Chandana - Osteomyelitis .omfs surgery bds

Osteomyelitis surgery Omfs

1. OSTEOMYELITIS Submitted by, C h a n d a n a . C Final year part 1 18002055 9

2. CONTENTS INTRODUCTION DEFINITION PREDISPOSING FACTORS ETIOLOGY CLASSIFICATION PATHOGENESIS MICROBIOLOGY MANAGEMENT REFERENCE

3. INTRODUCTION Nelaton(1834) coined osteomyelitis Greek word ‘osteon’ means bone and ‘myelos’ means marrow

4. DEFINITION Osteomyelitis may be defined as an inflammatory condition of bone that begins as an infection of medullary cavityand haversian system of the cortex and extends to involve the periosteum of the affected area

5. PREDISPOSING FACTORS Condition reducing host defences Diabetes Malnutrition Agranulocytes Leukemia Chronic alchoholism Febrile illness

6. 2. Condition compromising jaw vascularity Radiation Pagets disease Fibrous dyspalsia Malignancy

7. ETIOLOGY The source of infection may arise from : odontogenic infection Traumatic injuries to the jaws, fractures Infection of orofacial region derived from : Periostitis following gingival ulceration Lymph nodes infected from furnuncles Lacerations Peritonsillar abscess 4.Infection derived by hematogenous route

8. CLASSIFICATION BASED ON PATHOGENESIS Hematogenous osteomyelitis Peripheral vascular diseases Osteomyelitis secondary to a contiguous focus of infection

9. DEPENDING ON DURATION AND SEVERITY OF THE DISEASE Acute osteomyelitis Chronic osteomyelitis

10. CLINICAL TYPES Acute suppurative Secondary chronic Primary chronic Non suppurative

11. DEPENDING ON THE FORMATION OF PUSIN THE INFECTION Suppurative Acute Chronic Infantile Infantile 2.Non suppurative Sclerosing Garre’s Actinomycotic Radiation

12. PATHOGENISIS

13. MICROBIOLOGY OF OSTEOMYELITIS OF JAWS Most of the cases are caused by aerobic streptococci: alpha hemolytic streptococcus viridans, anaerobic streptococci and other anaerobes such as fusobacterium, bacteriodes, peptostreptococcus Special form of osteomyelitis caused by Mycobacterium tuberculosis, Treponema pallidum

14. MANAGEMENT OF OSTEOMYELITIS Treatment is basically divided into: Medical management Surgical management

15. MEDICAL MANAGEMENT Systemic antibiotics Penicillin Newer antibiotics : metrronidazole, clindamycin, ticarcilin, clavulanic acid, a variety of cephalosporin, vancomycin, ciprofloxacin2ciprofloxacin 2. Local application of antibiotics Closed wound irrigation – suction Antibiotic impregnated beads

16. SURGICAL MANAGEMENT Sequestrectomy Saucerisation Decortication Resection and reconstruction

17. REFERENCE Textbook of oral maxillofacial surgery – S. M Balaji Textbook of oral and maxillofacial surgery – Chitra chakravarthy