• Title/Summary/Keyword: Mandibular osteomyelitis

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RADIOlOGIC STUDY OF OSTEOMYELITIS OF THE JAW (악골 골수염의 방사선학적 연구)

  • Lee Young Ho
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.10 no.1
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    • pp.15-28
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    • 1980
  • The author studied age and sex distribution, etiology, affected site and several radiographic features of osteomyelitis of the jaw. And radiologic classification of osteomyelitis was also done. The material consisted of 118 males and 96 females examined and/or treated under the diagnosis of osteomyelitis during past 11 years (1970-1980.6) in SNUDH. The obtained results were as followings. 1. The incidence is the highest in teenages(22.9%) and the lowest in seventies. (2.8%). 2. 199 cases were found in lower jaw, and 15 cases in upper jaw. 30.8% of all cases were located at the posterior portion of mandibular body comprising alveolar region. 3. Radiographic examination of osteolytic lesion revealed that 21. 5% of all patients had periapical and alveolar bone rarefaction combined with osteoporotic changes and that in most of patients two or more of the above described changes were present at the same time. 4. Sclerotic lesions were seen in 62.2 % of all patients and 21.5% of sclerotic lesion were diffuse or homogenuous type. 5. Based on the radiologic study, classification of the osteomyelitis of the jaw was made. Loclized osteolytic type was the highest in incidence (38.8%) and localized sclerotic type was the lowest (7.0%)

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GARRE'S OSTEOMYELITIS OF THE MANDIBLE RESOLVED BY ENDODONTIC TREATMENT IN CHILDREN: A CASE REPORT (소아의 하악에 발생한 Garre 골수염의 근관치료에 관한 증례보고)

  • Lee, Dong-Hyun;Kim, Dae-Eop;Lee, Kwang-Hee
    • Journal of the korean academy of Pediatric Dentistry
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    • v.23 no.3
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    • pp.688-696
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    • 1996
  • Garre's osteomyelitis is a unique form of osteomyelitis characterized rediographically by localized thickening of the periosteum and deposition of laminated subperiosteal bone. The most common inciting factor is a mandibular infection in permanent first molar with necrotic pulp. This disease occurs primarily in children and to date in all instances it has occured only in mandible. It usually results in hard swelling over the jaws, producing facial asymmetry with little or no pain. The overlying skin is normal but can occasionally be inflammed mostly when pain is present. Palpation reveals a usually smooth, bone-hard lesion which feel like an inherent part of the mandible. Unlike other forms of osteomyelitis, there is no marked increase in fever, white bloods cell count, sedimentation rate or alkaline phosphatase value. The treatment of Garre's osteomyelitis usually consist of elimination of the sourses of infection, i.e., either extration of an offending infected teeth or root canal therapy. This treatment almost always results in resolution of the Garre's osteomyelitis. Resistant cases have involved secondary surgery, i.e., decortication and sequestrectomy. This report presents three cases of Garre's osteomyelitis resolved by endodontic treatment. Cliniqtl examination revealed swelling on the face with no tenderness. Periapical radiograph showed deep caries lesion extending into pulp chamber and periapical radiolucency. Occlusal radiograph showed an enlargement of bone and stretching the periosteum. A clinical diagnosis of the Garre's osteomyelitis was made. Endodontic treatment was accomplished with conventional method and restored facial symmetry. Long-term check-ups are necessary to evaluate the results of endodontic treatment.

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BISPHOSPHONATE(ZOLEDRONIC ACID) RELATED OSTEOMYELITIS ON MANDIBLE-A CASE REPORT (Bisphosphonate(Zoledronic acid)와 연관된 하악골의 골수염-증례보고)

  • Lee, Su-Youn;Choi, So-Young;Kim, Jin-Wook;Kwon, Tae-Geon;Jang, Hyung-Jung;Kim, Chin-Soo;Lee, Sang-Han
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.30 no.4
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    • pp.395-398
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    • 2008
  • Bisphosphonate are a class of drugs with a chemical structure which inhibit bone resorption, actually used for metastatic bone disease, osteoporosis, Paget's disease and multiple myeloma. Significant complication associated with their use is reported recently : mandibular and maxillary osteomyelitis or osteonecrosis. So we here report our case about the patient who was diagnosed of prostate cancer in 2004 April and treated with bisphosphonate(Zoledronic acid-$Zometa^{(R)}$, Novartis Co.) intravenously every 3 to 4weeks at a dose of 4mg to prevent bone metastasis, and also, the patient who came to the hospital due to the bony exposure of mandible and pain in 2006 November and was diagnosed osteomyelitis of mandible as a result of biopsy, bone scan, PET CT examination.

Mandibular osteonecrosis following herpes zoster infection in the mandibular branch of the trigeminal nerve: a case report and literature review

  • Song, Jae-Min;Seo, Jeong-Seok;Lee, Jae-Yeol
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.41 no.6
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    • pp.357-360
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    • 2015
  • Herpes zoster virus (HZV) infections are caused by reactivation of the varicella zoster virus. Reactivation symptoms commonly affect the thoracolumbar trunk, and rarely affect the mandibular branches of the trigeminal nerve. When the mandibular branches are involved, lesions appear proximal to the innervation area. This condition may be associated with exfoliation of the teeth and osteonecrosis of the jawbone. We report a case of mandibular osteomyelitis after herpes zoster infection and we present a review of the literature on mandibular-branch involvement of HZV-related osteonecrosis.

TREATMENT OF PRIMARY TUBERCULOUS OSTEOMYELITIS OF THE MANDBLE : A CASE REPORT (하악골에 발생한 원발성 결핵성 골수염의 치험례)

  • Oh, Su-Jin;Kim, Young-Soo;Kim, Cheoul-Hun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.17 no.1
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    • pp.90-95
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    • 1995
  • This is an extermely rare disease and a case of tuberculous osteomyelitis of mandible in a 45-year-old woman was reported. The patient was visited for complaining slight facial swelling on left side and purulent discharge from extracted socket. Roentgenograhic examination of the mandible revealed bone destruction on left side of mandibular body. Destructive lesion was removed with saucerization and specimen from the involved soft tissue and bone were sent for microscopic examination. This case proved to be primary tuberculous osteomyelitis caused by the absence of primary focus. After 3 months follow-up check, we noticed good prognosis of bone and soft tissue healing.

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Pediatric mandibular chronic nonbacterial osteomyelitis: A case report with 12 years of radiologic follow-up

  • Sehyun Choi;Min-Ji Kim;Sang-Hoon Kang;In-Woo Park
    • Imaging Science in Dentistry
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    • v.54 no.1
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    • pp.93-104
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    • 2024
  • Chronic nonbacterial osteomyelitis(CNO) is histologically characterized by nonspecific osteitis. This inflammatory disorder, which lacks an infectious origin, typically presents with chronic pain and swelling at the affected site that can persist for months or even years. However, it is rare for CNO to affect the mandible. A 10-year-old girl presented with a primary complaint of pain in her left mandible. She had no significant medical or dental history. On examination, swelling was visible on the left buccal side, and imaging revealed radiolucent bone deterioration within the left mandible. This case report presents the radiological changes observed over a 12-year follow-up period. Variations in radiopacity, radiolucency, and periosteal reactions were noted periodically. This case highlights the radiological characteristics and findings that are crucial for the diagnosis of CNO, a condition for which no clear diagnostic criteria are currently available.

CHRONIC OSTEOMYELITIS ON MANDIBLE INDUCED BY TRIGEMINAL ZOSTER (삼차신경 대상포진에 의한 만성 하악골 골수염)

  • Oh, Jung-Hwan;Yim, Jin-Hyuk
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.33 no.2
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    • pp.169-172
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    • 2007
  • The Varicella zoster virus is responsible for two common infectious diseases: chicken pox(Varicella) and shingles(Herpes zoster). Chicken pox is the primary infection. After the initial infection, the virus remains dormant in sensory ganglia until reactivation may occur decades later. The subsequent reactivation is Herpes zoster. Herpes zoster of the trigeminal nerve distribution manifests as painful, vesicle eruptions of the skin and mucosa innervated by the affected nerve. Oral vesicles usually appear after the skin manifestrations. Reports of osteomyelitis of jaw after trigeminal herpes zoster are extremely rare. We report a case of osteomyelitis on mandible caused by herpes zoster infection which was treated by antiviral drug, curettage. At 1 year post-operatively, mandibular mucosa had healed without recurrent sign. But post-herpetic neuralgia is remained.

THE LONG-TERM CONSERVATIVE DRAINAGE CARE OF EXTENSIVE OSTEOMYELITIS ASSOCIATED WITH MANDIBULAR COMPOUND FRACTURE : REPORT OF A CASE (장기간의 보존적 배농술로 치료된 하악 복합골절 관련 광범위 골수염 치험 : 증례보고)

  • Kim, Ha-Rang;Yoo, Jae-Ha;Choi, Byung-Ho;Sul, Sung-Han;Mo, Dong-Yub;Lee, Chun-Ui
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.31 no.6
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    • pp.544-549
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    • 2009
  • Failure to use effective methods of reduction, fixation and immobilization may lead to osteomyelitis with the exposed necrotic bone, as the overzealous use of transosseous wires & plates that devascularizes bone segments in the compound comminuted fractures of mandible. Once osteomyelitis secondary to fractures has become established, intermaxillary fixation should be instituted as early as possible. Fixation enhances patient comfort and hinders ingress of microorganisms and debris by movement of bone fragments. Teeth and foreign materials that are in the line of fracture should be removed and initial debridement performed at the earliest possible time. Grossly necrotic bone should be excised as early as possible ; no attempt should be made to create soft tissue flaps to achieve closure over exposed bone. The key to treatment of chronic osteomyelitis of the mandible is adequate and prolonged soft tissue drainage. If good soft tissue drainage is provided over a long period, sequestration of infected bone followed by regeneration or fibrous tissue replacement will occur so that appearance and function are not seriously altered. Localization and sequestration of infected mandible are far better performed by natural mechanism of homeostasis than by cutting across involved bone with a cosmetic or functional defect. As natural host defenses and conservative therapy begin to be effective, the process may become chronic, inflammation regresses, granulation tissue is formed, and new blood vessels cause lysis of bone, thus separating fragments of necrotic bone(sequestra) from viable bone. The sequestra may be isolated by a bed of granulation tissue, encased in a sheath of new bone(involucrum), and removed easily with pincettes. This is a case report of the long-term conservative drainage care in osteomyelitis associated with mandibular fractures.

TREATMENTS OF COMMINUTED MANDIBULAR FRACTURES (하악골 분쇄골절의 치료)

  • Jeon, Woo-Jin;Kim, Su-Gwan;Kim, Hyeon-Ho;Kim, Hak-Kyun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.27 no.1
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    • pp.71-75
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    • 2005
  • This study evaluated retrospectively the treatment method and postoperative complications of communited mandibular fractures. We analyzed the clinical and radiologic data of 14 patients with the comminuted mandibular fractures who were admitted to Chosun University Dental Hospital from January 1998 to December 2003. We reviewed the cause of trauma, fracture sites, treatment methods, and postoperative complications. Thirteen patients (93%) had a successful treatment outcome without complications. Only one patient developed postoperative osteomyelitis requiring early plate removal and sequestrectomy. For the comminuted fractures of mandible, internal fixation using micro- or mini-plate was an effective treatment method with a low incidence of major complications.