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El Fadhlallah PM, Nugraha AP, Prasetio O, Mulyawan I. Extensive Sequestration Chronic Maxillary Osteomyelitis in an Uncontrolled Diabetic Patient: Comprehensive Case Management of a Rare Entity. Eur J Dent 2024; 18:401-407. [PMID: 37848069 PMCID: PMC10959603 DOI: 10.1055/s-0043-1771536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2023] Open
Abstract
The hallmark of osteomyelitis was progressive bone destruction and sequestrum formation. In the underlying disease, like diabetes mellitus, osteomyelitis becomes severe and exacerbates the condition. It was essential for the oral and maxillofacial surgeon to comprehend its complex medical and surgical management to achieve complete disease eradication. The aim of this article was to report a rare case and comprehensive management of extensive sequestrating maxillary osteomyelitis with uncontrolled diabetes mellitus patients. A 58-year-old male patient with pain and swelling accompanied by discharge of pus in the sinistra maxilla region. The systemic disease was identified as uncontrolled diabetes mellitus, and had a history of unhealing wounds 1 year ago after upper left molar extraction. Computed tomography scan result showed extensive sequester formation and bony destruction in the right extending to the left maxilla. Microbial culture results were Klebsiella pneumoniae and Morganella morganii. Subsequently, extensive sequestrectomy and multiple extractions of the involved jaw and teeth were performed after diabetes mellitus was regulated. A suspension suture against oral and nasal mucosa was performed to avoid dead space formation. Comprehensive perioperative management in maxillary osteomyelitis in uncontrolled diabetes mellitus includes sequestrectomy, definitive antibiotic therapy based on culture results, and diabetes regulation to improve the successful management of this case.
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Affiliation(s)
| | - Andreas Pratama Nugraha
- Oral and Maxillofacial Surgery Specialist Program, Faculty of Dental Medicine, Airlangga University, Surabaya, Indonesia
| | - Okky Prasetio
- Department of Oral and Maxillofacial Surgery, Dr Mohamad Soewandhie General Hospital, Surabaya, Indonesia
| | - Indra Mulyawan
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine Universitas Airlangga, Surabaya, Indonesia
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Fenelon M, Gernandt S, Aymon R, Scolozzi P. Identifying Risk Factors Associated with Major Complications and Refractory Course in Patients with Osteomyelitis of the Jaw: A Retrospective Study. J Clin Med 2023; 12:4715. [PMID: 37510830 PMCID: PMC10380926 DOI: 10.3390/jcm12144715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 06/28/2023] [Accepted: 07/03/2023] [Indexed: 07/30/2023] Open
Abstract
Despite improved knowledge regarding the diagnosis and treatment of osteomyelitis of the jaw (OMJ), it remains a clinical challenge for oral and maxillofacial surgeons. This study aimed to identify risk factors associated with severe forms of OMJ, i.e., related to the occurrence of major complications or the refractory course of the disease. A retrospective study was performed based on the medical records of all patients diagnosed with OMJ from the past 20 years. Collected data included demographic information, medical and dental history, clinical, radiological, and bacterial findings as well as treatment modalities. The main outcome variables were the onset of major complications and treatment results. Fifty-four patients were included. Our results showed that alcohol and smoking habits, as well as malnutrition, were significantly associated with the occurrence of major complications. We also established that dental implant-induced OMJ should be considered an aggressive subtype of OMJ. Finally, clinical bone exposure was significantly associated with unfavorable outcomes, whereas dental causes or radiological evidence of periosteal reaction were predictive of successful outcomes. Identifying such factors could be useful in preventing serious complications and informing patients about the refractory course of the disease based on the presence of these factors.
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Affiliation(s)
- Mathilde Fenelon
- Division of Oral and Maxillofacial Surgery, Department of Surgery, Geneva University Hospitals, 1205 Geneva, Switzerland
- UFR des Sciences Odontologiques, University Bordeaux, 33000 Bordeaux, France
- Service de Chirurgie Orale, CHU de Bordeaux, 33000 Bordeaux, France
| | - Steven Gernandt
- Division of Oral and Maxillofacial Surgery, Department of Surgery, Geneva University Hospitals, 1205 Geneva, Switzerland
| | - Romain Aymon
- Division of Oral and Maxillofacial Surgery, Department of Surgery, Geneva University Hospitals, 1205 Geneva, Switzerland
| | - Paolo Scolozzi
- Division of Oral and Maxillofacial Surgery, Department of Surgery, Geneva University Hospitals, 1205 Geneva, Switzerland
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de Mello CH, Barbosa J, Cortezzi EBDA, Janini MER, Tenório JR. Recurrent chronic suppurative osteomyelitis in the maxilla of a patient with diabetes mellitus and glucose-6-phosphate dehydrogenase deficiency. SPECIAL CARE IN DENTISTRY 2023; 43:83-86. [PMID: 35561320 DOI: 10.1111/scd.12729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 04/27/2022] [Accepted: 04/29/2022] [Indexed: 01/21/2023]
Abstract
AIMS To report the case of chronic osteomyelitis of a maxilla in a woman with uncontrolled diabetes mellitus (DM), glucose-6-phosphate dehydrogenase (G6PD) deficiency and mental illness, in an attempt to clarify its pathogenesis and treatment. METHODS AND RESULTS A case of a woman with moderate G6PD deficiency (Class III) who developed bilateral and asynchronous chronic suppurative osteomyelitis (CSO) of her maxilla with extensive bone sequestra, fistulae and whose management was performed by local surgery for bony sequestra and fistulae removal; closure communication under 4 weeks antibiotic cover. CONCLUSIONS CSO of the jaw may be a complication of the G6PD deficiency and DM and its severity depends on patient's medical status.
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Affiliation(s)
- Carlos Henrique de Mello
- Department of Oral Pathology and Diagnosis, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Joyce Barbosa
- Department of Oral Pathology and Diagnosis, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Maria Elisa Rangel Janini
- Department of Oral Pathology and Diagnosis, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Jefferson R Tenório
- Department of Oral Pathology and Diagnosis, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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Chkadua TZ, Oltarzhevskaya ND, Cholokava TD, Baisova LM, Sogachev GV, Egiazaryan AK. [Post-Covid osteomyelitis of the facial bones]. STOMATOLOGIIA 2023; 102:68-72. [PMID: 38096398 DOI: 10.17116/stomat202310206268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
The pandemic of coronavirus infection existed from 2019 to 2023. The World Health Organization (WHO) has announced on May 5, 2023 that the pandemic had ended. However, it does not cease to have an adverse effect on the health of the world population. Necrotic lesions of the bones of the facial skeleton are now a characteristic sign of a severe coronavirus infection. We conducted a review of scientific publications that reflected the relationship between coronavirus and necrotic processes of the skull bones, methods of treatment, prevention and the latest developments in this direction. The purpose of this article is to review existing studies on Post-Covid osteomyelitis of facial bones, its impact, features of the clinical picture of this disease, analysis of methods and means of treatment of this group of patients. Analysis of literature data has shown that the search for an ideal dressing material continues, especially the developments of native developers stand emphasized. The advantages of modern materials over traditional ones have become unquestionable, but further research in this direction is required.
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Affiliation(s)
- T Z Chkadua
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | | | - T D Cholokava
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | - L M Baisova
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | - G V Sogachev
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | - A K Egiazaryan
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
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Lata J, Pansotra N. Osteomyelitis of Maxilla: A Rare Presentation Yet Not So Rare. J Maxillofac Oral Surg 2022; 21:1023-1031. [PMID: 36274895 PMCID: PMC9474749 DOI: 10.1007/s12663-021-01607-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 06/12/2021] [Indexed: 11/26/2022] Open
Abstract
Objective To retrospectively study the patients diagnosed with osteomyelitis of jaw in Punjab Government Dental College and Hospital, Amritsar. Material and Methods A total of 21 case records of patients with osteomyelitis of jaw were analysed retrospectively from January 2018 to December 2020 at Department of oral and maxillofacial surgery, Punjab Government Dental College and Hospital, Amritsar, India. Results Of the 21 patients, maxilla was involved in 14 (66.6%) patients, whereas 6 patients (28.6%) had mandibular osteomyelitis and 1 patient (4.8%) had osteomyelitis of zygoma. 18 patients had underlying systemic disease with diabetes present in 10 patients (47.6%). History of alcoholism was present in 5 patients (23.8%) as one of the predisposing factors. 14 patients had odontogenic cause as predominant aetiology followed by sinusitis in 3 patients. Osteomyelitis due to post-herpetic and hematogenous infection, trauma and unknown aetiology was found in 1 patient each. With adequate medical and surgical intervention, most of our patients had satisfactory outcome. Conclusions High incidence of maxillary osteomyelitis was found in our study in contrary to previous studies and literature. As this is a small study, further prospective studies with longitudinal follow up of larger number of patients would be desirable to confirm these findings.
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Affiliation(s)
- Jeevan Lata
- Department of Oral and Maxillofacial Surgery, Punjab Government Dental College and Hospital, Amritsar, Punjab India
| | - Neetu Pansotra
- Department of Oral and Maxillofacial Surgery, Punjab Government Dental College and Hospital, Amritsar, Punjab India
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Díaz-Castellón DF, Llaguno-Rubio JM, Medina-Ocampo PE. [Imaging features of osteomyelitis of the jaws with different diagnostic methods. A review]. REVISTA CIENTÍFICA ODONTOLÓGICA 2021; 9:e077. [PMID: 38464859 PMCID: PMC10919801 DOI: 10.21142/2523-2754-0903-2021-077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Accepted: 09/24/2021] [Indexed: 03/12/2024] Open
Abstract
Osteomyelitis of the jaws (OM) is an infectious pathology involving the bone marrow. It is due to various etiologies, the main one being odontogenic. The diagnosis of OM is a challenge for dentists, who must rely on clinical and imaging examinations. Panoramic radiography is the most frequently used imaging test, but it has some limitations that have improved with the incorporation of new imaging methods such as computed tomography, cone beam computed tomography, magnetic resonance imaging, and bone scintigraphy with radionuclides. The purpose of this review was to describe the imaging characteristics of OM of the jaws according to the radiological diagnostic methods available in the literature in order to provide radiologisst with greater knowledge and improve reporting in daily practice.
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Affiliation(s)
- Dirce Fernanda Díaz-Castellón
- Facultad de Odontología de la Universidad San Francisco Xavier de Chuquisaca. Sucre, Bolivia. Facultad de Odontología Universidad San Francisco Xavier de Chuquisaca Sucre Bolivia
| | - Jhoana Mercedes Llaguno-Rubio
- División de Radiología Bucal y Maxilofacial de la Universidad Científica del Sur. Lima, Perú. , Universidad Científica del Sur División de Radiología Bucal y Maxilofacial Universidad Científica del Sur Lima Peru
| | - Paola Eliana Medina-Ocampo
- División de Radiología Bucal y Maxilofacial de la Universidad Científica del Sur. Lima, Perú. , Universidad Científica del Sur División de Radiología Bucal y Maxilofacial Universidad Científica del Sur Lima Peru
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Stiefel K, Gangwani P, Cox D, Kolokythas A. Ill-defined extensive radiolucent lesion of the left posterior mandible. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 133:129-137. [PMID: 34364827 DOI: 10.1016/j.oooo.2021.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 06/16/2021] [Accepted: 06/21/2021] [Indexed: 11/15/2022]
Affiliation(s)
- Kyle Stiefel
- Private Practice, Oral and Maxillofacial Surgery, Plaistow, NH, USA
| | - Pooja Gangwani
- Assistant Professor, Department of Oral and Maxillofacial Surgery, Eastman Institute of Oral Health, University of Rochester, Rochester, NY, USA.
| | - Darren Cox
- Professor, Diagnostic Sciences, Arthur A. Dugoni School of Dentistry, University of the Pacific, San Francisco, CA, USA
| | - Antonia Kolokythas
- Professor and Chair, Department of Oral and Maxillofacial Surgery, Eastman Institute of Oral Health, University of Rochester, Rochester, NY, USA
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