Acute Osteomyelitis of the Jaws
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Questions and Answers

Who introduced the term osteomyelitis?

  • Norard (correct)
  • An unknown scientist
  • Dr. Saleem
  • Lannelongue
  • What is the basis of the disease osteomyelitis?

  • Lesion of the jaw muscles
  • Predominantly lesion of the bone marrow (correct)
  • Lesion of all structures of the bone
  • Lesion of the gums
  • What was suggested by Lannelongue in 1879?

  • A new diagnostic tool for osteomyelitis
  • A new treatment for osteomyelitis
  • That all types of inflammation of bone be defined as osteomyelitis (correct)
  • A new classification system for osteomyelitis
  • What is the purpose of the lecture?

    <p>To introduce modern concepts of etiology and pathogenesis of odontogenic and other forms of acute osteomyelitis</p> Signup and view all the answers

    What is the focus of the lecture plan for osteomyelitis?

    <p>Statistics and classification of osteomyelitis of the jaws</p> Signup and view all the answers

    What is the contemporary view of osteomyelitis?

    <p>Osteomyelitis is a lesion of all structures of the bone</p> Signup and view all the answers

    What is osteomyelitis primarily regarded as?

    <p>An infectious purulent and necrotic inflammatory process</p> Signup and view all the answers

    What is the most common cause of osteomyelitis in the jaws?

    <p>Odontogenic factors</p> Signup and view all the answers

    What is the age group most commonly affected by osteomyelitis?

    <p>Adults between 18-40</p> Signup and view all the answers

    What is the most common source of osteomyelitis in the jaws?

    <p>Mandible molars</p> Signup and view all the answers

    What percentage of osteomyelitis cases are caused by impacted third molars?

    <p>17%</p> Signup and view all the answers

    What is a characteristic of osteomyelitis development?

    <p>Local changes quickly increase with the development of the disease</p> Signup and view all the answers

    What is a factor that influences the clinical manifestations of osteomyelitis?

    <p>All of the above</p> Signup and view all the answers

    What is a complication of osteomyelitis that can cause the disease?

    <p>Caries</p> Signup and view all the answers

    What is a common complaint of a patient with acute odontogenic osteomyelitis?

    <p>Sharp pain in the tooth</p> Signup and view all the answers

    What happens to the pain in the affected tooth over time?

    <p>The pain subsides</p> Signup and view all the answers

    What is a characteristic feature of the dense, painful infiltrate in acute odontogenic osteomyelitis?

    <p>It encloses the jaw body like a coupling</p> Signup and view all the answers

    How many teeth typically respond to percussion in acute odontogenic osteomyelitis?

    <p>2-4 teeth</p> Signup and view all the answers

    What is a common complication of acute odontogenic osteomyelitis?

    <p>Purulent lymphadenitis and adenophlegmons</p> Signup and view all the answers

    What is used to evaluate the degree of the process intensity in acute odontogenic osteomyelitis?

    <p>A combination of anamnesis, clinical signs, and additional methods of investigation</p> Signup and view all the answers

    What is a characteristic laboratory finding in acute odontogenic osteomyelitis?

    <p>Increased leukocyte number with shift of the blood count to the left</p> Signup and view all the answers

    What is the role of radiographic signs in the diagnosis of acute odontogenic osteomyelitis?

    <p>They are not pronounced in the acute stage, but can help in complicated cases</p> Signup and view all the answers

    What occurs under the influence of osteoclasts and proteolytic enzymes of pus?

    <p>Gradual separation of necrotic areas of the bone</p> Signup and view all the answers

    What is a common location for fistula drainage in chronic odontogenic osteomyelitis?

    <p>In the oral cavity, on the skin of the face, and in submandibular and submaxillary areas</p> Signup and view all the answers

    What is the main component of the diagnostics of chronic odontogenic osteomyelitis?

    <p>Radiography of different kinds</p> Signup and view all the answers

    What determines the extent and term of the necrsequestrectomy?

    <p>Radiography</p> Signup and view all the answers

    What can be a systemic complication of chronic odontogenic osteomyelitis?

    <p>Anemia</p> Signup and view all the answers

    What can influence the clinical manifestations of chronic odontogenic osteomyelitis?

    <p>All of the above</p> Signup and view all the answers

    What can be a local complication of chronic odontogenic osteomyelitis?

    <p>Formation of a fistula</p> Signup and view all the answers

    What determines the treatment of complications of chronic odontogenic osteomyelitis?

    <p>Character and location of the complications</p> Signup and view all the answers

    What determines the foundation, choice of treatment, management, and outcome of acute odontogenic osteomyelitis?

    <p>Integral analysis of all discovered changes</p> Signup and view all the answers

    What is the main goal of treating acute odontogenic osteomyelitis?

    <p>All of the above</p> Signup and view all the answers

    What is one of the main components of the surgical stage of treating acute odontogenic osteomyelitis?

    <p>Extraction of the causative tooth</p> Signup and view all the answers

    What is the preferred method of administering medication in treating acute odontogenic osteomyelitis?

    <p>Infusion methods</p> Signup and view all the answers

    What is the main complication of acute purulent odontogenic osteomyelitis?

    <p>Purulent processes in perignathic soft tissues</p> Signup and view all the answers

    What determines the area of necrotic tissues in chronic osteomyelitis?

    <p>Impaired endo- and extraosseous blood circulation</p> Signup and view all the answers

    What is the extent of bone lesion during the acute stage of osteomyelitis determined by?

    <p>Impaired endo- and extraosseous blood circulation</p> Signup and view all the answers

    What is the mechanism of the development of chronic osteomyelitis related to?

    <p>Impaired endo- and extraosseous blood circulation</p> Signup and view all the answers

    Study Notes

    Acute Osteomyelitis of the Jaws

    • The term "osteomyelitis" was introduced by Norard in 1834 and later defined by Lannelongue in 1879 as an infectious, purulent, and necrotic inflammatory process of the osseous tissue.
    • Acute osteomyelitis is characterized by foci of purulent infiltration of the bone marrow, thrombosis, and purulent liquefaction of clots, hemorrhage, and osteo-myelonecrosis.
    • Classification of osteomyelitis of the jaws:
      • Odontogenic: up to 90% of cases, mainly caused by caries
      • Traumatic: 7-8% of cases, including gunshot wounds
      • Specific: 0.9-1.5% of cases
      • Radial (radionecrosis): 0.3-0.5% of cases
    • Clinical manifestations of acute osteomyelitis:
      • Sharp pain in the tooth, spreading to adjacent teeth
      • Tooth mobility and foul smell from the mouth
      • Symptoms of systemic intoxication
      • Tender swelling of soft tissues, difficulty opening the mouth
      • Dense, painful infiltrate enclosing the jaw body
    • Diagnostics of acute odontogenic osteomyelitis:
      • Evaluating anamnesis, clinical signs, and additional methods of investigation
      • Laboratory tests: increased leukocyte number, elevated ESR, altered protein level, and changes in immunocompetent cells
      • Radiographic signs: not pronounced in the acute stage, but helpful in complicated cases
    • Treatment of acute odontogenic osteomyelitis:
      • Elimination of local purulo-necrotic processes by exposure and drainage of foci
      • Decrease of intoxication degree with normalization of vital functions and organs
      • Extraction of the causative tooth
      • Adequate medication, physiotherapy, and complex measures
    • Complications of acute purulent odontogenic osteomyelitis:
      • Purulent processes in perignathic soft tissues (phlegmons and abscesses)
      • Acute sepsis, toxic lesions of kidneys, liver, and heart
      • Metastatic purulent foci in remote regions (brain, mediastinum)
      • Postoperative scars

    Chronic Osteomyelitis

    • The clinical picture of chronic osteomyelitis is determined by the extent of bone lesion during the acute stage.
    • Mechanism of development: impaired endo- and extraosseous blood circulation, necrotic tissues, osteoclasts forming new osseous tissue, and granulation development.
    • Formation of fistulas, discharge of pus, and separation of necrotic areas of the bone (sequestra).
    • Clinical manifestations:
      • Functioning fistula or scarred indrawn areas of the skin and mucosa
      • Discharge of pus through fistulas
      • Quaggy, hypertrophic bleeding granulations
    • Diagnostics of chronic odontogenic osteomyelitis:
      • Radiography of different kinds (conventional radiographs, CT, and MRI)
      • Determination of extent and term of necrsequestrectomy radiographically
    • Treatment of chronic odontogenic osteomyelitis:
      • Sequestrectomy (rarely used in oral surgery)
      • Determination of access, margins of excision of affected tissues, and tactics concerning granulations of the sequestral capsule
      • Usage of particular compositions to fill in bone defects and cavities resulting from the operation
    • Complications of chronic osteomyelitis:
      • Systemic: anemia, renal amyloidosis, sepsis, malignization of chronic process, exacerbation of accompanying disorders
      • Local: depending on the form and extent of the lesion

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    Learn about the definition, characteristics, and classification of acute osteomyelitis of the jaws, a serious inflammatory process of the bone tissue.

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