Chronic suppurative osteomyelitis of the mandible is often considered difficult to treat and may lead to refractory osteomyelitis. The combination of antibiotic therapy and surgical debridement is effective in the treatment of chronic suppurative osteomyelitis cso. This case report describes the successful surgical treatment of chronic suppurative osteomyelitis cso of the mandible in a 75 year old man. Case report sc yeoh, s macmahon, m schifter abstract background. Chronic suppurative osteomyelitis of posterior maxilla. Acute and chronic suppurative osteomyelitis of the jaws. An unusual case of chronic suppurative osteomyelitis of mandible. Osteomielitis supuratif kronis pada mandibula edentulus.
Diagnosis and management of osteomyelitis of osteomyelitis. It occurs due to inoculation of microorganisms either directly or by continuous accumulation through a hematogenous way. Osteomyelitis is an inflammatory disease of the bone that usually begins as an infection of the medullary cavity, rapidly involves the haversian system, and quickly extends to the periosteum of the. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Osteomyelitis is an infection of the bone or bone marrow, usually caused by pyogenic bacteria or mycobacterium.
Topazian 1994, 2002 and can mostly be used interchangeably with the term secondary chronic osteomyelitis, which is predominantly used in the literature from continental europe hjortinghansen 1970. The precipitant factor was thought to be a retained tooth root. Chronic suppurative osteomyelitis of the mandible mallikarjun k. The treatment were sequesterectomy and extraction the radix of tooth 43 by general anesthesia, and combinating with antibiotics. Tissue necrosis entails as proteolytic enzymes are liberated with destruction of bacteria along with vascular thrombosis and ischemia. On the basis of clinical, radiological and histological findings, primary. Mar 01, 2018 osteomyelitis is inflammation of the bone caused by an infecting organism. Chronic suppurative osteomyelitis of the mandible article pdf available in journal of indian society of pedodontics and preventive dentistry 292.
It is an inflammatory condition involving the medullary. Recurrent chronic suppurative osteomyelitis of the mandible. In this case, it was reported an elderly patient with a diagnosis of chronic osteomyelitis of mandible edentulous dextra. The word osteomyelitis originates from the ancient greek words osteon bone and muelinos marrow and means infection of medullary portion of the bone. The condition is seen exclusively in children or young adults. Th e lack of normal disc signal at the circled segment black arrow represents infection. Acute osteomyelitis differs from chronic osteomyelitis, which has duration of four weeks after the onset of clinical symptoms, 14. Osteomyelitis may be classified based on the mechanism of infection hematogenous versus nonhematogenous and the duration of illness acute versus chronic. In established suppurative osteomyelitis, symptoms include deep pain, malaise, fever and anorexia. Chronic osteomyelitis results from incompletely healed or persistent suppurative acute infection. The area healed appropriately within one month figures 3a and 3b. Acute suppurative osteomyelitis chronic suppurative osteomyelitis chronic focal sclerosing osteomyelitis pseudopaget,condensing osteomyelitis chronic diffuse sclerosing osteomyelitis chronic osteomyelitis with proliferative. Chronic suppurative osteomyelitis of the mandible treated. Chronic osteomyelitis is a challenging condition to treat.
Chronic nonsuppurative osteomyelitis with proliferative. Chronic suppurative osteomyelitis can only be treated successfully by a combination of antimicrobial therapy and surgery for total elimination of the infected and necrotic bony tissue. Sixteen patients with chronic suppurative osteomyelitis of the. Chronic sclerosing nonsuppurative osteomyelitis of garre. Accepted manuscript acute and chronic suppurative osteomyelitis of the jaws. Chronic suppurative osteomyelitis with proliferative. Chronic suppurative osteomyelitis of the maxilla and.
Osteomyelitis caused secondary to infection caused due to vascular insufficiency 3. This type of spinal infection is seen more commonly in children. Chronic osteomyelitis an overview sciencedirect topics. Not only has there been lack of unanimity in the proper interpretation of this osseous lesion, but there has been actual distortion of the features which garre 1, 2 defined under this heading. Chronic osteomyelitis is a bone disease that is characterized by inflammatory processes, including necrosis of mineralized and marrow tissues, suppuration, resorption, sclerosis, and hyperplasia. Treatment of chronic suppurative osteomyelitis of the mandible. Symptoms may include pain in a specific bone with overlying redness, fever, and weakness. Risk of persisting into a chronic osteomyelitis if delay in diagnosis treatment, extensive bone necrosis, inadequate duration of antibiotic therapy, inadequate surgical debridement, decreased host ability to fight infection recurrences reduced with treatment of contributing risk factors ex. Pdf chronic suppurative osteomyelitis of the mandible. Although bone is normally resistant to bacterial colonization, events such as trauma, surgery, presence of foreign bodies, or prostheses may disrupt bony integrity and lead to the onset of bone infection. Full text optimal management of chronic osteomyelitis. In this present study of 105 cases of non suppurative benign lesions of bone grouped in the laboratory under pagets disease, ossifying periostitis, and nonsuppurating osteomyelitis, we are attempting a classification on the basis of the changes produced in the roentgenogram and on etiology.
Upper jaw chronic osteomyelitis mx este documento es elaborado por medigraphic performed with treble cero polyglycolic acid. Pdf accepted manuscript acute and chronic suppurative. Osteomyelitis of the jaws is a lesion with distinct fea tures, but is often challenging in. Issues related to the classification, epidemiology, microbiology, clinical manifestations, and diagnosis of osteomyelitis in adults are presented here. Osteomyelitis of the jaws is a lesion with distinct fea tures, but is often challenging in diagnosis and treatment. Osteomyelitis of the maxillofacial skeleton is rare in developed countries such as australia. This case report describes the successful surgical treatment of chronic suppurative osteomyelitis cso of the mandible in a 75.
Garres osteomyelitis is a distinctive type of chronic osteomyelitis associated with gross thickening of the periosteum of the bones and peripheral reactive bone formation resulting from mild irritation or infections. Chronic suppurative osteomyelitis is a rare but welldescribed. Lytic enzymes released from the inflammatory cells cut channels through the bone, leading to the formation of bone fragments that ultimately detach from the main bone mass. Chronic suppurative osteomyelitis cso, like most other forms of jaw osteomyelitis, is more commonly seen in the mandible and is associated with recurrent discharge of pus. Early phase of osteomyelitis, usually a suppurative purulent condition that exists when an acute inflammatory process moves away from the site of initial infection and spreads through the medullary space of the bone. Waldegrel and lew classified osteomyelitis of jaw bones broadly as suppurative or nonsuppurative. Osteomyelitis is an infection that affects bone and bone marrow. The chronic suppurative osteomyelitis is an inflammation of infectious origin, which invades the bone marrow spaces, being able to reach the cortical bone and the harvesian system, extending until the periosteum, causing the decrease of the blood. Within 1014 days after onset, teeth in the involved area begin to loosen and become sensitive to percussion. Sixteen patients with chronic suppurative osteomyelitis of the mandible were treated with a relatively simple protocol, consisting of sequestrectomy or decortication and i. Chronic osteomyelitis is generally sec ondary to open fractures, bacteremia, or the incidence of chronic osteomyelitis is increasing because of the prevalence of predisposing conditions such as dia. Chronic osteomyelitis necrotic bone information from waldvogel fa, medoff g, swartz mn. Shriyanka department of oral medicine and radiology, bangalore institute of dental sciences and research centre, bengaluru, karnataka, india abstract the term osteomyelitis encompasses a wide group of infectious diseases involving the.
Chronic suppurative osteomyelitis of the mandible mallikarjun. Osteomyelitis occurring primarily in children and adolescents pathogenic microorganism cause inflammation and infection of bone, which lead to osteomyelitis and signs appears. Osteomyelitis, chronic suppurative osteomyelitis, maxillary osteomyelitis. When antimicrobial agents or drainage prove unsuccessful, acute osteomyelitis may become chronic. Many authors advocate that chronic osteomyelitis involving the jawbone can be further divided into two major categories. The material was submitted to histopathological examination which revealed nonviable bone and a mixed inflammatory infiltrate of lymphocytes and plasma cells, confirming the diagnosis of chronic suppurative osteomyelitis. It can manifest as early or adult onset and is characterised by lack of pus formation, fistula or bony sequestra formation. Nov, 20 suppurative osteomyelitis can involve all three components of bone.
Osteomyelitis is an infection that affects bone and. Chronic suppurative osteomyelitis is an often preferred term in angloamerican texts bernier et al. Primary chronic osteomyelitis of the jaw is an uncommon non suppurative, chronic inflammatory disease of unknown origin. Inclusion criteria were a diagnosis of suppurative osteomyelitis of the jaw, age older than 18 years, and complete medical.
Suppurative osteomyelitis can involve the periosteum, cortex sadj october 2016, vol 71 no 9 p412 p414 cj perumal,1 3as singh,2 k rajkumar chronic suppurative osteomyelitis of the maxilla and zygomatic bone. The case presented here is of chronic osteomyelitis with an extraoral draining sinus. It is seen mostly after open fractures or in implantrelated infections following treatment of fractures and prosthetic joint replacements. Osteomyelitis caused due to hematogenous spread of infection 4. It was concluded that patient of chronic suppurative osteomyelitis of the. The long bones of the arms and legs are most commonly involved in children, while the feet, spine, and hips are most commonly involved in adults.
It can be classified as acute, subacute or chronic, depending on the clinical presentation. Nov 07, 2012 classification based on clinicalpicture, pathology, etiology andradiology. Pathophysiology and pathogenesis of osteomyelitis 5 fig. Surgical debridement and oral antibiotics were considered as the treatment of. Pdf on apr 1, 2011, madhumati amritraj singh and others published chronic suppurative osteomyelitis find, read and cite all the research. This approach can lead to complete cure of osteomyelitis and further resolution of proliferative periostitis. Nonsuppurative the occurrence of osteomyelitis in the jaws is rare and multifactorial. Tissue necrosis entails as proteolytic enzymes are liberated with destruction of. Pdf osteomyelitis is an infection of the bone or bone marrow, usually caused by pyogenic bacteria or mycobacterium.
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