28yr female. complains of pain and swelling since 5 days. also complains of pain near eye. iopa do not show any major pathology. pts economic condition is not good. doctors.. ur diagnosis and management pls..



Iopa clearly shows periapical abcess.. you are just loosing it's depth...understanding constrained economic conditions... At least ...OPG is much needed...but I'm OPG Also you may not apprciated 3rd dimension....but will meet nearly... Write for free consideration on your prescription...regularly they consider..or I say, pay her.....in good sense but don't jump to treat. Did you aspirate...? Anyways start appropriate antibiotics after elciting her 1st line of antibiotics if any? Analgesics Trypsin / Chymotripsin May be simple abcess on application of heat spreads in 3Dimension...ask her not to, if she has done so...on the contrary not even cold packs.

Inj. Oframax.tbc. Inj.amikacin 500. For 3 days . Higher antibiotic analgesic.chymoralfort.is helpful in first lune of treatment.

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This patient is having buccal space infection with canine space infection, please refer to oral and maxillofacial surgeon for immediate incision n drainage, as swelling and inflammation is very much, eventually it may advance cavernous sinus thrombosis

thank u sir...

I think its manage with Inj.oframax tbc... Inj.amikacin...500 Inj.hydrocort......for reduce inflamation . Tab.goodcef cv...bd Tab ebility...bd Cap.omez...bd Tab.chymoralfort od empty stimac. nessasary

For such huge swellings...I would put Chymoral FORTE DS...initiall 3tid..later reduce to2...tisue fluid PH barrier..

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agree with Dr. Narayana S we would like to see the opg bcz i am not able to make out anything in iopa but it surely due to periapical pathology. I&D is needed and complete antibiotic prophylaxis.


This is an inflammatory reaction caused by the 6.... m sorry but it's bad to say no major pathology just by seeing an 2d Iopa....

Dentoalvelar Abscess with related buccal space infection...start with standard oral / injectable antibiotics with pain killers and chx mouthwash, after 24 hrs of antibiotics coverage give a stab incision through the sulcus of the offending tooth to express the pus, and with the help of a blunt but sterile curetter / artery forcep just open the pus loci and observe the beautiful pus flow collect or drain , give multivitamin syrup and Becosule syrup for a fortnight, chymoral forte will be very helpful try to milk out as much pus you can during this appointment and leave the area open with a drain if available ...see the patient after 48 hours and re-upload a fresh good iopa and clinical intraoral and extra oral picture then we can discuss some definitive treatment.

Gives inj piperacilline 4.5gm preoperative,nd extract involve under the coverage of augmentin 625mg,zerodol sp

Periapical bacess Opg

Buccal and canine space infection give iv antibiotics convering anaerobes it will be better to go for opg


upper first molar has caries exposure with PA rarefaction, which are signs of odontogenic infection. I&D and further mgt under antibiotics.

thanks.. doc..
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