Causes, signs and treatment of jaw osteomyelitis

Osteomyelitis is called inflammation of bone tissue and bone marrow. One third of all diseases of this group are osteomyelitis of the jaw. At the same time, the lower jaw is affected twice as often . The disease can occur in acute, subacute and chronic forms. The source of infection is odontogenic, traumatic, hematogenous and specific. In addition, osteomyelitis is limited and diffuse (diffuse); Light, medium and heavy; With complications and without them.

Causes of osteomyelitis of the jaw

The disease develops as a result of infection in the bone tissue. As a rule, the causative agent is Staphylococcus aureus, as well as other cocci, rod-shaped bacteria, rarely viruses.

Most often in medical practice, odontogenic osteomyelitis occurs, in which the infection enters the bone from the pulp of the diseased tooth through the lymphatic vessels or bone ducts. In 70% of cases this occurs through large molar lower teeth.

Traumatic osteomyelitis of the jaw can develop with a jaw fracture as a result of the entry of microorganisms into the wound. Its prevalence is no more than 25% of all cases of the disease.

The least commonly diagnosed is hematogenous osteomyelitis, which occurs when the infection is transferred from the blood from the inflammatory foci to the bone tissue. This can happen in chronic tonsillitis, as well as acute processes, such as scarlet fever, diphtheria and others. In this case, first the bone is damaged, and then the teeth.

Osteomyelitis of the jaw. Symptoms

In the case of an acute process, an elevated body temperature is observed. Patients complain of general malaise, pain, swelling, reddening of the mucosa in the area of the causative tooth, mobility of the neighboring ones. There is a decrease in the mobility of the jaw, development of an abscess, an increase and soreness of the cervical lymph nodes.

With relief after the release of pus comes subacute form. Inflammation is somewhat dulled, but the disintegration of bone tissue continues. At this stage, sequestrants are formed - areas of necrotic bone. Sequesters can be different in form, multiple and single, small and large. The resulting defects or sequestral cavities, lined with granulation tissue, communicate with the mucosa and skin with fistulous passages.

Chronic osteomyelitis is characterized by a prolonged course - up to several months. The periods of stagnation are replaced by exacerbations with the formation of new fistulas, there is a rejection of the dead parts of the bone. Self-healing happens rarely.

Diagnosis of the osteomyelitis of the jaw

The diagnosis is made on the basis of examination, patient complaints, X-ray examination, blood test. Differential diagnostics with acute purulent periostitis and tumors is carried out.

Complications of the osteomyelitis of the jaw

The danger of the disease is that severe complications such as abscess, phlegmon, phlebitis of facial veins, sepsis are not excluded.

Treatment and prevention

Treatment is primarily to remove the sick tooth. In addition, an incision is made for the periosteum for the outflow of exudate - the fluid that forms during the inflammatory process. The lavage of the bone with antiseptics is carried out, anti-inflammatory, detoxifying and symptomatic treatment is prescribed. Physiotherapy is shown: electrophoresis, UHF, ultrasound. Often you have to resort to surgery to remove dead bone. Small sequesters can dissolve themselves. After their retreatment or surgical removal of the cavity fills the connective, and then the bone tissue, the scarring of fistulous passages occurs.

Prevention of osteomyelitis of the jaw reduces to the timely treatment of caries, jaw injuries, acute and chronic infections of the upper respiratory tract.