Osteomyelitis

Question 1

What’s acute phase duration ?

Answer 1

7-12 days

Question 2

Subacute duration ?

Answer 2

4-8 days

Question 3

What’s radiographic changes in acute phase ?

Answer 3

** X-ray examination reveals only tipical signs of chronic periodontitis.
** slight decrease in density of involved bone.

Question 4

Subacute radiographic changes ?

Answer 4

areas of bone resorption that have no clear boundaries

Question 5

Secondary phase radiographic changes ?

Answer 5

osteolytic or radiolusent regions, which surround a portion of dead bone sequestrum.
Parallel with the destructive process regeneration of the bone is observed. Around the sequestra developes a new bone formation- the involucrum.

Question 6

What’s the radiolucent and radio-opaque area of X-ray ?

Answer 6

sequestra appear more radio-opaque than normal bone as it attract calcium,

a line of radiolucensy(granulation tissue) separtes the sequestrum from the normal bone.

Question 7

What’s acute phase treatment ?

Answer 7

1. Remove the causitive tooth
2. dranage of pus ( by Intraoral or extraoral incisions)
3. Anti-inflammatory treatment (antibacterial therapy,desensibilization, desintoxication, analgesic medication, vitaminotherapy)

Question 8

Subacute treatment ?

Answer 8

It is continiued antibacterial therapy

Question 9

Chronic phase treatment ?

Answer 9

Sequestrectomy, saucerization, Decortication.
The aim is to debride the necrotic or poorly vascularized bony sequestra in the infected area and improve blood flow.

Question 10

What’s local , regional , diffuse osteomyelitis ?

Answer 10

Localized (around 2-3 teeth)
Regional (alveolar process, body or ramus)
Diffuse (total affection of the whole or half of jaws)

Question 11

What’s classification of jaw osteomyelitis according to etiology ?

Answer 11

1. odontogenic (from inflammatory periodontium)
2. Hematogenous (by blood mostly in infants, sepsis newborns)
3. Traumatic (after jaw fractures)
4. Contact (from purulent foci in the soft tissues around the jaw: abscess, phlegmon, furuncle)
5. Specific(certain etiologic microbial factors)

Question 12

Which teeth mostly associated with osteomyelitis ?

Answer 12

Lower jaw molars (70%).
In the lower jaw the first place in frequency is occupied by the first molar; the second place belongs to the lower wisdom tooth, in third place is the lower second molar.