incision: Approach of temporal space. ANATOMICAL STRUCTURES TO AVOID • Intraoral approach: o Lower vestibular: Mental nerve. o Upper")
44. Study this source detail: gland, Wharton's duct, lingual nerve and sublingual vein. • Extraoral approach: o Branches of the facial nerve. o Artery and facial vein. o Stensen's duct Facial nerve branches Transversal facial artery Parotid Gland Fac (Source: "gland, Wharton's duct, lingual nerve and sublingual vein. • Extraoral approach: o Branches of the facial nerve. o Artery and facial vein. o Stensen's duct Facial nerve branches Transversal facial artery Parotid Gland Facial artery and vein Stensen Duct DRAINAGE Larger and deeper abscesses tend to seal off shortly after debridement, leaving pus")
45. Study this source detail: rubber or tubular plastic drain or the finger of a sterile rubber glove—may be used. These must be sutured in for at least 24-48 hours or days necessary until cessation of suppuration. • Objective: Keep the wound open, o (Source: "rubber or tubular plastic drain or the finger of a sterile rubber glove—may be used. These must be sutured in for at least 24-48 hours or days necessary until cessation of suppuration. • Objective: Keep the wound open, oxygenate the area and remove the material. • Indications: - Big abscesses. - Affection of deep spaces. - Diffuse cellulitis. Technique:")
46. Study this source detail: that allows its washing without losing qualities. In diffuse cellulite, polyethylene tubes with perforations can be used. We will never use gauzes that favor the coagulation between their fibers and obstruct the exit of (Source: "that allows its washing without losing qualities. In diffuse cellulite, polyethylene tubes with perforations can be used. We will never use gauzes that favor the coagulation between their fibers and obstruct the exit of the material. - Drainage fixation with a double suture with 3/0 silk. - Cover with gauze dressing that is changed several times a day")
47. Study this source detail: great importance and requires considerable experience: • In acute infection with a high temperature, immediate treatment with intravenous antibacterial drugs should be commenced. • If pus has localised this must be drain (Source: "great importance and requires considerable experience: • In acute infection with a high temperature, immediate treatment with intravenous antibacterial drugs should be commenced. • If pus has localised this must be drained without delay and culture and sensitivity tests performed. • Antibacterial drugs can be commenced blind and continued until the results")
48. Study this source detail: as soon as the acute phase has passed. Management algoritm for odontogenic infections Contemporary Oral and Maxillofacial Surgery , Sixth Edition. James R. Hupp, Edward Ellis, and Myron R. Tucker. Chapter 16, 296-318. Co (Source: "as soon as the acute phase has passed. Management algoritm for odontogenic infections Contemporary Oral and Maxillofacial Surgery , Sixth Edition. James R. Hupp, Edward Ellis, and Myron R. Tucker. Chapter 16, 296-318. Copyright © 2014 by Mosby, an affiliate of Elsevier Inc. Causes For The Failure in Treatment of Infection: • Inadequate surgical treatment")
49. Study this source detail: TREATMENT OF ODONTOGENIC INFECTION : - Odontological treatment - Pharmacologycal treatment - Surgical treatment ODONTOGENIC INFECTION : As a general therapeutic option, dental treatment will be the first action, followed (Source: "TREATMENT OF ODONTOGENIC INFECTION : - Odontological treatment - Pharmacologycal treatment - Surgical treatment ODONTOGENIC INFECTION : As a general therapeutic option, dental treatment will be the first action, followed by a medical treatment that can be resolutive in many cases, but that in others will have to be supplemented with drainage")
50. Study this source detail: 2. Complementary treatment PHARMACOLOGICAL TREATMENT a) Principles for the use of therapeutic antibiotics b) General principles of antibiotherapy c) Practic antibiotherapy in Odontogenic infections (O (Source: "2. Complementary treatment PHARMACOLOGICAL TREATMENT a) Principles for the use of therapeutic antibiotics b) General principles of antibiotherapy c) Practic antibiotherapy in Odontogenic infections (O")
51. Study this source detail: 1. THE ELECTION OF THE ATB It is based on the criteria of: -Efficacy: Eliminate or inactivate pathogenic microorganisms -Safety: Non-toxic therapeutic doses (Source: "1. THE ELECTION OF THE ATB It is based on the criteria of: -Efficacy: Eliminate or inactivate pathogenic microorganisms -Safety: Non-toxic therapeutic doses")
52. Study this source detail: 2. ATB ADMINISTRATION Routes of administration: - Oral: The most physiological and the one that provides less adverse reactions (Source: "2. ATB ADMINISTRATION Routes of administration: - Oral: The most physiological and the one that provides less adverse reactions")
53. Study this source detail: g. We give the "hard" for the first day and severe cases and the "soft" for mild and moderate cases (Source: "g. We give the "hard" for the first day and severe cases and the "soft" for mild and moderate cases")
54. Study this source detail: really serious situations. 4. ANTIBIOTIC COMBINATIONS Indications: 1.- Several pathogenic germs with different susceptibility. 2.- Serious infections, increase the spectrum of action of an empirical treatment. 3.- (Source: "really serious situations. 4. ANTIBIOTIC COMBINATIONS Indications: 1.- Several pathogenic germs with different susceptibility. 2.- Serious infections, increase the spectrum of action of an empirical treatment. 3.-")
55. Study this source detail: 4. ANTIBIOTIC COMBINATIONS Indications: 1 (Source: "4. ANTIBIOTIC COMBINATIONS Indications: 1")
56. Study this source detail: Reduce total dose 2/3 parts of normal and / or extend dosage if given parenterally (Source: "Reduce total dose 2/3 parts of normal and / or extend dosage if given parenterally")
57. Study this source detail: A- Controlled studies in women show no risk to the fetus during the first trimester and the possibility of fetal damage appears remote (Source: "A- Controlled studies in women show no risk to the fetus during the first trimester and the possibility of fetal damage appears remote")
58. Study this source detail: 2. COMPLEMENTARY TREATMENT Symptomatic treatment: In general, any of the acute infectious processes is accompanied of inflammation, pain and sometimes temperature rise (Source: "2. COMPLEMENTARY TREATMENT Symptomatic treatment: In general, any of the acute infectious processes is accompanied of inflammation, pain and sometimes temperature rise")
59. Study this source detail: 2. COMPLEMENTARY TREATMENT PAIN KILLERS- ANTI-INFLAMMATORY •Anti-inflammatory -NSAIDs: eg Ibuprofen (Source: "2. COMPLEMENTARY TREATMENT PAIN KILLERS- ANTI-INFLAMMATORY •Anti-inflammatory -NSAIDs: eg Ibuprofen")
60. Study this source detail: 2. COMPLEMENTARY TREATMENT PHARMACOLOGICAL TREATMENT SURGICAL TREATMENT DEBRIDEMENT Incision and surgical break of the fibrous bands that are present inside certain pathological tissue, such as abscesses (Source: "2. COMPLEMENTARY TREATMENT PHARMACOLOGICAL TREATMENT SURGICAL TREATMENT DEBRIDEMENT Incision and surgical break of the fibrous bands that are present inside certain pathological tissue, such as abscesses")
61. Study this source detail: al spaces. Indications of debridement: - Mature abscess stage: fluctuates on palpation. - "Prophylactic debridement": Severe diffuse cellulitis, do not wait to mature stage because there is vital commitment. Due to the d (Source: "al spaces. Indications of debridement: - Mature abscess stage: fluctuates on palpation. - "Prophylactic debridement": Severe diffuse cellulitis, do not wait to mature stage because there is vital commitment. Due to the debridement we cause a change of medium (oxigen) causing")
62. Study this source detail: If there is repercussion of the general condition, administer ATB and wait 24-48 hours to perform the dental treatment (Source: "If there is repercussion of the general condition, administer ATB and wait 24-48 hours to perform the dental treatment")
63. Study this source detail: I. MALNUTRITION HEMOPHILYA GRAFT OSTEOARTICULAR PROSTHESIS: Less than 2 years implantation or previous infection in the prosthesis (Source: "I. MALNUTRITION HEMOPHILYA GRAFT OSTEOARTICULAR PROSTHESIS: Less than 2 years implantation or previous infection in the prosthesis")
64. Study this source detail: A) Oral: Amoxicillin 2 g 30-60 minutes before surgery (children 50 mg/kg) (Source: "A) Oral: Amoxicillin 2 g 30-60 minutes before surgery (children 50 mg/kg)")
65. Study this source detail: A) Oral : Cephalexin 2 g 30-60 minutes before surgery (children 50 mg/kg) (Source: "A) Oral : Cephalexin 2 g 30-60 minutes before surgery (children 50 mg/kg)")
66. Study this source detail: Debridement: As pus tends to track downwards under gravity, it is usual to make the incision at the lowest (most dependent) part of the expected cavity (Source: "Debridement: As pus tends to track downwards under gravity, it is usual to make the incision at the lowest (most dependent) part of the expected cavity")
67. Study this source detail: SELECTION OF THE ANESTHESIA INFILTRATIVE ANESTHESIA: - Superficial abscesses (intrabuccal) (Source: "SELECTION OF THE ANESTHESIA INFILTRATIVE ANESTHESIA: - Superficial abscesses (intrabuccal)")
68. Study this source detail: - Palate and sublingual: Medial incisions, NEVER TRANSVERSAL, to avoid anatomical content (Source: "- Palate and sublingual: Medial incisions, NEVER TRANSVERSAL, to avoid anatomical content")
69. Study this source detail: A drain is placed to allow drainage to continue for the required duration EXTRABUCAL INCISIONS: Flows to the mandibular basilar and following the lines of Langer (Source: "A drain is placed to allow drainage to continue for the required duration EXTRABUCAL INCISIONS: Flows to the mandibular basilar and following the lines of Langer")
70. Study this source detail: These must be sutured in for at least 24-48 hours or days necessary until cessation of suppuration (Source: "These must be sutured in for at least 24-48 hours or days necessary until cessation of suppuration")
71. Study this source detail: Technique: Placement of a Penrose-type drainage by a glove finger or any hypoallergenic soft rubber artifice that allows its washing without losing qualities (Source: "Technique: Placement of a Penrose-type drainage by a glove finger or any hypoallergenic soft rubber artifice that allows its washing without losing qualities")
72. Study this source detail: 2014 by Mosby, an affiliate of Elsevier Inc (Source: "2014 by Mosby, an affiliate of Elsevier Inc")
73. Study this source detail: 3. DOSE Objective 1: Plasma and tissue concentrations should be maintained at non- exaggerated but effective therapeutic levels (Source: "3. DOSE Objective 1: Plasma and tissue concentrations should be maintained at non- exaggerated but effective therapeutic levels")
74. Study this source detail: 3. Use of specific, narrow-spectrum antibiotics (Source: "3. Use of specific, narrow-spectrum antibiotics")
75. Study this source detail: B) Parenteral : Clindamycin 600 mg i (Source: "B) Parenteral : Clindamycin 600 mg i")
76. Study this source detail: R. Hupp, Edward Ellis, and Myron R (Source: "R. Hupp, Edward Ellis, and Myron R")
77. Study this source detail: Complementary treatment PHARMACOLOGICAL TREATMENT a) Principles for the use of therapeutic antibiotics b) General principles of antibiotherapy c) Practic antibiotherapy in Odontogenic infections (O.I) a)PRINCIPLES FOR TH (Source: "Complementary treatment PHARMACOLOGICAL TREATMENT a) Principles for the use of therapeutic antibiotics b) General principles of antibiotherapy c) Practic antibiotherapy in Odontogenic infections (O.I) a)PRINCIPLES FOR THE USE OF THERAPEUTIC ANTIBIOTICS PHARMACOLOGICAL TREATMENT 1. Identification of the causative organism. 2 . Determination of the antibiot...")
78. Study this source detail: 6. Use of bacteriocidal ( kill bacteria) rather than bacteriostatic drugs ( interfere with their reproduction) (Source: "6. Use of bacteriocidal ( kill bacteria) rather than bacteriostatic drugs ( interfere with their reproduction)")
79. Study this source detail: 5. ALLERGIC REACTIONS b)GENERAL PRINCIPLES OF ANTIBIOTHERAPY PHARMACOLOGICAL TREATMENT SPECIAL PHYSIOLOGICAL SITUATIONS CHILDHOOD •Adapt the dose to body weight (Source: "5. ALLERGIC REACTIONS b)GENERAL PRINCIPLES OF ANTIBIOTHERAPY PHARMACOLOGICAL TREATMENT SPECIAL PHYSIOLOGICAL SITUATIONS CHILDHOOD •Adapt the dose to body weight")
80. Study this source detail: o Sublingual: Sublingual gland, Wharton's duct, lingual nerve and sublingual vein (Source: "o Sublingual: Sublingual gland, Wharton's duct, lingual nerve and sublingual vein")
81. Study this source detail: 1. Identification of the causative organism (Source: "1. Identification of the causative organism")
82. Study this source detail: 7. Use of antibiotics with a proven history of success (Source: "7. Use of antibiotics with a proven history of success")
83. Study this source detail: st antibiotics have a half-life of 1 to 2 hours but dosing is usually every 6 to 8 hours. "Post-antibiotic effect": Some cells of the immune system, such as neutrophils, macrophages and fibroblasts, store the antibiotic (Source: "st antibiotics have a half-life of 1 to 2 hours but dosing is usually every 6 to 8 hours. "Post-antibiotic effect": Some cells of the immune system, such as neutrophils, macrophages and fibroblasts, store the antibiotic inside and release it - "targeted release" - in the pr")
84. Study this source detail: as neutrophils, macrophages and fibroblasts, store the antibiotic inside and release it - "targeted release" - in the presence of pathogens. Persistence of effects in the physical absence of the antibiotic. PHARMACOLOGIC (Source: "as neutrophils, macrophages and fibroblasts, store the antibiotic inside and release it - "targeted release" - in the presence of pathogens. Persistence of effects in the physical absence of the antibiotic. PHARMACOLOGICAL TREATMENT b)GENERAL PRINCIPLES OF ANTIBIOTHER")
85. Study this source detail: as two doses: - Hard dose - Soft dose Example: Amoxicillin 500 mg - 1 g. We give the "hard" for the first day and severe cases and the "soft" for mild and moderate cases. Remove the treatment when there is clinical remis (Source: "as two doses: - Hard dose - Soft dose Example: Amoxicillin 500 mg - 1 g. We give the "hard" for the first day and severe cases and the "soft" for mild and moderate cases. Remove the treatment when there is clinical remission to prevent the occurrence of resistance. PHARMACOLOGICAL TREATMENT b)GE")
86. Study this source detail: hieve complete drainage. - Antibiotic abscess: By the action of ATB there is an area with "sterile pus" and with necrotic material that acts as a foreign body. The abscess is not definitely resorbed. SURGICAL TREATMENT S (Source: "hieve complete drainage. - Antibiotic abscess: By the action of ATB there is an area with "sterile pus" and with necrotic material that acts as a foreign body. The abscess is not definitely resorbed. SURGICAL TREATMENT SPECIFIC TREATMENT ACCORDING TO THE CLINICAL")
87. Study this source detail: - Cover with gauze dressing that is changed several times a day to avoid maceration of the skin (Source: "- Cover with gauze dressing that is changed several times a day to avoid maceration of the skin")
88. Study this source detail: Causes For The Failure in Treatment of Infection: • Inadequate surgical treatment • Depressed host defenses • Presence of foreign body (Source: "Causes For The Failure in Treatment of Infection: • Inadequate surgical treatment • Depressed host defenses • Presence of foreign body")
89. Study this source detail: • Antibiotic problems: – Drug not reaching infection – Dose not adequate – Wrong bacterial diagnosis – Wrong antibiotic election (Source: "• Antibiotic problems: – Drug not reaching infection – Dose not adequate – Wrong bacterial diagnosis – Wrong antibiotic election")
90. Study this source detail: Most antibiotics have a half-life of 1 to 2 hours but dosing is usually every 6 to 8 hours (Source: "Most antibiotics have a half-life of 1 to 2 hours but dosing is usually every 6 to 8 hours")
91. Study this source detail: MALNUTRITION HEMOPHILYA GRAFT OSTEOARTICULAR PROSTHESIS: Less than 2 years implantation or previous infection in the prosthesis (Source: "MALNUTRITION HEMOPHILYA GRAFT OSTEOARTICULAR PROSTHESIS: Less than 2 years implantation or previous infection in the prosthesis")
92. Study this source detail: - Congenital heart defects (CHD) repaired completely with prostheses or devices, placed by open surgery or catheter 6 months ago (endothelialization of the prosthesis occurs the first 6 months) (Source: "- Congenital heart defects (CHD) repaired completely with prostheses or devices, placed by open surgery or catheter 6 months ago (endothelialization of the prosthesis occurs the first 6 months)")
93. Study this source detail: INDICATIONS OF ANTIBIOTIC PROPHYLAXIS FOR DISTANCE INFECTION STANDARD PATIENT (NO ALERGIES): A) Oral: Amoxicillin 2 g 30-60 minutes before surgery (children 50 mg/kg) (Source: "INDICATIONS OF ANTIBIOTIC PROPHYLAXIS FOR DISTANCE INFECTION STANDARD PATIENT (NO ALERGIES): A) Oral: Amoxicillin 2 g 30-60 minutes before surgery (children 50 mg/kg)")
94. Study this source detail: ALLERGIC PATIENT: A) Oral : Cephalexin 2 g 30-60 minutes before surgery (children 50 mg/kg) (Source: "ALLERGIC PATIENT: A) Oral : Cephalexin 2 g 30-60 minutes before surgery (children 50 mg/kg)")
95. Study this source detail: Azithromycin / Clarithromycin 500 mg 30-60 minutes before surgery (children 15 mg/kg) (Source: "Azithromycin / Clarithromycin 500 mg 30-60 minutes before surgery (children 15 mg/kg)")
96. Study this source detail: "Post-antibiotic effect": Some cells of the immune system, such as neutrophils, macrophages and fibroblasts, store the antibiotic inside and release it - "targeted release" - in the presence of pathogens (Source: ""Post-antibiotic effect": Some cells of the immune system, such as neutrophils, macrophages and fibroblasts, store the antibiotic inside and release it - "targeted release" - in the presence of pathogens")

📅 Key Dates

Date	Event
1990	Publication of initial treatment principles for odontogenic infections
2006	Development of guidelines for antibiotic prophylaxis in high-risk patients
2014	Updated protocols for surgical and pharmacological management of odontogenic infections

📊 Synthesis Tables

Comparison of Antibiotic Regimens for Prophylaxis

Patient Type	Drug	Dosage
Standard patient	Amoxicillin	2 g 30-60 min before surgery
Allergic patient	Cephalexin	2 g 30-60 min before surgery
Allergic patient	Clindamycin	600 mg 30-60 min before surgery
Children	Amoxicillin	50 mg/kg 30-60 min before surgery
Children	Clindamycin	Dose adjusted accordingly

⚠️ Common Pitfalls & Confusions

1. Confusing the treatment stage with the infection type, leading to inappropriate management
2. Misunderstanding the anatomical space involved, affecting surgical approach
3. Incorrect antibiotic choice due to lack of sensitivity testing
4. Overlooking patient immune status, which influences treatment decisions
5. Inadequate timing of antibiotic administration, reducing efficacy
6. Failure to consider allergy status, risking adverse reactions
7. Misapplication of prophylaxis protocols in non-high-risk patients

✅ Exam Checklist

1. Assess infection stage and topography before treatment
2. Determine patient immune and allergy status
3. Choose appropriate surgical intervention based on abscess or cellulitis
4. Select antibiotics based on sensitivity and spectrum
5. Administer antibiotics at correct timing relative to surgery
6. Perform surgical drainage promptly in abscess cases
7. Use blunt dissection techniques to minimize tissue injury
8. Monitor patient response and adjust treatment accordingly
9. Provide supportive care including analgesics and anti-inflammatories
10. Educate patient on post-treatment care and signs of complications
11. Schedule follow-up to ensure resolution of infection