Chronic Osteomyelitis of the Maxilla and Mandible: Microbiological and Clinical Aspects

Abstract

osteomyelitis of the mandible and maxilla are common in developing countries and their treatment may be long-standing and difficult. Thus, the aim of this study was to discuss the main biological aspects of the chronic osteomyelitis of the jaws of especial interest for dental team. These infections are associated with a complex microbiota composed mainly by anaerobic bacteria, sometimes associated with microorganisms originated from the skin and digestive tract. These data suggest that chronic osteomyelitis of the mandible and maxilla should be treated as anaerobic infections in most cases. In addition, local surgical treatments are relevant in the therapy outcome, associated to the use of antimicrobial agents, and the failure to accomplish them is a major cause of treatment failure.

Analysis of the factors affecting the formation of the microbiome associated with chronic osteomyelitis of the jaw

“…Therefore, a comprehensive bacterial investigation is required. Although some studies have investigated the bacterial communities associated with COMJ , most of these have used only culture‐dependent methods. Most of the infectious diseases in the oral and maxillofacial regions are caused by polymicrobial infection of anaerobes , and all of the causative bacteria may not be culturable with the methods used in previous reports.…”

Strontium ranelate improves delayed healing of osteolytic lesions of the jaw in a man with chronic osteomyelitis. Case report

“…The outcome of acute or chronic osteomyelitis of the jaw is documented scarcely in the literature. When surgery is performed, systematic or local antibiotic therapy is continued for 1-2 months and early signs of radiological improvement usually present within this time frame (2). Follow-up period according to various authors varies from 6-18 months, and success rates vary according to different cases and treatment regimes (1,2).…”

“…When surgery is performed, systematic or local antibiotic therapy is continued for 1-2 months and early signs of radiological improvement usually present within this time frame (2). Follow-up period according to various authors varies from 6-18 months, and success rates vary according to different cases and treatment regimes (1,2). Strontium Ranelate (SrRan) is currently approved for the treatment of severe osteoporosis in postmenopausal women and in men with increased risk of fracture in numerous countries; 2g of SrRan per os daily have been shown to reduce risk of vertebral and non-vertebral fractures in postmenopausal women with osteoporosis, with or without prior fractures (3)(4)(5)(6).…”

Maxillary Osteomyelitis with Candidiasis due to Extraction in Uncontrolled Diabetes State-A Case Report

“…Among the skull bones, the CO is more frequently observed in the mandible and, in fewer cases, in the maxilla, but generally limited to one anatomic site as mentioned by Lew [20], although it may spread out to other areas, especially in diabetic, immunosuppressed and hospitalized patients as recorded by Brady [21]. The radiographic characteristics of the osteolysis observed in the chronic osteomyelitis of the maxilla and mandible are more evident in younger patients; meanwhile the bone condensation is more frequent in adults, particularly in lesions of the mandible [22]. The treatment of these infections depends on the SE, surgical debridement of the wound, and removal of the bone cortex, associated to the systemic use of antimicrobials has been evaluated by Lew [20].…”