Questions and Answers
Who introduced the term osteomyelitis?
What is the basis of the disease osteomyelitis?
What was suggested by Lannelongue in 1879?
What is the purpose of the lecture?
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What is the focus of the lecture plan for osteomyelitis?
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What is the contemporary view of osteomyelitis?
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What is osteomyelitis primarily regarded as?
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What is the most common cause of osteomyelitis in the jaws?
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What is the age group most commonly affected by osteomyelitis?
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What is the most common source of osteomyelitis in the jaws?
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What percentage of osteomyelitis cases are caused by impacted third molars?
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What is a characteristic of osteomyelitis development?
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What is a factor that influences the clinical manifestations of osteomyelitis?
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What is a complication of osteomyelitis that can cause the disease?
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What is a common complaint of a patient with acute odontogenic osteomyelitis?
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What happens to the pain in the affected tooth over time?
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What is a characteristic feature of the dense, painful infiltrate in acute odontogenic osteomyelitis?
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How many teeth typically respond to percussion in acute odontogenic osteomyelitis?
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What is a common complication of acute odontogenic osteomyelitis?
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What is used to evaluate the degree of the process intensity in acute odontogenic osteomyelitis?
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What is a characteristic laboratory finding in acute odontogenic osteomyelitis?
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What is the role of radiographic signs in the diagnosis of acute odontogenic osteomyelitis?
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What occurs under the influence of osteoclasts and proteolytic enzymes of pus?
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What is a common location for fistula drainage in chronic odontogenic osteomyelitis?
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What is the main component of the diagnostics of chronic odontogenic osteomyelitis?
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What determines the extent and term of the necrsequestrectomy?
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What can be a systemic complication of chronic odontogenic osteomyelitis?
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What can influence the clinical manifestations of chronic odontogenic osteomyelitis?
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What can be a local complication of chronic odontogenic osteomyelitis?
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What determines the treatment of complications of chronic odontogenic osteomyelitis?
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What determines the foundation, choice of treatment, management, and outcome of acute odontogenic osteomyelitis?
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What is the main goal of treating acute odontogenic osteomyelitis?
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What is one of the main components of the surgical stage of treating acute odontogenic osteomyelitis?
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What is the preferred method of administering medication in treating acute odontogenic osteomyelitis?
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What is the main complication of acute purulent odontogenic osteomyelitis?
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What determines the area of necrotic tissues in chronic osteomyelitis?
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What is the extent of bone lesion during the acute stage of osteomyelitis determined by?
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What is the mechanism of the development of chronic osteomyelitis related to?
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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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Description
Learn about the definition, characteristics, and classification of acute osteomyelitis of the jaws, a serious inflammatory process of the bone tissue.
