Decortication in treatment of osteomyelitis of the mandible
01 May 1970-Oral Surgery, Oral Medicine, Oral Pathology (Oral Surg Oral Med Oral Pathol)-Vol. 29, Iss: 5, pp 641-655
TL;DR: Decortication is strongly recommended as a means of treating osteomyelitis of the jaws as it arrested the symptoms of the disease and complete healing was encountered in patients with acute/subacute or secondary chronic osteomyelsitis.
About: This article is published in Oral Surgery, Oral Medicine, Oral Pathology.The article was published on 1970-05-01. It has received 78 citations till now. The article focuses on the topics: Decortication & Osteomyelitis.
Citations
More filters
TL;DR: ONJ is a rare devastating side effect of oral bisphosphonates associated with patient morbidity and high financial burden and Clinicians must be aware of this entity and inform patients of the risks of dental surgery.
Abstract: Osteonecrosis of the jaw (ONJ) is a well-known devastating side effect of bisphosphonate therapy for cancer. Several ONJ cases of patients using oral bisphosphonates have been reported in the literature. The present study analyzed the clinical features, predisposing factors, and treatment outcome of 11 patients with oral bisphosphonates-related ONJ. Osteonecrosis of the jaw (ONJ) is a well-known side effect of parenteral bisphosphonates therapy. Although ONJ has been reported in patients using oral bisphosphonates, documentation of this entity is sparse. It was hypothesized that the clinical features, predisposing factors, and treatment outcome of this population are different from those of oncologic patients. This retrospective bi-central study involved 98 ONJ patients, 13 of whom were treated with oral bisphosphonates. Two patients were excluded because of previous use of intravenous bisphosphonates. The profiles of 11 patients were analyzed. The mean duration of alendronate use before developing ONJ was 4.1 years. ONJ was triggered by dental surgery in 9 patients and by ill-fitted dentures in 2. Heavy smokers were the most recalcitrant subjects. Among the nine patients with at least 6 months of follow-up, ONJ healed completely in three, partially in four, and not at all in two. ONJ is a rare devastating side effect of oral bisphosphonates associated with patient morbidity and high financial burden. Clinicians must be aware of this entity and inform patients of the risks of dental surgery. The synergistic effect of smoking in the pathogenesis of ONJ should be further investigated.
211 citations
Cites background from "Decortication in treatment of osteo..."
...Primary chronic osteomyelitis of the jaws is a very rare entity, defined as a non-suppurative chronic inflammation of the jaw with no underlying cause [21, 22]....
[...]
TL;DR: A subclassification into early and adult onset primary chronic osteomyelitis has been established based on differences in age at presentation, clinical appearance and course, radiology and histology, which revealed different stages of chronic inflammation in all cases.
Abstract: Introduction: Primary chronic osteomyelitis of the jaw is a rare, non-suppurative, chronic inflammatory disease of unknown aetiology. To date, classification is confusing due to a non-uniform terminology. The aim of this study was to establish a simple (clinical) classification based on patient data from our clinic. Methods: Retrospective analysis revealed 30 cases of which clinical course, radiology, pathology, therapy and outcome were analysed. Results: Both sexes were equally represented. The mean age at onset of disease was 35 years (range 5–76 years). Onset of disease revealed two peaks of incidence, one in adolescence and one after age 50 years. While clinical symptoms were similar in all cases, an increased intensity of these symptoms was noted in younger individuals as well as in the early stages of the disease. Five adults and one adolescent presented with additional non facial bone, joint and skin manifestations consistent with the diagnosis of SAPHO (synovitis, acne, pustulosis, hyperostosis, osteitis) syndrome, or chronic recurrent multifocal osteomyelitis. Radiology demonstrated sclerosis, osteolysis and periosteal reaction in variable stages in all cases. However, findings were more extensive in younger patients. Histology revealed different stages of chronic inflammation in all cases. Microabscess formation was noted in 11 cases, six of which were children/adolescents. Therapy consisted mainly of surgery, antibiotics and hyperbaric oxygen therapy. At the end of the follow up period, 11 patients demonstrated complete remission, while in 14 cases amelioration and in 5 no significant improvement was noted. Conclusion: Based on differences in age at presentation, clinical appearance and course, radiology and histology, a subclassification into early and adult onset primary chronic osteomyelitis has been established. Cases with purely mandibular involvement should further be distinguished from cases associated with other syndromes.
133 citations
TL;DR: Long-term antibiotic therapy was found to have a positive influence on the course of the disease in its early stages, while cortisone therapy, and sometimes decortication, were found to be more effective in chronic stages.
125 citations
TL;DR: Taxonomic and experimental evidence that supports an infectious etiology are presented and specific culture protocol used to identify organisms from clinical specimens is described.
85 citations
TL;DR: Clinical and radiographic findings in this study of 27 patients suggested an infectious origin of the disease, but bacteriologic findings in 11 of these cases did not support this suggestion.
82 citations
References
More filters
Journal Article•
56 citations
TL;DR: In this article, 13 cases of chronic osteomyelitis of the mandible have been reported, where previous dental caries and tooth extractions were the probable causative agents in eight cases.
44 citations
TL;DR: Thirty-five cases of acute osteomyelitis have been reviewed with the object of determining the causes of relapse, and the criteria for making an early diagnosis are discussed, including the value and limitation of blood culture.
Abstract: 1. Forty-five cases of acute osteomyelitis have been reviewed with the object of determining the causes of relapse. The importance of an early diagnosis and prompt treatment is stressed, and the question of when to stop antibiotic drugs is discussed. 2. The provisional diagnosis was anterior poliomyelitis in seventeen out of forty-five patients; acute osteomyelitis was diagnosed in twelve only. The criteria for making an early diagnosis are discussed, including the value and limitation of blood culture. 3. The place of operation is discussed and certain conclusions are set out.
39 citations
37 citations
TL;DR: It is probable that many cases of chronic osteomyelitis, often associated with the appearance of antibiotic-resistant organisms, are due to inadequate antibiotic therapy and delay in the onset of treatment.
Abstract: It has been said that when treating acute osteomyelitis, in this the era of antibiotic-resistant bacteria, the antibiotic given to the patient when first seen is usually chosen by " inspired " guesswork (Mercer, 1964). If an antibiotic were available to which all commonly encountered pathogens were sensitive then this guesswork would be eliminated. It would be unnecessary to change an antibiotic or give a combination of antibiotics when organism-sensitivity reports became available (Neligan and Elderkin, 1965). Mann (1963) attributes the progression of the disease from the acute to the chronic phase in 7 out of 59 cases reviewed in 1963 to the initial use of the "wrong antibiotic" (as shown by later sensitivity reports). It is probable that many cases of chronic osteomyelitis, often associated with the appearance of antibiotic-resistant organisms, are due to inadequate antibiotic therapy and delay in the onset of treatment.
30 citations