Acute and Chronic sinusitis, focal and foci of infection.pptx

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1. Acute and Chronic Maxillary sinusitis Focal infection and Foci of infection Dr Soumya A Dept of Oral Path, SRDC II BDS Flipped Class

2. Acute and Chronic Maxillary sinusitis Focal infection and Foci of infection Dr Soumya A Dept of Oral Path, SRDC II BDS Flipped Class Lesson Plan L01-Introduction to Sinusitis L02-Clinical features, diagnosis, Histology, Treatment of Acute Sinusitis L03-Clinical features, diagnosis, Histology, Treatment of Chronic Sinusitis L04-What is Focal infection, Mechanism of focal infection L05-Oral Foci of Infection, Significance of Oral Foci of infection

3. Acute and Chronic Maxillary sinusitis Focal infection and Foci of infection Dr Soumya A Dept of Oral Path, SRDC LO1: Introduction to Sinusitis Acute or Chronic Inflammation O ften due to direct extension of dental infection, B ut originates also from infectious diseases due to bacteria, fungus, or virus such as the common cold, influenza and the exanthematous diseases. F rom local spread of infection in the adjoining frontal or paranasal sinuses; or from traumatic injury of the sinuses with a superimposed infection. The common organisms Streptococcus pneumoniae , Hemophilus influenzae , Moraxella catarrhalis I n children, gram-negative bacilli, A naerobic organisms, Rhinovirus Parainfluenza viruses .

4. Acute and Chronic Maxillary sinusitis Focal infection and Foci of infection Dr Soumya A Dept of Oral Path, SRDC LO1: Introduction to Sinusitis

5. Acute and Chronic Maxillary sinusitis Focal infection and Foci of infection Dr Soumya A Dept of Oral Path, SRDC L02-Clinical features, diagnosis, Histology, Treatment of Acute Sinusitis Acute sinusitis may result from an acute periapical abscess or acute exacerbation of a chronic inflammatory periapical lesion, which involves the sinus through direct extension. In some cases, a latent chronic sinusitis may be awakened by extraction of a maxillary bicuspid or molar and perforation of the sinus. Usually, the organisms involved in acute sinusitis are S. pneumoniae , H. influenzae , and Moraxella catarrhalis . Anaerobic organisms are isolated during acute infections at times.

6. Acute and Chronic Maxillary sinusitis Focal infection and Foci of infection Dr Soumya A Dept of Oral Path, SRDC L02-Clinical features, diagnosis, Histology, Treatment of Acute Sinusitis Clinical Features. M oderate to severe pain with swelling H eadache. Pressing over the maxilla increases the pain. Often, the painful sensation is one of pressure. Pain may be referred to various areas, including the cheek, posterior teeth, and ear. P atient may feel numbness in maxillary molars and premolars. Sinus pain increases when the patient bends over or is supine. The patient may complain of a discharge of pus into the nose and often a fetid breath. Fever and malaise are usually present. The diagnosis of acute maxillary sinusitis from clinical manifestations alone is quite difficult.

7. Acute and Chronic Maxillary sinusitis Focal infection and Foci of infection Dr Soumya A Dept of Oral Path, SRDC L02-Clinical features, diagnosis, Histology, Treatment of Acute Sinusitis

8. Acute and Chronic Maxillary sinusitis Focal infection and Foci of infection Dr Soumya A Dept of Oral Path, SRDC L02-Clinical features, diagnosis, Histology, Treatment of Acute Sinusitis Diagnosis. Clinical signs and symptoms T ransillumination with strong flashlight in darkroom, S inus view radiograph, N asal and sinus endoscopy, Computed tomography

9. Acute and Chronic Maxillary sinusitis Focal infection and Foci of infection Dr Soumya A Dept of Oral Path, SRDC L02-Clinical features, diagnosis, Histology, Treatment of Acute Sinusitis Histologic Features. The lining of the maxillary sinus may show a typical acute inflammatory infiltrate with edema of the connective tissue and often hemorrhage. A squamous metaplasia of the specialized ciliated columnar epithelium occurs sometimes.

10. Acute and Chronic Maxillary sinusitis Focal infection and Foci of infection Dr Soumya A Dept of Oral Path, SRDC L02-Clinical features, diagnosis, Histology, Treatment of Acute Sinusitis Treatment and Prognosis. The prime objective of treatment is the removal of the infecting locus. This is particularly efficacious if the infection is of dental origin. Because of the infection present, antibiotics should also be administered

11. Acute and Chronic Maxillary sinusitis Focal infection and Foci of infection Dr Soumya A Dept of Oral Path, SRDC L03-Clinical features, diagnosis, Histology, Treatment of Chronic Sinusitis Introduction: Chronic sinusitis refers to sinusitis of more than three months duration M ay develop as the acute lesion subsides or may represent a chronic lesion from the onset. Common predisposing factors are recent upper respiratory viral infections or allergic sinusitis. T he organisms A naerobes S treptococcus B acteroides, Veillonella

12. Acute and Chronic Maxillary sinusitis Focal infection and Foci of infection Dr Soumya A Dept of Oral Path, SRDC L03-Clinical features, diagnosis, Histology, Treatment of Chronic Sinusitis Clinical Features lacking, and the condition may be discovered only during routine examination. Sometimes headache, fever, vague facial pain or upper toothache is present T here is a stuffy sensation on the affected side of the face. There may be a mild discharge of pus into the nose and a fetid breath. Children may have persistent cough, fever, and purulent rhinorrhea. In chronic sinusitis, rarely will there be dystrophic calcification termed antrolith, which may be detected radiographically

13. Acute and Chronic Maxillary sinusitis Focal infection and Foci of infection Dr Soumya A Dept of Oral Path, SRDC L03-Clinical features, diagnosis, Histology, Treatment of Chronic Sinusitis Radiographic Features. Sinusitis can be seen on the radiograph as a clouding of the sinus due to the hyperplastic tissue or fluid present. Films of both sinuses should be compared before a diagnosis is attempted. CT scan may reveal thickening of the mucosa.

14. Acute and Chronic Maxillary sinusitis Focal infection and Foci of infection Dr Soumya A Dept of Oral Path, SRDC L03-Clinical features, diagnosis, Histology, Treatment of Chronic Sinusitis Histologic Features. The mucosa lining the maxillary sinus may show remarkable thickening and the development of numerous sinus ‘instances. These polyps are simply hyperplastic granulation tissue with lymphocytic and sometimes plasma cell infiltration. This tissue, which is usually covered by ciliated columnar epithelium, tends to fill the sinus and obliterate it. In some instances, there is no remarkable proliferation of granulation tissue; rather, there is only a mild lymphocytic infiltration of the lining tissue with squamous metaplasia of the epithelium.

15. Acute and Chronic Maxillary sinusitis Focal infection and Foci of infection Dr Soumya A Dept of Oral Path, SRDC L03-Clinical features, diagnosis, Histology, Treatment of Chronic Sinusitis Treatment and Prognosis The treatment for chronic maxillary sinusitis consists in removal of the cause of the disease. The prognosis is considered good if the disease is due to dental infection, since it can be eliminated. Infection from other sites may be difficult to eradicate.

16. Acute and Chronic Maxillary sinusitis Focal infection and Foci of infection Dr Soumya A Dept of Oral Path, SRDC L04-Focal Infections, Mechanism of Focal Infection A focal infection is a localized or general infection caused by the dissemination of microorganisms or toxic products from a focus of infection. Focus of infection refers to a circumscribed area of tissue, which is infected with exogenous pathogenic microorganisms and is usually located near a mucous or cutaneous surface. This should be carefully distinguished from focal infection.

17. Acute and Chronic Maxillary sinusitis Focal infection and Foci of infection Dr Soumya A Dept of Oral Path, SRDC L04-Focal Infections, Mechanism of Focal Infection Mechanisms: 2 Ways In one instance there may be a metastasis of microorganisms from an infected focus by either hematogenous or lymphogenous spread. Secondly, toxins or toxic products may be carried through the blood stream or lymphatic channels from a focus to a distant site where they may incite a hypersensitive reaction in the tissues. The spread of microorganisms through vascular or lymphatic channels is a recognized phenomenon, as is their localization in tissues. Thus, certain organisms have a predilection for isolating themselves in specific sites in the body.

18. Acute and Chronic Maxillary sinusitis Focal infection and Foci of infection Dr Soumya A Dept of Oral Path, SRDC L04-Focal Infections, Mechanism of Focal Infection Mechanisms: 2 Ways This localization preference is probably an environmental phenomenon rather than an inherent or developed feature of the microorganisms. The production of toxins by microorganisms and their dissemination by vascular channels are also recognized occurrences. One of the most dramatic examples is in scarlet fever, the remarkable cutaneous features of the disease being due to the erythrogenic toxin liberated by the infecting streptococci

19. Acute and Chronic Maxillary sinusitis Focal infection and Foci of infection Dr Soumya A Dept of Oral Path, SRDC L05-Oral Foci of Infection, Significance of Oral Foci of infection A variety of situations exist in the oral cavity which are at least theoretical sources of infection and which may set up distant metastases. These include Infected periapical lesions such as the periapical granuloma, cysts, or abscesses Teeth with infected root canals Periodontal disease with special reference to tooth extraction or manipulation.

20. Acute and Chronic Maxillary sinusitis Focal infection and Foci of infection Dr Soumya A Dept of Oral Path, SRDC L05-Oral Foci of Infection, Significance of Oral Foci of infection Organisms and Etiology Severity or degree of periodontal diseases present after manipulation of the gingiva or more commonly, after tooth extraction. S imple massage of inflamed gingiva resulted in a transitory bacteremia. A transitory bacteremia was seen who had severe periodontal disease after tooth extraction. The organism usually recovered was Streptococcus viridans. The ‘rocking’ of teeth in their sockets by forceps before extraction ‘Pumping’ action occurring during dental extraction may force microorganisms from the gingival crevice into the capillaries of the gingiva as well as into the pulp of the tooth

21. Acute and Chronic Maxillary sinusitis Focal infection and Foci of infection Dr Soumya A Dept of Oral Path, SRDC L05-Oral Foci of Infection, Significance of Oral Foci of infection Significance of Foci of infection There have been a vast number of reports, based chiefly on clinical evidence alone, purporting to show that oral foci of infection either cause or aggravate a great many systemic diseases. The diseases most frequently mentioned are: Arthritis, chiefly of the rheumatoid and rheumatic fever type Valvular heart disease, particularly subacute bacterial endocarditis Gastrointestinal diseases Ocular diseases Skin diseases Renal diseases.

22. Acute and Chronic Maxillary sinusitis Focal infection and Foci of infection Dr Soumya A Dept of Oral Path, SRDC L05-Oral Foci of Infection, Significance of Oral Foci of infection Significance of Foci of infection There have been a vast number of reports, based chiefly on clinical evidence alone, purporting to show that oral foci of infection either cause or aggravate a great many systemic diseases. The diseases most frequently mentioned are: Arthritis, chiefly of the rheumatoid and rheumatic fever type Valvular heart disease, particularly subacute bacterial endocarditis Gastrointestinal diseases Ocular diseases Skin diseases Renal diseases.

23. Acute and Chronic Maxillary sinusitis Focal infection and Foci of infection Dr Soumya A Dept of Oral Path, SRDC L05-Oral Foci of Infection, Significance of Oral Foci of infection