Osteomyelitis caused secondary to infection caused due to vascular insufficiency 3. Case report sc yeoh, s macmahon, m schifter abstract background. This case report describes the successful surgical treatment of chronic suppurative osteomyelitis cso of the mandible in a 75 year old man. 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. Osteomyelitis of the jaws is a lesion with distinct fea tures, but is often challenging in diagnosis and treatment. It is an inflammatory condition involving the medullary. Osteomyelitis of the maxillofacial skeleton is rare in developed countries such as australia. The word osteomyelitis originates from the ancient greek words osteon bone and muelinos marrow and means infection of medullary portion of the bone. It occurs due to inoculation of microorganisms either directly or by continuous accumulation through a hematogenous way.
Diagnosis and management of osteomyelitis of osteomyelitis. 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. Tissue necrosis entails as proteolytic enzymes are liberated with destruction of bacteria along with vascular thrombosis and ischemia. When antimicrobial agents or drainage prove unsuccessful, acute osteomyelitis may become chronic. Osteomyelitis of the jaws is a lesion with distinct fea tures, but is often challenging in. 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 mallikarjun. Nov 07, 2012 classification based on clinicalpicture, pathology, etiology andradiology. The area healed appropriately within one month figures 3a and 3b. Treatment of chronic suppurative osteomyelitis of the mandible. Osteomyelitis occurring primarily in children and adolescents pathogenic microorganism cause inflammation and infection of bone, which lead to osteomyelitis and signs appears.
Osteomyelitis caused due to hematogenous spread of infection 4. Chronic suppurative osteomyelitis with proliferative. Pdf 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. On the basis of clinical, radiological and histological findings, primary. 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. Inclusion criteria were a diagnosis of suppurative osteomyelitis of the jaw, age older than 18 years, and complete medical. 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.
Tissue necrosis entails as proteolytic enzymes are liberated with destruction of. Waldegrel and lew classified osteomyelitis of jaw bones broadly as suppurative or nonsuppurative. 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. Chronic suppurative osteomyelitis of the mandible is often considered difficult to treat and may lead to refractory osteomyelitis. Acute and chronic suppurative osteomyelitis of the jaws. It was concluded that patient of chronic suppurative osteomyelitis of the. 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. An unusual case of chronic suppurative osteomyelitis of mandible. Acute osteomyelitis differs from chronic osteomyelitis, which has duration of four weeks after the onset of clinical symptoms, 14. Pdf accepted manuscript acute and chronic suppurative. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Within 1014 days after onset, teeth in the involved area begin to loosen and become sensitive to percussion.
Issues related to the classification, epidemiology, microbiology, clinical manifestations, and diagnosis of osteomyelitis in adults are presented here. 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. Chronic suppurative osteomyelitis is a rare but welldescribed. 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. Osteomyelitis is an infection that affects bone and. The condition is seen exclusively in children or young adults. Pdf chronic suppurative osteomyelitis researchgate.
Chronic suppurative osteomyelitis of the mandible treated. This approach can lead to complete cure of osteomyelitis and further resolution of proliferative periostitis. Chronic osteomyelitis is a challenging condition to treat. 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. Th e lack of normal disc signal at the circled segment black arrow represents infection.
Nonsuppurative the occurrence of osteomyelitis in the jaws is rare and multifactorial. Chronic suppurative osteomyelitis of posterior maxilla. Osteomyelitis may be classified based on the mechanism of infection hematogenous versus nonhematogenous and the duration of illness acute versus chronic. Chronic osteomyelitis necrotic bone information from waldvogel fa, medoff g, swartz mn. Osteomyelitis is an infection of the bone or bone marrow, usually caused by pyogenic bacteria or mycobacterium.
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 suppurative osteomyelitis of the mandible mallikarjun k. Chronic suppurative osteomyelitis of the mandible article pdf available in journal of indian society of pedodontics and preventive dentistry 292. 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. 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. Sixteen patients with chronic suppurative osteomyelitis of the. Surgical debridement and oral antibiotics were considered as the treatment of.
Nov, 20 suppurative osteomyelitis can involve all three components of bone. Accepted manuscript acute and chronic suppurative osteomyelitis of the jaws. Pathophysiology and pathogenesis of osteomyelitis 5 fig. Chronic nonsuppurative osteomyelitis with proliferative. In this case, it was reported an elderly patient with a diagnosis of chronic osteomyelitis of mandible edentulous dextra. Chronic osteomyelitis an overview sciencedirect topics. Chronic sclerosing nonsuppurative osteomyelitis of garre. Primary chronic osteomyelitis of the jaw is an uncommon non suppurative, chronic inflammatory disease of unknown origin. This case report describes the successful surgical treatment of chronic suppurative osteomyelitis cso of the mandible in a 75. This type of spinal infection is seen more commonly in children. 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.
The treatment were sequesterectomy and extraction the radix of tooth 43 by general anesthesia, and combinating with antibiotics. Chronic osteomyelitis is a bone disease that is characterized by inflammatory processes, including necrosis of mineralized and marrow tissues, suppuration, resorption, sclerosis, and hyperplasia. Full text optimal management of chronic osteomyelitis. A 28yearold woman presented with swelling on the left side of her mandible. Upper jaw chronic osteomyelitis mx este documento es elaborado por medigraphic performed with treble cero polyglycolic acid. Many authors advocate that chronic osteomyelitis involving the jawbone can be further divided into two major categories. The case presented here is of chronic osteomyelitis with an extraoral draining sinus. Symptoms may include pain in a specific bone with overlying redness, fever, and weakness. In established suppurative osteomyelitis, symptoms include deep pain, malaise, fever and anorexia.
Chronic suppurative osteomyelitis is an often preferred term in angloamerican texts bernier et al. 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. It can manifest as early or adult onset and is characterised by lack of pus formation, fistula or bony sequestra formation. 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. It can be classified as acute, subacute or chronic, depending on the clinical presentation. Mar 01, 2018 osteomyelitis is inflammation of the bone caused by an infecting organism. Osteomyelitis is acute and chronic inflammatory process based upon the histopathological finding rather than duration of infection.
The surgical sample was sent to the oral pathologist who reported upper jaw chronic osteomyelitis with lesion free borders. Osteomyelitis, chronic suppurative osteomyelitis, maxillary osteomyelitis. Osteomyelitis is an infection that affects bone and bone marrow. Chronic osteomyelitis results from incompletely healed or persistent suppurative acute infection. Chronic suppurative osteomyelitis of the maxilla and. It is seen mostly after open fractures or in implantrelated infections following treatment of fractures and prosthetic joint replacements. Osteomielitis supuratif kronis pada mandibula edentulus. Pdf chronic suppurative osteomyelitis of the mandible. The combination of antibiotic therapy and surgical debridement is effective in the treatment of chronic suppurative osteomyelitis cso. Recurrent chronic suppurative osteomyelitis of the mandible.
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