OSTEOMYELITIS

Inflammatory condition of bone which begins as an infection of the medullary cavity of the jaws and extends to involve the periosteum.

Causes

• Odontogenic infection
• Compound jaw infection
• Hematogenous spread from distant site

Clinical features

• Deep intense pain
• Fever malaise, anorexia
• Parathesia or anaesthesia of the mental nerve
• Loose teeth - percussion tenderness
• Firm cellulitis of surrounding soft tissues
• Regional lymphadenitis
• Fistula formation and pus drainage
• OPG - Moth eaten appearance of bone with zone of radiolucency surrounding sequestrum in advanced stages

MANAGEMENT

• Fast
• IVT fluid
• Analgesia
• Antibiotic therapy (penicillin and metronidazole IV)
• Surgical debridement - contact oral and maxillofacial surgeon (RAH has reg on call)
• Nutritional support
• Rehabilitation

Dr George Chu BDSc MBBS
Ed: Dr. Derek Louey MBBS FACEM