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DNT 243. DR.SHAHZADI TAYYABA HASHMI. DISORDERS OF MAXILLA AND MANDIBLE. DISORDERS OF MAXILLA AND MANDIBLE. MAJOR INFECTIONS OF JAWS. OSTEOMYELITIS Definition: An inflammatory process within medullary ( trabecular) bone that involves the marrow spaces
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DNT 243 DR.SHAHZADI TAYYABA HASHMI DISORDERS OF MAXILLA AND MANDIBLE
MAJOR INFECTIONS OF JAWS OSTEOMYELITIS Definition: An inflammatory process within medullary ( trabecular) bone that involves the marrow spaces Osteomyelitis of jaws is mainly a disease of adults with several potential sources of infection.
ACUTE OSTEOMYELITIS DEFINITION A rapidly destructive inflammatory process within bone that consist of Granulation tissue, Purulent exudate and islands of non-vital bone (sequestra)
CAUSES OF ACUTE OSTEOMYELITIS • Caused by direct extension of untreated periapical abcess • Minor traumatic incident involving a mandible that has its blood supply compromised by previous high doses of radiation for the treatment of malignancy( OSTEORADIONECROSIS)
CLINICAL FEATURES OF ACUTE OSTEOMYELITIS • Commonly affects males with infection of mandible • Early complaints are Severe, Throbbing pain and swelling with external swelling due to inflammatory edema • Laterdistension of periosteum with pus occurs • Finally, subperiosteal bone formation causes the swelling to become firm • Associated teeth are tender and mobile • Overlying gingiva is red, swollen and tender • Paresthesia of lower lip of affected side • Regional lymph nodes are enlarged and tender • Difficulty in mouth opening and swallowing
RADIOGRAPHIC FEATURES OF OSTEOMYELITIS • Loss of trabecular pattern and areas of radiolucencyindicates bone destruction • Ill-defined margins with fluffy and moth-eatenappearance • Areas of dead bone appears as dense areas TREATMENT: • Surgical treatment to establish drainage of purulent exudates • Use of antibiotics to kill the microorganisms involved
RADIOGRAPHIC FEATURES AND TREATMENT Radiographic features: • Radiographic features are variable but sometimes distinctive • Sequestra will usually separate spontaneously TREATMENT: • Antibiotics
CHRONIC OSTEOMYELITIS • Persistent low grade infection associated with bone destruction and Granulation tissue formation with little suppuration CLINICAL FEATURES: Persistent ache / pain with exposed bone
GARRE OSTEOMYELITIS It is an unusual hyperplasic reaction of the periosteum to a chronic osteomyelitis of the posterior mandible that is unique to young patients. CLINICAL FEATURES: • Most frequently associated with advanced acutecaries in young patients • Occurs when free gingival margin remain above the height of contour of tooth results in foodimpaction
RADIOGRAPHIC APPEARANCE AND TREATMENT Radiographic appearance: • onion skin appearance TREATMENT: • Identification of source of infection • Extraction of the tooth involved in infection • Surgical treatment of tissues in molar area
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