Clinical Characteristics and Treatment of Osteopetrosis Complicated by Osteomyelitis of the Mandible

Abstract

Osteopetrosis represents a heterogeneous group of rare, hereditary bone disorders with variable clinical features, and an increase in bone density. Osteomyelitis of the jaws is a significant complication of osteopetrosis. In this article, a reported patient with osteopetrosis complicated by osteomyelitis of the mandible was examined. The patient was treated with intravenous antibiotic therapy, debridement of necrotic bone and hyperbaric oxygen therapy; in addition, the authors attempted to implant the calcium sulfate and vancomycin to reconstruct the bone defect. The patient demonstrated satisfactory healing, and no recurrence of osteomyelitis was observed during the 6-month follow-up period. The treatment of osteopetrosis complicated by osteomyelitis of the mandible is difficult. The treatment of osteopetrosis complicated by osteomyelitis is controversial. The authors recommend the following sequential treatment of osteopetrosis complicated by osteomyelitis of the mandible: systemic antibiotic therapy and hyperbaric oxygen therapy before and after surgery; debridement of the necrotic bone; sufficient periosteal coverage and adequate soft tissue to cover the wound; implantation with calcium sulfate and vancomycin to reconstruct the bone defect as much as possible, which may be helpful in treating the disease.

Multiple oral sinus tract and trismus leading to a surprising diagnosis of osteopetrosis: Case report

“…Classical osteopetrosis has distinct subforms, which are classified into three clinical groups according to age of onset, inheritance, and severity. 8 Autosomal recessive osteopetrosis (ARO), malignant form, is typically fatal during early infancy when not treated. The second form is an autosomal recessive intermediate form that manifests dur-ing childhood, with significant severe signs and symptoms compared to benign osteopetrosis.…”

“…14 Osteomyelitis of the jaws is a recognized complication of osteopetrosis that occurs almost exclusively in the mandible instead of the maxilla, demonstrating a thin cortical bone and rich collateral blood supply. 8 It is generally developed as a result of tooth extraction or pulp necrosis. 18 It tends to recur due to bacterial camouflage inside the bone, where there is a decrease in blood flow.…”

“…Classical osteopetrosis has distinct subforms, which are classified into three clinical groups according to age of onset, inheritance, and severity 8 . Autosomal recessive osteopetrosis (ARO), malignant form, is typically fatal during early infancy when not treated.…”

Osteomielite maxilar aguda em paciente acometido por osteopetrose infantil maligna: relato de um caso raro de sobrevida

“…É importante lembrar que a antibioticoterapia nesses pacientes não tem bons índices de cura, pois a densificação óssea dificulta a penetração das substâncias no local de infecção. Assim, o melhor tratamento seria a remoção cirúrgica do foco infeccioso 14 .…”

Development of bone regeneration strategies using human periosteum‐derived osteoblasts and oxygen‐releasing microparticles in mandibular osteomyelitis model of miniature pig

“…HBO increases oxygen tension to counteract the local effects of hypoxia in medullary infections. The treatment can arrest certain types of infection, induce angiogenesis, and reestablish blood flow to the tissues (Memar, Yekani, Alizadeh, & Baghi, ; Savvidou et al, ; Shandley et al, ; Sun, Xue, Wu, & Zhou, ).…”