Osteomyelitis of the jaw
Introduction
Introduction to jaw osteomyelitis A disease caused by infection of the jaw bone, often involving the periosteum, cortical bone and bone marrow tissue, common with suppurative jaw osteomyelitis, infant osteomyelitis and radiation osteomyelitis. Jaw osteomyelitis can be divided into suppurative, specific, radioactive and so on. Clinically, suppurative jaw osteomyelitis is the most common. There are three main sources of infection for osteomyelitis of the jaw, namely, odontogenic, injurious and blood-borne. There are three main sources of infection for osteomyelitis of the jaw, namely, odontogenic, injurious and hematogenous. Blood-borne jaw osteomyelitis is rare, mainly in children, and odontogenic osteomyelitis is the most common. It accounts for about 90% of all osteomyelitis of the jaw. Due to the improvement of medical conditions, the incidence rate has been greatly reduced. The odontogenic osteomyelitis is more common. This is dense with the bones of the mandibular cortex and has thick muscles around it. The adhesion of the dense fascia, the accumulation of pus in the medullary cavity is not easy to break through the drainage and other factors. basic knowledge The proportion of illness: 0.003% Susceptible people: good for infants and young children Mode of infection: non-infectious Complications: anemia
Cause
Cause of osteomyelitis of the jaw
There are three main sources of infection for osteomyelitis of the jaw, namely, odontogenic, injurious and hematogenous. Blood-borne jaw osteomyelitis is rare, mainly in children, and odontogenic osteomyelitis is the most common. It accounts for about 90% of all osteomyelitis of the jaw. Due to the improvement of medical conditions, the incidence rate has been greatly reduced. The odontogenic osteomyelitis is more common. This is dense with the bones of the mandibular cortex and has thick muscles around it. The adhesion of the dense fascia, the accumulation of pus in the medullary cavity is not easy to break through the drainage and other factors.
Prevention
Jaw osteomyelitis prevention
In order to prevent the occurrence of radiation-induced osteonecrosis and osteomyelitis, appropriate preventive measures should be taken. According to the nature of the tumor, the appropriate radiation type, dose and radiation field should be selected. Before the radiotherapy, all the infections inside and outside the mouth should be eliminated, and the whole mouth should be cleaned. ;
Remove the incurable diseased teeth; treat dental caries, periodontitis and other sick teeth that can still be preserved; remove the original metal dentures in the oral cavity;
Active dentures should be worn again after a period of termination of radiotherapy to prevent mucosal damage. In radiation therapy, barriers should be applied to non-irradiated areas.
When an ulcer occurs in the mouth, a topical antibiotic ointment is applied to prevent infection. After radiation therapy, once odontogenic inflammation occurs, surgery or tooth extraction must be performed, and surgical damage should be minimized;
Effective antibiotics should be used before and after surgery to control secondary infections.
Complication
Jaw osteomyelitis complications Complications anemia
In the later stage, the nasal cavity and the oral cavity can be worn through the pus. If prolonged, it can cause weight loss, anemia, and weakness.
Symptom
Jaw bone marrow inflammation symptoms common symptoms toothache weight loss lower lip numb dead bone
(1) Acute jaw osteomyelitis
The onset is rapid, the systemic symptoms are obvious, and the local first-infected tooth is painful, and it quickly spreads to the adjacent teeth, causing pain on the affected side and releasing it to the ankle. The corresponding parts of the face are swollen, the gums and vestibular sulcus are swollen, and many teeth in the affected area are loose. There is pus overflow from the periodontal, mandibular osteomyelitis, due to the masticatory muscle invasion, often varying degrees of mouth opening, the lower alveolar nerve involvement, there may be numbness of the affected side of the lower lip, maxillary osteomyelitis more common in newborns Infants, infants, the source of infection is often blood-derived, and its local manifestations are obvious redness and swelling in the lower part of the sputum, and often extend to the eye to cause eyelids to open, and later in the sputum, nasal and oral perforation.
(two) chronic jaw osteomyelitis
Acute jaw osteomyelitis can be converted to chronic if it is not completely treated. The common cause is simple conservative treatment with drugs. The pus is worn by itself and the drainage is not smooth. During the period of chronic osteomyelitis of the jaw, most of the acute symptoms subsided. Symptoms are not obvious, pain is significantly reduced, local fibrous tissue hyperplasia, swelling, hard, fistula, often overflowing pus, and even discharge small pieces of dead bone, multiple teeth in the lesion area loose, sputum overflow, when the body's resistance is reduced or When the drainage is not smooth, it can be acute, such as prolonged delay, can lead to weight loss, anemia, and physical weakness.
Examine
Examination of jaw osteomyelitis
Detailed medical history, local examination, and feasible X-ray examination to confirm the diagnosis.
The total number of white blood cells is increased, the proportion of neutrophils is increased, and when an abscess has formed, pus can be withdrawn from the center of the abscess.
Diagnosis
Diagnosis and diagnosis of osteomyelitis of the jaw
Chronic X-ray diagnosis in the maxilla should pay attention to the maxillary sinus cancer, in the mandible should be differentiated from central cancer, bone proliferative marginal osteomyelitis should be differentiated from osteosarcoma and ossifying fibroma. A biopsy should be performed if necessary.
