Mgmnt of osteomyelitis

Question 1

Does spread of infection typically go to osseous structure or soft tissue/fascial spaces more commonly?

Answer 1

Soft tissue

Question 2

Inflammation and infection of the bone marrow with a tendency to progression.

• This process starts of in the medullary bone and then continues to involve adjacent cortical plates and often periosteum (More frequently seen in the Mandible)
• The disease if untreated progresses from inflammatory destruction of bone, to necrosis (sequestra).
• In the oral region, it is usually a result of bacterial infection secondary to odontogenic infections, trauma.

Answer 2

Osteomyelitis

Question 3

Which arch is more affected by osteomyelitis?

Answer 3

Mandible

Question 4

Primarily a result of odontogenic infections or trauma, which cause inoculation of
bacteria into the jaws.

Results in an inflammatory cascade that is usually self-limiting in the healthy patient.

With progression, the condition is considered pathologic.

Answer 4

Osteomyelitis

Question 5

dead bone is surrounded by the new viable bone this is called _______.

Answer 5

Involucrum

Question 6

What is the most common cause microbiologically of osteomyelitis of long bones?

Answer 6

Staph aureus

Question 7

If the osteomyelitis process has been present for less than a month, what is it called?

Answer 7

Acute osteomyelitis

Question 8

If the osteomyelitis process has been present for more than a month, what is it called?

Answer 8

Chronic osteomyelitis

Question 9

What two types of bacteria are present in osteomyelitis infections of the jaws?

Answer 9

Alpha Hemolytic Streptococci and anaerobic bacteria

Question 10

____ is a form of osteomyelitis where there is new bone formed around the infection: bone swelling around infection

Answer 10

Garre’s osteomyelitis

Question 11

How much destruction of cortical bone must take place before osteomyelitis is evident on radiograph?

Answer 11

30-60%

Question 12

How long are IV antibiotics used for osteomyelitis?

Answer 12

6 weeks

Question 13

_______ is a persistent or recurrent bone infection lasting longer than six
months despite appropriate surgical and medical treatment.

Answer 13

Chronic refractory osteomyelitis

Question 14

How is Chronic refractory osteomyelitis treated?

Answer 14

HBOT hyperbaric oxygen therapy

Question 15

_______ is the removal of infected and avascular pieces of bone.

• Since the sequestrum is avascular, antibiotics will not be able to penetrate into it.

Answer 15

Sequestrectomy

Question 16

_______ involves the removal of the adjacent bony cortices and open packing to permit healing by
secondary intention after the infected bone has been removed.

Here the margins of the bone which lodge the sequestra are trimmed down. This create a saucer shaped
defect instead of a deep hollow cavity. This saucer shaped defect can’t accumulate a large clot

Answer 16

Saucerization