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

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. CT images of 78 patients were analyzed with reference to lateral asymmetry of shape and density of fascial spaces and tissues. 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. Infection spread characteristics are related to the causal teeth, and the pathways were clearly demonstrated on CT images.