21. Periostitis of the jaws and facial bones. Etiology, pathogenesis, classification, clinics. 22. Odontogenic cysts of the jaws. Classification, etiology, p

Question 1

Different classifications of periostitis of the jaws and facial bones

Answer 1

• Classification according to:=>
• Degree of Pathogenic Bacteria Involvement
• Nature of Exudative Discharge
• Severity of the Process
• Form of the Disease
• Inflammatory extent

Question 2

Periostitis classification according to Degree of Pathogenic Bacteria Involvement

Answer 2

• Suppurative periostitis
• Aseptic periostitis

Question 3

Periostitis classification according to Nature of Exudative Discharge

Answer 3

• Exudative periostitis
• Proliferative periostitis

Question 4

Periostitis classification according to Severity of the Process

Answer 4

• Acute periostitis
• Chronic periostitis

Question 5

Periostitis classification according to Form of the Disease

Answer 5

• Simple periostitis
• Fibrous periostitis
• Serous periostitis
• Suppurative periostitis
• Ossifying periostitis

Question 6

Etiology of periostitis

Answer 6

• Inflammatory Periostitis
• Toxic Periostitis=>infectious agents enter through bloodstream, related to systemic diseases
• Traumatic Periostitis=> infection entering due to injury
• Specific Periostitis=>diseases like actinomycosis and tuberculosis
• Allergic and Rheumatic Periostitis

Question 7

Characteristics of acute purulent periostitis

Answer 7

• Acute purulent inflammatory process in the periosteum
• Commonly => lower jaw in area of large multi-rooted teeth
• Upper jaw=> molars and premolars

Question 8

Pathogenesis of periostitis

Answer 8

• Purulent foci from previous diseases empty through tooth canals, fistulas, or gingival pockets=>
• Outflow blocked=>purulent exudate spreads from periodontal tissues to the periosteal plate
• Exudate accumulates between the jawbone and the periosteum=>
• Inflammatory process

Question 9

Periostitis classification based on the inflammatory extent

Answer 9

• Acute serous periostitis
• Acute limited purulent periostitis
• Acute diffuse purulent periostitis
• Chronic periostitis

Question 10

Acute Serous Periostitis:

Answer 10

• Painful sensations and marked edema of the soft tissues
• Cold can soothe pain temporarily
• heat exacerbates it

Question 11

Limited Purulent Periostitis

Answer 11

• Affects only the compact plate of the alveolar process
• Intense pain, facial edema, increased temperature

Question 12

Diffuse Purulent Periostitis

Answer 12

• Affects the jawbone up to the base
• More severe symptoms and a broader area of inflammation

Question 13

Specific clinical signs of acute purulent periostitis

Answer 13

• Pain, facial edema, and increased temperature
• Front teeth=>upper lip/ middle face edema=>
• Molars=> cheek, cheekbone, parotid region, and possibly the lower eyelid Increased
• Regional lymph nodes enalrged, thickening of the alveolar process,
• Visible pus
• Abscess Formation

Question 14

Treatment approach for serous periostitis

Answer 14

• Endodontic therapy=>
• Allow exudate (fluid) to flow out from the affected area

Question 15

Purulent periostitis treatment

Answer 15

• Surgery=> To drain the abscess=>
• periostotomy
• Conservative Treatment=> Antibiotics
• Causative tooth extracted

Antibiotics such as lincomycin, metronidazole derivatives, broad-spectrum antibiotics, and macrolides is recommended

Question 16

Physiotherapeutic procedures recommended after an intervention for acute purulent periostitis

Answer 16

• scheduled from the second day=>
• Warm mouth baths antiseptic solutions
• Bandages with vaseline

Question 17

Characteristics for chronic periostitis

Answer 17

• Patients with primary or secondary immunodeficient conditions
• Long course of the disease w/ periodic exacerbations
• Minor changes in facial configuration
• Painless or weakly painful submandibular lymph nodes.
• Edema, hyperemia, and thickening of the alveolar part in the area of several teeth

Relatively rare and is more common in children and adolescents

Question 18

Treatment approaches for chronic periostitis

Answer 18

• Removal of the causative tooth
• Physiotherapy procedures
• Laser therapy with infrared and helium-neon rays
• Surgical removal of ossified sites if other treatments are ineffective

Question 19

Prevention Measures of Periostitis

Answer 19

• Elimination of chronic odontogenic foci of infection
• Strengthen immune system=> prevent progression to chronic osteomyelis