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