Spread of odontogenic infection originating in the maxillary teeth: computerized tomographic assessment.

OBJECTIVE: The aim of this study was to investigate the pathways of infection originating in the maxillary teeth through the interpretation of computerized tomographic (CT) appearances.

STUDY DESIGN: CT images of 78 patients were analyzed with reference to lateral asymmetry of shape and density of fascial spaces and tissues.

RESULTS: Changes in the alveolar cortical plates were observed more frequently in the labial/buccal side than in the palatal side. The facial expression muscles were involved in 23 (19.4%) patients. Infection caused by anterior teeth often spread into the levator labii superioris and levator anguli oris muscles. Deep spread into the fascial space was found in 9 (11.5%) patients. Masticator space changes were predominantly seen in the patients with infection caused by molars. Maxillary sinus changes were found in 57 (71.3%) patients with infection originating in the canines, premolars and molars.

CONCLUSION: Infection spread characteristics are related to the causal teeth, and the pathways were clearly demonstrated on CT images.