title: Spread of odontogenic infections: a retrospective analysis and review of the literature.
abstract: OBJECTIVE
  To provide an empirical description of the relationship between the spread of head and neck infections, and the causal tooth.
  
  
  METHODS
  The hospital records of 155 patients presenting with odontogenic head and neck infections due to a single identifiable tooth from January 2000 to August 2011 were reviewed. The following data were collected: age, sex, clinical presentation, etiology, location, and spread of infection. The causal tooth and location of infection were subsequently compared to the literature.
  
  
  RESULTS
  In the present study population, the causal tooth most frequently (47.1%) consisted of the third mandibular molar. Infection of maxillary teeth most commonly spread to the buccal space, whereas infection originating in the mandible mostly spread to the submandibular, pterygomandibular, and buccal spaces. The literature search provided 18 usable articles. Fourteen studies discriminated between mandibular and maxillary origin of infection, and three articles elaborated on the direct relationship between causal tooth and location of infection. Spaces most frequently affected in the literature are the submandibular, masticator, lateral pharyngeal, buccal, and sublingual spaces. A large amount of discrepancy was found between studies.
  
  
  CONCLUSIONS
  When describing the location of infection, most studies do not discriminate between maxillary and mandibular origin. Although the literature seems to be unambiguous about the predetermined spread, this article demonstrates that it is more difficult to predict the spread of an infected tooth than previously expected. Large studies with clearly noted causal teeth in relation to location of spread should shed more light on the discrepancies found in this review.
authors.affiliation: Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center/ Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands. m.moghimi@vumc.nl
authors.forename: Meshkan
authors.initials: M
authors.lastname: Moghimi
authors.forename: Jacques A
authors.initials: JA
authors.lastname: Baart
authors.forename: K Hakki
authors.initials: KH
authors.lastname: Karagozoglu
authors.forename: Tymour
authors.initials: T
authors.lastname: Forouzanfar
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001424:Bacterial Infections / Q000453:epidemiology / Q000635:transmission*; D002481:Cellulitis / Q000453:epidemiology*; D018562:Disease Transmission, Infectious / Q000706:statistics & numerical data*; D005260:Female; D005491:Focal Infection, Dental / Q000453:epidemiology* / Q000635:transmission*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008964:Molar, Third / Q000382:microbiology; D010482:Periapical Abscess / Q000453:epidemiology* / Q000635:transmission*; D012189:Retrospective Studies; D014081:Tooth Extraction / Q000009:adverse effects / Q000706:statistics & numerical data; D019553:Tooth, Nonvital / Q000150:complications; D055815:Young Adult