Buccal Space Infection — ORE Part 1 MCQ

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ModerateOral SurgeryBuccal Space InfectionORE Part 1

A patient presents with an acutely swollen right cheek. Intraoral examination shows a fluctuant swelling in the buccal sulcus adjacent to the upper right first premolar. The tooth is tender to percussion and has a large mesial carious lesion. Into which fascial space has the infection spread?

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Correct answer: D — Buccal space

The correct answer is **A. Buccal space**. The decisive features are a maxillary premolar source, swelling in the buccal sulcus and corresponding cheek swelling, indicating spread through the buccal cortex into the buccal space. The canine space is classically associated with infection from a maxillary canine, whose long root may extend beyond the levator anguli oris attachment. The submandibular space is usually involved by mandibular posterior teeth when infection tracks below the mylohyoid line. Masticator and parapharyngeal spaces are deeper spaces and would be considered with more posterior or extensive infection, often accompanied by features such as trismus, dysphagia or systemic deterioration.

Reference: Hoerter JE, Malkin BD. Odontogenic Orofacial Space Infections. StatPearls; updated 2023. https://pubmed.ncbi.nlm.nih.gov/36943966/