Endodontic Resident Texas A&M University Baylor College of Dentistry Dallas, Texas, United States
Endodontic patients frequently present with swelling related to odontogenic infection. Infections of endodontic origin can be serious and may result in life-threatening complications including airway obstruction, cavernous sinus thrombosis, jugular vein thrombosis, brain abscess, mediastinitis, and endocarditis. These complications may occur as purulent exudate from an infection of endodontic origin perforates through bone and enters fascial spaces, or layers of cervical fascia that encase the contents of the face and neck. Knowledge of fascial spaces in endodontics is critical, as they serve to direct the spread of infection. Odontogenic infections of the cervicofacial region with fascial space involvement are difficult to assess accurately by conventional endodontic radiologic techniques or clinical evaluation. Multidetector computed tomography (MDCT) is valuable in identifying the precise location and extent of fascial space infections and guiding surgical drainage of infection. MDCT produces 2-dimensional images of the scanned area, which can be used to construct an enhanced, 3D model by Materialise Interactive Medical Image Control System (Mimics), a 3D medical image segmentation software, resulting in improved visualization of the area of interest. The purpose of this table clinic is to illustrate in 3D various examples of fascial space infections of endodontic origin using contrast-enhanced MDCT images and Mimics software. In addition, the anatomical boundaries of each space will be outlined and the relevant literature will be highlighted.
