Decompressive effects of draining tube on suppurative and sclerosing osteomyelitis in the jaw

Abstract

Background Osteomyelitis (OM) in the jaw is an inflammatory disease of osseous tissue that begins in the medullary space and progressively expands to the cortical portion of the bone, the Haversian system, the periosteum and the overlying soft tissue. Despite advances in dental and medical care, OM persists and is of important concern in modern medicine. Active negative pressure is known to prevent post-operative hematoma; decrease the number of bacterial pathogens, accumulation of toxins, and necrotic tissue; and promote osteogenesis and angiogenesis with the use of a draining tube such as the Jackson-Pratt (JP) or Hemovac. The purpose of this study was to assess the effectiveness of decompression for the treatment of OM in the jaw. Methods This retrospective study included a total of 130 patients, 55 patients with sclerosing OM and 75 patients with suppurative OM were included. The radiographic bone densities expressed as a grayscale values (GSVs), were measured using an easy digitalized panoramic analysis (EDPA) method, processed on the conditional inference tree, generated by the R program® 3.2.3 with a probability of 96.8%. Rectangle annotation analysis of INFINITT PACS® (INFINITT Healthcare, Seoul, Korea) of 50 mm2 was determined as the region of interest (ROI). Student’s t-test and ANOVA were used to determine significance (p < 0.05). Results Significant changes was observed between radiographic bone density in the sclerosing type with drain and without drain at the six-month and one-year follow-up (p < 0.05). Significant difference was demonstrated between the suppurative OM with drain and without drain groups at the one-year follow-up (p < 0.05). Conclusion The OM groups with drain exhibited more enhanced bone density compared to the groups without drain at the six-month and one-year follow-ups. The drain insertion for decompression is effective for the management of sclerosing and suppurative OM. It is recommended to implement it for the management of OM.

Femoral Head Necrosis Due to Brucella Infection in China: Case Series and Literature Review

“…Suppurative osteomyelitis occurs when the bone becomes infected, and pus enters the Haversian canal and the bone’s perforating canal, obstructing the bone’s small nutritive arteries and disrupting the blood supply to the femoral head. 15 , 16 There have only been three reports of osteonecrosis of the femoral head due to Brucella infection to date ( Table 2 ): In the first two cases of osteonecrosis of the femoral head, Brucella was presumed as the likely cause due to a lack of diagnostic bases such as pathology and bacterial culture; 7 , 8 in the third case, the diagnosis and treatment methods were outdated and the follow-up period was too short. 9 Our study confirmed that Brucella could cause osteonecrosis of the femoral head: Brucella was detected by Giemsa staining, and B. melitensis was identified by real-time PCR testing.…”

“…Suppurative osteomyelitis occurs when the bone becomes infected, and pus enters the Haversian canal and the bone's perforating canal, obstructing the bone's small nutritive arteries and disrupting the blood supply to the femoral head. 15,16 There have only been three reports of osteonecrosis of the femoral head due to Brucella infection to date (Table 2):…”

Decompression effects on bone healing in rat mandible osteomyelitis

“…The current study results strongly support the clinical relevance of decompression in combination with the conventional surgical treatment for jaw OM. From our ongoing clinical study, this treatment method has many clinical merits, such as reducing swelling, discomfort, easy to use, convenient and economical 34 . The results of this clinical study revealed that the group of patients treated with saucerization and drain insertion exhibited more enhanced bone density compared to the groups without drainage at the six-month and one-year follow-ups.…”

Odontogenic Keratocyst in the Masseter Muscle

“…OKC arising from purely soft tissue other than gingival is extremely rare, especially OKC arising from muscles. [1][2][3][4] The current case had no evident lesion within the jawbone nor any history of injury and surgery, and was not secondary to any preexisting lesions.…”

“…Following excision of the mass, we performed gentle curettage to remove any mass remnants and irrigated the surgical site with normal saline. The flap was repositioned and a silastic drain was placed and sutured 2 . The drain was removed 1 day after the surgery.…”