Osteomyelitis of the tooth. How osteomyelitis of the upper and lower jaw manifests itself - diagnosis, treatment and prognosis

Osteomyelitis of the jaw ICD 10: code K10.2 () - osteomyelitis of the jaw (acute, chronic, purulent)

The process of tooth decay cannot stop by itself. Powerless against him and any therapeutic procedures such as rinsing. The only way to stop it is to have the tooth treated by a dentist who, using the appropriate tools, will clean the carious cavity of bacteria and dead tissue and place a filling in it. If this is not done in time, then the carious cavity will constantly deepen - until it connects with the pulp chamber. As a result, an infection that has penetrated into the pulp will cause an inflammatory process - pulpitis, accompanied by severe pain.

But pain is not the most important of the problems that have arisen. If a person does not treat a tooth, but endures pain or constantly soothes it with analgesics, then after a while the pain will cease to be felt due to the death of nerve endings. However, the focus of infection, located in the pulp, will not remain localized in it forever. It will expand. Pathogenic microorganisms will penetrate through the root canal into the periodontium, causing inflammation of the tissues adjacent to the tooth. Developed periodontitis in the absence of treatment will serve as the beginning of even more serious complications.

Orthopantomogram: acute odontogenic osteomyelitis

As a result of an infectious lesion of the periosteum, a serious illness occurs (it is also a flux), accompanied by severe pain, swelling and general intoxication of the body. This disease requires immediate treatment, as it can cause further complications - infection of the brain with the development of meningitis, general blood poisoning, etc. The presence of a focus of infection can also lead to infection of the jaw bone tissue, which will cause the onset of another serious odontogenic disease - osteomyelitis. What is this pathology?

What is odontogenic osteomyelitis of the jaw

The word "osteomyelitis" itself is literally translated from Greek as "inflammation of the bone marrow." In this sense, this term is not entirely correct in relation to this disease, since in this case not only the bone marrow is inflamed, but also the entire bone tissue as a whole. In addition, inflammation also affects the soft tissues adjacent to the bone. Therefore, such names of this disease as osteitis or osteitis are considered more accurate. Nevertheless, the name "osteomyelitis" has historically been firmly entrenched in this disease, and therefore is officially considered correct and is used most often.

Osteomyelitis is an inflammatory lesion of bone tissue, accompanied by the formation of purulent masses and necrotic process. In this case, the following ways of infection penetration into the bone are possible:

Odontogenic route of infection.
Traumatic way of infection.
hematogenous route of infection.

In the first case, pathogens enter the jawbone from a diseased tooth and adjacent tissues. Thus, it is a complication of such dental diseases as:

advanced caries;
pulpitis;
periodontal inflammation;
inflammation of the periosteum;
inflammation of soft tissues adjacent to erupting teeth;
inflammation of the walls of the hole left from the torn tooth;
cyst or granuloma.

Infection of the jawbone occurs through the infected pulp and root canal.

In the second case, the infection is introduced into the jawbone as a result of a fracture or a gunshot wound. In addition, the disease may be preceded by trauma to the mucous membrane of the nasal cavity.

Hematogenous infection of bone tissue occurs as a result of the penetration of pathogenic microorganisms through the bloodstream. This form of osteomyelitis can develop as a complication of diseases such as:

furunculosis of the face;
purulent inflammation of the ear;
tonsillitis;
scarlet fever;
diphtheria.

In addition, infection with the blood stream can be introduced even from distant areas of the body. Thus, a purulent-septic inflammation of the skin of the navel and the subcutaneous fatty tissue under it in newborns can become a source of infection of the jawbone.

The most common one is found in eighty cases of inflammation of the jawbone. Traumatic osteomyelitis occurs in 11% of cases of infectious lesions of the jaw bone tissue, and hematogenous - only in 9% (usually in children).

Infection in the bone causes a massive migration of white blood cells to the focus of inflammation. Enzymes produced by leukocytes cause the decomposition of bone tissue. In the infected area of the bone, dead bacteria, dead leukocytes and the remains of destroyed cells form purulent masses that spread through the blood vessels. This leads to the rejection of dead bone, which is a prerequisite for the formation of a focus of chronic infection. New bone tissue grows around the area of necrotic bone lesion.

Low phagocytic activity of leukocytes

From the point of view of the nature of the flow, there are:

acute osteomyelitis;
subacute osteomyelitis;
chronic osteomyelitis.

With an inflammatory lesion of the jawbone, both the processes of destruction and rejection, and the processes of formation of a new bone substance, can prevail. In this regard, distinguish productive form of osteomyelitis(flowing without the formation of areas of dead tissue) and destructive form(at which these sections are formed). In addition, it also happens intermediate form diseases.

A purulent-necrotic process in osteomyelitis can be localized on the alveolar process or in the volume of the jaw in an area of 2-4 teeth. In this case, they speak of limited osteomyelitis. At the same time, inflammation can cover a significant area of the jawbone or even the entire jaw. In such a situation, they speak of a diffuse form of the disease.

Purulent-necrotic process in osteomyelitis of the jaw

As a rule, osteomyelitis affects the lower jaw. The most susceptible to osteomyelitis are people with weakened immune systems, as well as those suffering from diabetes, blood diseases, rheumatism, polyarthritis, kidney and liver pathologies.

Symptoms of osteomyelitis of the jaw

The acute form of this disease is characterized by a sudden onset. In this case, the first common symptoms of the disease appear, such as:

temperature rise to 38-39 degrees;
chills;
deterioration of the general condition in the form of weakness and weakness;
loss of appetite;
sleep disorder.

Local symptoms of this disease include:

Pain sensations - first localized in the area of the diseased tooth, and then becoming diffuse, radiating to the temple, eye area and ear.
Mobility of the causative tooth and adjacent teeth.
Swelling of the gums.
Suppuration from gums.
Putrid odor from the mouth.

Soft tissue damage leads to difficulty breathing and painful swallowing. It becomes difficult for the patient to open his mouth. When the lower jaw is affected, the sensitivity of the lower lip is often disturbed, which begins to go numb. The patient feels goosebumps and tingling on it. The same sensations extend to the mucous membrane of the vestibule of the mouth and the chin.

Diagnosis of osteomyelitis: facial asymmetry

Acute osteomyelitis causes facial asymmetry due to developing edema and swelling of the lymph nodes. This form of the disease is often accompanied by such phenomena as:

maxillary abscesses;
purulent fusion of subcutaneous fatty tissue in the area of the affected jaw;
adenophlegmon.

The defeat of the maxillary bone can lead to complications such as phlegmon of the orbit, sinusitis, blockage of the branches of the facial vein by blood clots and inflammation of their walls.

Subacute course of osteomyelitis is characterized by less pronounced signs of general intoxication, and less swelling and suppuration. However, when the disease passes into a subacute form, the teeth in the area of inflammation remain mobile. In some cases, their mobility may even increase.

Chronic osteomyelitis can be both a primary disease and the result of an acute form of bone inflammation.

In the destructive form of osteomyelitis, general intoxication of the body is accompanied by damage to the lymph nodes. The disease proceeds with the formation of fistulas, from which pus is released. Destructive osteomyelitis is characterized by extensive areas of dead tissue (sequesters). In the chronic course of destructive inflammation of the jawbone, a pathological fracture of the jaw may occur. In the case of destructive-productive chronic osteomyelitis, numerous small areas of bone tissue affected by necrosis are formed.

a - osteomyelitis of the lower jaw, b - pathological

The productive form of osteomyelitis is characterized by the absence of fistulas and areas of dead tissue, since the processes of growth of new bone predominate. With this form of the disease, the jawbone is deformed, and fusion of the jaw joints can also occur, limiting the mobility of the lower jaw or even completely making it immobile. Another complication of osteomyelitis is trismus, a spasm of the masticatory muscles, leading to the inability to open the jaw.

Diagnosis and treatment of osteomyelitis of the jaw

The success of the treatment of this disease depends, first of all, on how correctly the diagnosis is made. It is important to differentiate osteomyelitis from other diseases with similar external symptoms, in particular, from periostitis. When making a diagnosis, it is necessary to accurately determine the form of osteomyelitis, the size of the inflammation focus, the degree of bone tissue destruction, etc.

Diagnosis of osteomyelitis

If this disease is acute, then pathological changes in tissues are either not displayed at all on the x-ray, or are displayed, but not clearly. Therefore, a dental surgeon or traumatologist diagnoses osteomyelitis based on the clinical picture and the results of laboratory analysis. In particular, when analyzing the blood of a patient with acute inflammation of the bone tissue, the following changes are detected:

a strong increase in the content of neutrophils in the blood of white blood cells;
a decrease in the content of lymphocytes and eosinophils in the blood;
increased erythrocyte sedimentation rate;
an increased concentration in the blood of C-reactive protein, indicating an acute inflammatory process;
increased content of globulin and albumin.

A general urine test shows the presence of cylinders, erythrocytes, and traces of protein.

To establish the exact nature of the causative agent of inflammation, a bacteriological culture of the fluid taken from the zone of the inflammatory process is performed.

In subacute and chronic osteomyelitis, pathological changes in tissues become visible on X-ray or tomographic examination. These methods show:

changes in the structure of bone tissue, expressed in a decrease in bone mass and an increase in its fragility (osteoporosis);
compaction of bone tissue with the growth of a compact substance and bone trabeculae (osteosclerosis);
coarse fibrous structure of bone tissue;
areas with rejection of dead bone.

In the case of an acute course of the disease with diagnosis of osteomyelitis it is necessary to differentiate this disease from such diseases as:

purulent inflammation of the periosteum (flux);
acute periodontal inflammation;
suppuration of the jaw cyst;
damage to the jawbone by tuberculosis, syphilis, actinomycete infection.
oncological diseases of the jaw.

How is osteomyelitis of the jaw treated?

In the treatment of this disease, both local and general medical procedures are used. First of all, the source of infection is eliminated. So, if the patient ondogenic osteomyelitis of the jaw, That . If the infection of the bone occurred through the blood, then the primary inflammatory process is treated. To prevent the development of traumatic osteomyelitis, suturing the wound should be preceded by careful primary surgical treatment.

Diffuse osteomyelitis of the upper jaw. Treatment of osteomyelitis should be started as early as possible.

With further treatment of osteomyelitis of the jaw the following local treatment activities are carried out:

surgical opening of the periosteum;
removal of purulent masses from the focus of inflammation;
washing the bone cavity with antiseptic solutions;
installation of a drainage tube to remove pus.

If the teeth adjacent to the causative tooth have become mobile, then they are strengthened with the help of splinting.

Common therapeutic measures include antibiotic therapy with antibiotics such as cephalosporins and penicillins. Measures are also taken for detoxification, immunomodulation, desensitization.

Common treatment procedures for osteomyelitis also include:

oxygen therapy using pressure chambers;
purification of blood plasma;
detoxification of blood and lymph using sorbents.
intramuscular injection of the patient's own blood;
exposure to ultraviolet radiation.

With inflammation of the jawbone, physiotherapeutic methods are actively used, such as UHF therapy and treatment with ultrasound and a magnetic field.

If osteomyelitis has taken a chronic course, then, based on x-ray data, a surgical operation may be prescribed to remove areas of dead bone tissue and granulations. After surgical cleaning of the jawbone, the voids formed in it are filled with osteoplastic materials containing antibacterial drugs. To prevent fractures, the jaw is strengthened by splinting.

Odontogenic osteomyelitis- a serious disease that requires serious treatment, and it is better to prevent this disease than to treat it. To do this, you just need not to run teeth affected by caries or pulpitis, and contact a dentist in time, who professionally and efficiently eliminates the existing problem.

- a purulent, infectious-inflammatory process that captures all the structural components of the jawbone and leads to osteonecrosis. Osteomyelitis of the jaw is accompanied by general symptoms (weakness, fever, chills) and local signs (pain, limited mouth opening, tooth mobility, inflammatory infiltration of the soft tissues of the face, the formation of fistulas, sequesters, abscesses, etc.). Osteomyelitis of the jaw is diagnosed on the basis of clinical and radiological signs, hemogram studies. Treatment of osteomyelitis of the jaw includes antimicrobial and detoxification therapy, removal of an infected tooth, drainage of a subperiosteal abscess, and sequestrectomy.

General information

Osteomyelitis of the jaw is a purulent-inflammatory disease of the maxillofacial region, characterized by infection and destructive changes in the bone tissue of the jaws. Osteomyelitis of the jaws occupies one of the leading places in the structure of surgical dentistry among odontogenic inflammatory lesions, along with acute and chronic periodontitis, periostitis of the jaw. Among osteomyelitis of various localization, osteomyelitis of the jaws accounts for about 30% of cases. Odontogenic osteomyelitis of the jaw is more often diagnosed at the age of 20-40 years, mainly in men. Osteomyelitis of the lower jaw develops 2 times more often than the upper.

Classification

Taking into account the source and mechanism of infection, osteomyelitis of the jaws is divided into odontogenic (associated with dental pathology), hematogenous (associated with the introduction of infection from distant foci with blood flow) and traumatic (associated with direct damage to the jaws).

According to the nature of the clinical course, jaw inflammation can be acute, subacute or chronic. In accordance with the predominance of the processes of building or death of bone substance, 3 clinical and radiological forms of chronic odontogenic osteomyelitis of the jaws are distinguished: productive (without the formation of sequesters), destructive (with the formation of sequesters) and destructive-productive.

Depending on the prevalence of the purulent-necrotic process, osteomyelitis of the jaw is limited (localized within the alveolar process or the body of the jaw in the region of 2-4 teeth) and diffuse (diffuse damage to a significant part or the entire jaw).

Causes of osteomyelitis of the jaw

Odontogenic (stomatogenic) osteomyelitis is the most common type of pathology, occurring in 75-80% of cases. As a rule, the development of odontogenic osteomyelitis of the jaw is etiologically associated with advanced caries, pulpitis, periodontitis, pericoronitis, alveolitis, dental granuloma or tooth cyst. In this case, the penetration of infection into the jawbone occurs through the infected pulp and root of the tooth.

The primary source of infection in hematogenous osteomyelitis of the jaw can be boils and carbuncles of the maxillofacial region, purulent otitis media, tonsillitis, omphalitis and umbilical sepsis of newborns, infectious foci in diphtheria, scarlet fever, etc. With hematogenous spread of infection, the jaw bone is first affected, and dental tissues are involved in the purulent-inflammatory process for the second time.

Traumatic osteomyelitis may be the result of a jaw fracture, gunshot wound, damage to the nasal mucosa. In these cases, the infection enters the bone tissue from the external environment. The share of traumatic osteomyelitis of the jaw accounts for 11% of cases, hematogenous - 9%.

The pathogenic microflora that causes osteomyelitis of the jaws can be detected in the form of monocultures or microbial associations and is mainly represented by Staphylococcus aureus, group B streptococcus, Escherichia coli, Klebsiella, Proteus, Fusobacteria, Pseudomonas aeruginosa and other pathogens.

Certain value for the development of osteomyelitis of the jaw is the state of general and local immunity. Osteomyelitis of the jaw is often accompanied by blood diseases, diabetes mellitus, polyarthritis, rheumatism, liver and kidney diseases.

Symptoms of osteomyelitis of the jaw

With odontogenic osteomyelitis of the jaw, the patient is worried about pain in the area of the causative tooth, which is the source of infection. The pain from the local soon becomes diffuse, radiating to the ear, eye socket, temple. The infected tooth, as well as adjacent intact teeth, become mobile; gingival mucosa is edematous. Purulent contents are often separated from the gum pockets; a fetid putrid odor emanates from the patient's mouth. With the spread of infiltration to soft tissues, there is a restriction of mouth opening, pain when swallowing, difficulty breathing. Osteomyelitis of the lower jaw occurs with a violation of the sensitivity of the lower lip (numbness, tingling, crawling), mucous membrane of the vestibule of the mouth and skin of the chin.

In acute osteomyelitis of the jaw, there is a pronounced inflammatory infiltration, edema and hyperemia of the soft tissues, regional lymphadenitis, due to which the contour of the face becomes asymmetric. For acute osteomyelitis of the jaws, the formation of subperiosteal abscesses, perimaxillary phlegmons, and adenophlegmons is typical. Diffuse osteomyelitis of the upper jaw can be complicated by odontogenic sinusitis, phlegmon of the orbit, thrombophlebitis of the branches of the facial vein.

In the subacute course of osteomyelitis of the jaw, the general condition improves, inflammatory infiltration and suppuration decrease, but pathological tooth mobility persists and even increases. Chronic osteomyelitis of the jaw is characterized by a protracted course and can develop as an outcome of acute osteomyelitis or as a primary chronic process.

The destructive form proceeds with symptoms of intoxication and lymphadenitis, against which fistulas with purulent exudate and protruding granulations are formed, as well as large sequesters. Chronic destructive osteomyelitis often leads to a pathological fracture of the jaw. In the destructive-productive form of chronic osteomyelitis, multiple small sequesters are formed. In the productive form, due to the predominance of the processes of active construction of bone substance in the periosteum, fistulas and sequesters are absent; there is a deformation of the jaw, ankylosis of the TMJ, trismus, soft tissue infiltrates.

Diagnostics

In the acute phase, due to the absence or lack of radiological signs of osteomyelitis of the jaws, the disease is diagnosed by a dental surgeon or traumatologist based on clinical and laboratory data. Hemogram deviations in osteomyelitis of the jaw are represented by neutrophilic leukocytosis, lympho- and eosinopenia, and an increase in ESR. In a biochemical blood test, C-reactive protein is found in large quantities, hyperglobulinemia and hypoalbuminemia are noted; in the general analysis of urine, erythrocytes, cylinders, traces of protein are detected. To identify the pathogen, a bacteriological culture of the inflammation separated from the focus is shown.

In the subacute and chronic phases, the dynamics of bone changes is increasing, which is detected during X-ray or tomography of the jaws: areas of osteoporosis and osteosclerosis, a coarse-fibered bone pattern, and foci of sequestration are found. When probing fistulas, uneven contours of bone sequesters are found. Acute osteomyelitis of the jaw requires differential diagnosis with purulent periostitis, acute periodontitis, festering jaw cysts, specific lesions of the jaws (tuberculosis, actinomycosis, syphilis), tumors of the jaws.

Treatment of osteomyelitis of the jaw

The approach to the treatment of osteomyelitis consists of a complex of local and general measures. The primary task in osteomyelitis of the jaw is the elimination of the primary purulent focus: in the odontogenic form -

The topic of today's article is such a serious disease as osteomyelitis of the jaw. From the material presented by us, you will learn about what it is, what are the causes of its appearance, as well as about methods of diagnosis and treatment.

What is osteomyelitis of the jaws?

The term "osteomyelitis" refers to a purulent-inflammatory process that affects bone tissue. In this case, we are talking about the jawbone. The main danger of the disease is that it tends to spread throughout the body. The infection is transmitted through the circulatory and lymphatic systems.

Most often, osteomyelitis of the jaw is diagnosed in men aged 20 to 40 years. The vast majority of cases are associated with damage to the lower jaw.

For the first time, descriptions of the symptoms of osteomyelitis are found in the writings of ancient scientists and doctors, such as Hippocrates, Avicenna (Ibn Sina), Paracelsus. But due to poorly developed diagnostics and therapeutic dentistry, it was only by the 19th century that it was possible to determine the main causes of the onset of the disease and methods of its treatment.

Video - Osteomyelitis of the jaw

How is osteomyelitis of the jaw classified?

In modern dentistry, there is a clear classification, on the basis of which osteomyelitis of the jaw is divided into three types.

Odontogenic osteomyelitis. In this case, the disease is associated with dental pathologies. For example, not treated.
Traumatic osteomyelitis. These are lesions of the jaw bone resulting from damage.
Hematogenous pathway. In this case, the infection enters from other parts of the body along with the blood.

Osteomyelitis is also divided into acute, subacute and chronic, and three clinical and radiological forms are defined:

productive (sequesters are not formed);
destructive (the picture shows sequesters in the bone tissue);
destructive and productive.

According to the level of development of purulent-necrotic processes, the disease can be limited and diffuse. In the first case, the affected area is limited to the alveolar process or a fragment of the jaw tissue, on which 2-4 teeth are located. In the second, the situation is much more complicated. Inflammatory and purulent-necrotic processes cover almost the entire jaw.

Causes of infection

For example, osteomyelitis of the jaw in infants can even be associated with umbilical sepsis. Reasons include:

otitis;
tonsillitis;
scarlet fever, diphtheria, other infectious diseases;
carbuncles and boils on the face.

The main causative agent of infection is Staphylococcus aureus. The list also includes E. coli, Klebsiella, a number of gram-negative bacteria, and other microorganisms.

Symptoms of the disease

The main task of the doctor is to correctly identify the disease. The fact is that the symptoms that appear during the course of the disease can resemble a dozen other diseases. Among the main manifestations:

headache;
weakness;
fever, chills;
sleep disorders;
inflammation of the submandibular lymph nodes;
tooth mobility;

As you can see, the symptoms can hardly be called specific. For this reason, it is necessary to conduct a comprehensive diagnosis for clarification.

In most cases, acute odontogenic osteomyelitis occurs. It appears unexpectedly. First, the body temperature rises, chills and general weakness appear. The patient complains of sleep disturbances, his appetite disappears. After some time, the tooth starts to hurt. The pain spreads, radiates to the temple, eye, neighboring areas of the jaw. The gums in the affected area swell, the teeth become mobile. Quite often, the discharge of pus from the gum pockets begins. All this is accompanied by a real stench.

With the defeat of the lower jaw, there may be problems with its opening, swallowing and even breathing. Numbness, goosebumps, and other specific symptoms may occur in the chin and lower lip area.

At the same time, damage to the submandibular lymph nodes, edema may occur. All this in many ways resembles a flux.

The spread of infection to surrounding tissues often leads to complications such as sinusitis, orbital phlegmon, and even thrombophlebitis of the facial vein. That is why it is so important to start treatment on time.

Diagnostic methods

Most often in dental practice, X-rays are used. In the picture, the doctor usually sees various changes in bone tissue. However, an integrated approach is usually used to get the full picture. It includes a number of analyzes, including biochemical. With the hematogenous type, it is the blood test that gives the most accurate result.

What indicators should you pay attention to first of all:

ESR increased;
C-reactive protein is above normal;
urine analysis shows the presence of traces of protein, erythrocytes, cylinders;
neutrophilic leukocytosis;
lymphopenia;
eosinopenia.

Biochemical blood test - the norm

X-rays may show:

sequesters;
areas of osteoporosis;
bone with coarse fibrous structure;
osteosclerosis.

Differential diagnosis is extremely important. A number of similar symptoms can be observed in acute periodontitis, infectious lesions of the jawbone caused by tuberculosis, syphilis, and other diseases.

How is osteomyelitis of the jaw treated?

How is osteomyelitis of the jaw treated? There are a lot of articles on this topic on the web. Half of them have a clear anti-scientific nature, the other advertises miracle drugs. Considering that this is a serious infectious disease, accompanied by the formation of suppuration and fraught with complications such as, it makes no sense to use folk remedies.

Primary care measures depend on the form of the disease. If we are talking about odontogenic osteomyelitis, then the doctor removes the tooth, under which there is a focus of infection. With a traumatic form - the primary treatment of the wound, and with a hematogenous - sanitation.

So, in order. First, a periostomy is performed. Then the focus is cleared of pus. The bone cavity is treated with powerful antiseptic solutions. After this procedure, drainage is installed. To protect their neighboring teeth.

Some patients start taking antibiotics without a doctor's prescription. Under no circumstances should this be done. Each type of infection is caused by certain microorganisms. Therefore, drugs are selected individually.

Then complex treatment begins. It includes measures to detoxify the patient's body, stimulate the immune system. Penicillin preparations, cephalosporins, macrolides are also used. Autohemotherapy, lymphosorption, plasmapheresis and UV blood are effective. Physiotherapeutic procedures, including magnetotherapy, UHF, ultrasound, etc., can be recommended in the complex of therapeutic measures.

If we are talking about a chronic form with the formation of sequesters, then an operation is performed to remove sequesters, granulations from the affected area.

Osteomyelitis of the jaw - treatment

After this procedure, the bone cavity is washed. It must be filled with special materials, which include antibiotics. These materials contribute to tissue repair. If there is a possibility of a jaw fracture, it is splinted.

It is extremely important to start treatment in a timely manner. Complications of osteomyelitis of the jaw are a real threat and are fraught with diseases such as meningitis, brain abscess, lung abscess, sepsis. With a productive form, there is a risk of amyloidosis of the kidneys and heart.

Complications in chronic osteomyelitis

Photo	Complications	Description
	Fractures of the jaw bones	The clinical picture is characterized by pain, displacement of fragments, their mobility; often there is a visible deformation of the maxillofacial region
	jaw bone defect	The appearance of the patient varies depending on the location of the lesion. In this case, there is a violation of chewing, articulation
	Bone deformity	A symptom complex characterized by the absence or loss of bone tissue, which leads to a violation of the anatomical integrity of the structures of the facial skeleton, aesthetic and functional disorders
	ankylosis	Inactivity of the joint leads to the formation of bone, cartilage or fibrous fusion of the articular limbs of the articulating bones
	Malignization of fistula walls	If the inflammatory process is not eliminated and an infected cavity remains in the depths of the tissues, sometimes with a sequester, then this channel does not grow together, but a purulent fistula is formed. from the roots of the tooth through the jaw bone and gums sometimes occur in chronic periodontitis

Preventive measures

Since the vast majority of cases are associated with advanced dental diseases, such as caries, periodontitis, etc., it is important to carry out sanitation in a timely manner. It is also necessary to prevent maxillofacial injuries.

The cost of treatment for osteomyelitis

We have collected pricing information for some of the procedures required during treatment. Of course, this is not all that is needed; various preparations and consumables are not taken into account. Prices are given for clinics in Moscow, therefore they are approximate. In Kyiv, Minsk, and other cities of the post-Soviet space, they may differ significantly from those presented.

The use of osteoplastic materials to fill the cavity in the jawbone together with the procedure will cost the patient 4.7 thousand rubles. At the time of writing, it was 75 US dollars, or about 2,000 Ukrainian hryvnias.
A little less (4.5 thousand rubles) will cost splinting of one tooth.
An analysis for C-reactive protein costs an average of 350 rubles.
Biochemical blood test - 1,500 rubles (620 hryvnia / 24 dollars).
Membrane plasmapheresis - 8.3 thousand rubles (133 dollars / 3400 hryvnias).
Hemosorption - 10-11 thousand rubles (4100-4550 hryvnia / 426 dollars).
Consultations of a traumatologist, physiotherapist and other specialists cost from 1,500 to 2,000 rubles.

As you can see, the complex treatment of this disease leads to significant costs. That is why it is so important to eliminate the root causes in a timely manner.

Video - Osteomyelitis of the jaw

Osteomyelitis of the jaw - what is it? What causes the disease, what are the symptoms and what methods are used to treat it?

Osteomyelitis of the jaw is a dangerous disease accompanied by an inflammatory process with the addition of an infection that affects not only the jaw, but the entire skeletal system. It is more common in people aged 20 to 40, usually males. As a rule, the lower jaw is affected.

The classification of the pathological condition takes into account several criteria:

the etiology of the inflammation process;
the severity of the disease;
focus localization;
pathway for the pathogen.

According to the type of pathogen, osteomyelitis of the jaw is divided into:

Nonspecific (pathogens - opportunistic microorganisms living under normal conditions on the mucous membranes, skin. These include staphylococcal and streptococcal flora);
Specific (caused by specific bacteria, this includes the following types: syphilitic, actinomycotic or tuberculosis).

According to the way the infection enters the body, the following types of pathology can be distinguished:

traumatic osteomyelitis - develops with injuries or fractures of the jaw. Pathogenic bacteria and various viruses penetrate into the damaged area. This pathology is quite rare, usually there is a complication in fractures of the facial bone;
odontogenic - the most common, the cause is complications of dental diseases (deep caries, alveolitis or stomatitis. The affected tissues become open gates for infection, then it enters the pulp, reaches the root and passes to the jaw tissue. This type of osteomyelitis can also occur in adults, and in children;
hematogenous - (divided, in turn, into toxic, septicopyemic, local). It occurs due to infection of the blood, carrying the virus throughout the body. It develops most often due to chronic osteomyelitis;
radiation - occurs when the jaw bone tissue is damaged by a malignant tumor. It can also be caused by a course of radiation or chemical therapy. Infection, once in the focus, provokes the development of purulent and necrotic processes;
due to tooth extraction - with incomplete removal of the dental nerve, irritation and further suppuration of the cavity occur, leading to serious consequences.

According to the nature of the course, osteomyelitis is classified:

in the acute stage.
Subacute.
Chronic (it can be primary or secondary).

According to the location of the focus, osteomyelitis of the upper jaw and lower jaw are distinguished.

Video: what is osteomyelitis?

Causes

Why does osteomyelitis of the jaw occur? There are not too many chances for infection to enter the body with the creation of favorable conditions for the progression of the disease. Here are the main ones:

diseases of an infectious and viral nature with a protracted chronic course;
not fully cured periodontitis with various complications;
infections with an acute course and the addition of an inflammatory process;
various injuries (fractures, wounds);
after tooth extraction;
introduction through the blood plasma (possibly with transfusions or injections).

Symptoms

The signs of the disease are determined by its form.

Acute osteomyelitis of the jaw

Usually characterized by a sudden onset with a sharp rise in temperature. There is a headache, a feeling of weakness and weakness, sleep is disturbed, appetite disappears. The lymph nodes are enlarged.

✦ Acute odontogenic osteomyelitis is characterized by the occurrence of pain near the affected tooth. Gradually, it spreads, gives to the temple, ear or eye socket. A sick tooth and neighboring ones gain mobility, swelling of the oral mucosa is detected. Facial asymmetry is also possible.

✦ Such symptoms are typical for the most common types of acute osteomyelitis - local and septicopyemic.

✦ It is also possible to develop a more dangerous and rare form - toxic, in which there is a temperature of up to 40 degrees and impaired consciousness.

Pain in osteomyelitis affecting the lower jaw is concentrated in the region of the lower teeth. Lymph nodes in the neck increase, the lower part of the face may become numb.

During the acute stage, a diagnosis and treatment are urgently required, otherwise complications are possible. In particular, the liver and spleen may be affected.

Subacute osteomyelitis

The condition of a person during this period improves, pain sensations decrease. Fistulas are formed, through them there is an outflow of purulent contents. May increase tooth mobility. It may seem to the patient that the disease is receding, but in fact, inflammatory processes are only gaining momentum.

Chronic osteomyelitis

This form can develop as a primary process or as a result of acute osteomyelitis. This type of disease is difficult to treat and threatens with various complications, although for some time it may seem to the patient that he has completely recovered.

Chronic osteomyelitis of the jaw is atypical or primary (this form develops without a pronounced acute period) and secondary (is a consequence of the acute form).

✦ The causes of secondary infection are:

late admission to the hospital or self-medication;
weakened immunity due to injuries, stress, infections;
erroneous diagnosis and incorrectly chosen treatment tactics.

✦ Primary chronic osteomyelitis

The medical history is characterized by the presence of an atypical pattern of manifestations. It is represented by several rather rare atypical forms, which are more often observed in children and rarely affect the jaw bones.

multifocal recurrent - more common in young children, and the pathogenesis and etiology of the disease have not been elucidated. In the bone tissue, many destructive foci are formed without sequestration and suppuration. There are signs of inflammation, but the bacterial infection does not join. The disease is protracted, periods of remission alternate with exacerbations;
Garre osteomyelitis (sclerosing) - an inflammatory sluggish process in the bone tissue is observed. The symptoms are mild, signs of inflammation and purulent infection are present, but the formation of cavities, as well as sequesters, does not occur. There is also a thickening of the bone tissue, an X-ray examination shows osteosclerosis;
Brody's abscess - a limited cavity is formed in the bone tissue containing liquid pus and granulations. The disease can last for years, and since there are no special complaints, it is difficult to diagnose. Usually conservative treatment is prescribed;
Ollier's albuminous osteomyelitis is a rare form of the disease caused by staphylococcus aureus. Small cavities appear in the tissue, but without suppuration, with serous fluid, in which there is a high concentration of protein. Little pronounced clinical signs;
desmorphine osteomyelitis - occurs only in injection drug addicts. There is a slowly developing purulent destruction of the jaw bone caused by drug exposure and deterioration of the blood supply to the tissues. Often, destruction extends to large areas of the jaw, causing facial deformity and disfigurement.

Osteomyelitis is a serious pathology of the jaw (more often the lower one). This is an infectious inflammatory process that covers all the structural parts of the jaw bones and leads to their complete destruction. Accompanied by pronounced symptoms of different levels of distribution. It is diagnosed with the help of laboratory tests (blood and urine), radiography and computed tomography. Does not respond to exposure to herbal and other home remedies. Can cause irreversible consequences, and death is not ruled out.

The concept of osteomyelitis of the jaw

Osteomyelitis is an infection localized in the bone and soft tissues located around. Such an ailment destroys all the bones and joints in the human body without any problems, but most often people have a pathology of the jaw region. This purulent process is fraught with the development of serious irreversible consequences and complications in the form of bone and brain destruction (necrotic process), therefore, diagnosis at the initial stages and professional treatment, started as early as possible, are fundamental in the matter of resisting the disease.

Causes and symptoms of various types of osteomyelitis

Osteomyelitis of the jaw is divided into several varieties according to certain characteristics:

according to the source of infection: traumatic, odontogenic, hematogenous;
classification according to the form of pathology development: acute, subacute, chronic (and its exacerbation);
by localization: upper or lower.

There is also osteomyelitis of the hole after tooth extraction. In rare cases, a radial type can be observed. The tactics of treatment is directly dependent on what type of pathological process is diagnosed in the patient. Let us consider in more detail each of the types of pathology.

Traumatic

As a rule, this type of osteomyelitis of the jaw is accompanied by an open fracture and damage to the joints. The reason for the development of the disease is infection of the wound area at the time of injury (bone fracture, injury). The risk increases in the case of extensive tissue damage, comminuted fractures, and a decrease in human immunity. Main symptoms:

feverish chills;
toxic poisoning of organs and systems, expressed in migraine and weakness of the whole body, the desire to lie down all the time;
increase in blood ESR;
anemia and leukocytosis;
unpleasant and painful manifestations in the region of the fracture or wound;
liquid purulent discharge from the site of injury.

You can visually get acquainted with the external signs of traumatic osteomyelitis and false joint in the photo. The occurrence of osteomyelitis in a traumatic form can be associated not only with mechanical damage to bones and joints in the form of blows, but also with gunshot wounds.

Odontogenic

The most well-known type of osteomyelitis is odontogenic. The main cause of odontogenic osteomyelitis of the jaw is the complication of dental diseases due to their neglect (for example, in the case of pulpitis). Odontogenic osteomyelitis appears due to infection of the pulp, root and periradicular tissue. Rarely observed in the area of the upper jaw. Symptoms:

an unexpected increase in body temperature by several degrees (up to 40);
inflammation and swelling in the face;
swelling of the edge of the orbit, as a result of which the movement of the eyelids is difficult or impossible;
swelling of the lymph nodes;
the nasal passages are filled with liquid contents mixed with pus;
the skin over the edema turns red, begins to shine;
severe tissue tenderness on palpation.

Most often, the appearance of odontogenic osteomyelitis of the jaw occurs when an untimely visit to a dentist to eliminate carious formations occurs. It is important to remember that you need to visit a dental clinic if you have even the mildest form of caries - in the stain stage.

Hematogenous

Hematogenous osteomyelitis develops when harmful microscopic organisms penetrate into the tissues of the jaw from another focal area of a purulent disease (tonsillitis, furunculosis). It is not uncommon for it to occur on the basis of some kind of chronic inflammation. The bone begins to break down first, and then the tooth itself. Symptoms:

lethargy and unwillingness to eat;
high body temperature;
pale skin from head to toe;
swelling of the oral mucosa;
early occurrence of fistulas and sequesters.

Chronic

In the absence of therapeutic intervention in osteomyelitis of the jaw, within a reasonable time, it can degenerate into a chronic stage. This is the most serious and intractable form, which is accompanied by the following symptoms:

false reduction of pain;
reduced throughput of soft tissues;
the appearance of purulent fistulas on damaged areas of the skin and mucous membranes;
exit of granulations from fistulous openings;
tooth mobility;
compaction in the area of the pathological focus;
separation of sequesters from intact bone tissue.

Acute osteomyelitis is one of the probable responses of the protection of internal organs and systems to the infectious process. Symptoms of the disease in this phase:

feeling unwell in general (unwillingness to do anything, weakness of muscles and joints);
severe migraine;
restless sleep;
increase in body temperature;
inability to eat due to pain;
the mucous membrane of the oral cavity acquires a red tint;
an increase in the size of the lymph nodes;
facial asymmetry;
loosening of teeth;
severe toothache that radiates to the neck, ear, or temple;
purulent contents in the gum pockets with an unpleasant odor;
the disappearance or deterioration of the sensitivity of the lips and chin muscles.

subacute

Subacute osteomyelitis of the jaw is observed in the absence of acute treatment in due time. Symptoms:

areas of skin necrosis develop on hard bone tissues;
the occurrence of fistulas (dental fistula: what is it and how is it treated?);
outflow of purulent fluid;
dulling of symptoms of acute osteomyelitis of the jaw (false lowering of temperature, disappearance of pain);
increase in tooth mobility.

Osteomyelitis in children

In infancy, osteomyelitis is observed quite often. This is due to differences in the structure of hard and soft tissues and the level of immunity of a child and an adult.

The acute form of odontogenic osteomyelitis is observed in children most often. It is characterized by an acute clinical picture with symptoms of a general disorder of the body's vital functions, the appearance of purulent inflammation of bone and soft tissues. Causes of the process in children:

Acute and chronic odontogenic type of osteomyelitis develops when pathogenic organisms are introduced from the outside into the jaws of a child. For example, from the teeth destroyed by caries. Most often, children 7-12 years old suffer, but there are exceptions.
An acute hematogenous process appears as a result of the spread of infection from other pathological foci. Sources: purulent mastitis in a woman in labor, inflammation of the umbilical ring, tonsillitis, purulent otitis media, skin infections. Osteomyelitis of the lower jaw under the influence of these factors develops less frequently.
Acute traumatic osteomyelitis is not observed as often as other types. Occurs due to injury and infection of the lesion.

Symptoms of the disease of the upper and lower jaw in a child:

excessive lethargy;
refusal of food;
insomnia and fever;
tooth and jaw pain;
swelling of the mucous membrane;
spasm of chewing muscles;
edema and violations of the symmetry of the face.

Often odontogenic (acute and subacute), traumatic and hematogenous osteomyelitis in a child leads to the destruction of the rudiments of molars or to problems in their development. It is not excluded the appearance of a false joint of the lower jaw as a result of improper fusion.

To prevent the development of a chronic form of the disease and the occurrence of negative consequences, it is important to consult a dentist when the first symptoms of acute osteomyelitis of the jaw appear.

Diagnostic methods

A dentist-therapist or a dentist-surgeon is able to diagnose pathology at the earliest stages (what does a dentist-therapist do?). To do this, doctors use the clinical picture and test results. In subacute and chronic forms, radiography and computed tomography are indicated. Research will allow to detect pathological transformations in the bone tissue (areas of osteoporosis, the appearance of a false joint of the lower jaw, other specific lesions).

Laboratory research

In the acute form of the pathology, laboratory tests of blood and urine are carried out. Deviations of the hemogram are expressed in neutrophilic leukocytosis, lympho- and eosinopenia, an increase in the ESR. A biochemical blood test shows the presence of C-reactive protein in significant amounts, signs of hyperglobulinemia and hypoalbuminemia are observed. In the urine, erythrocytes, protein, cylinders are found. It is recommended to carry out bacteriological culture from the lesion to identify the causative agent of the disease.

Radiography and computed tomography

Based on the words of the patient and the data obtained from the studies, the doctor prescribes an x-ray. Early radiological properties of pathology:

the presence of areas of rarefaction and compaction;
insufficient clarity of the bone pattern;
thickening of the periosteum.

Late signs:

formation of foci of decomposition with sequesters;
thickening and compaction of bone tissue in the area of impact.

In cases where x-ray examination is not enough, the doctor prescribes computed tomography. This procedure allows you to best designate the extent of bone tissue damage and see purulent inflammation.

When osteomyelitis of the jaw is detected, dentists practice restorative, stimulating and symptomatic therapy. The sooner the affected tooth is removed and the infection is eliminated, the more likely it is that it will not spread further and cause irreversible consequences. Proper care of the hole after tooth extraction is organized. Movable teeth are fixed with splints or braces. A special washing of the oral cavity with antiseptics is carried out.

General events

Treatment of acute odontogenic and other types of osteomyelitis in any form means tooth extraction. Extraction is mandatory, because the infection can pass to healthy tissues, and it will be extremely difficult to stop the pathological process.

Patients are shown early periostomy. This is a procedure that consists in incising the periosteum and cleaning out fluid and pus from the lesion. With an odontogenic infection, it is necessary to take antibiotics, perform antiseptic washings, and in severe cases, surgical removal of sequesters is recommended.

Chronic osteomyelitis of the jaw and other forms of the disease are treated according to the general plan:

extraction of a diseased tooth;
removal of pus from the hole or wound;
elimination of keratinized tissue areas;
prescribing antibiotics;
detoxification;
local therapy.

Features of the treatment of the disease depending on its type

The disease occurs and spreads very quickly, so it is important to diagnose the causes of its development as soon as possible and prescribe competent treatment. With the odontogenic form of osteomyelitis, tooth extraction and the appointment of drugs to improve the functioning of organs and systems are indicated.

If traumatic or hematogenous osteomyelitis is observed, it is important to first eliminate the factors of the disease (treat injuries, defeat infections). In some cases, surgical intervention is indicated (drainage of the focus of infection of the bone or false joint of the lower jaw). If abscesses and phlegmon are found, the surgeon performs dialysis by incising the soft tissues.

Treatment of acute odontogenic osteomyelitis is accompanied by the use of antibacterial drugs. Antibiotics are prescribed along with the operation, which is possible only in stationary conditions.

Folk remedies

It is impossible to cure odontogenic, chronic and other types of osteomyelitis at home. You can use folk remedies at the stage of recovery after treatment for odontogenic and other forms of osteomyelitis as an adjuvant therapy.

Mumiyo promotes rapid healing of wounds. A solution of 2 g of the substance and a glass of water should be taken in 1 tbsp. 2 times a day - in the morning and in the evening.

The healing of fistulous passages is facilitated by rinsing with propolis tincture, which can be purchased at a pharmacy or prepared at home. Pour a piece of propolis with 200 ml of vodka and leave for about 2 weeks. Next, dissolve 10 drops of the resulting liquid in a glass of warm water and use for daily rinsing 2-3 times a day.

Decoctions of most medicinal herbs will also be useful. Natural antiseptics: nettle, chamomile, calendula, string and others.

Recently, ointments from comfrey have been common. Homeopathic remedies are also shown: Stillingia, Strontium carbonicum, Fluoricum acidum.

It must be remembered that only a doctor should prescribe treatment. The use of folk remedies is unacceptable without the consent of the attending surgeon.

Possible Complications

In the absence and insufficiently high level of therapeutic intervention, osteomyelitis of the jaw causes complications:

pathological fracture;
phlegmon - purulent inflammation of soft tissues, spilled over a significant surface;
abscess - accumulation of purulent secretions in tissue areas and internal organs as a result of inflammation;
sepsis - blood poisoning (in most cases occurs due to the neglect of the odontogenic process);
contracture - a decrease in the dynamics of the lower jaw;
thrombophlebitis of the facial veins;
the appearance of a false joint of the lower jaw;
sinusitis;
the transition of inflammation to the eye opening;
meningitis;
pneumonia;
purulent pleurisy;
death.

Preventive measures

Osteomyelitis of the jaw (with the exception of the hematogenous type) is easy to avoid if you follow these recommendations:

monitor oral hygiene: brush your teeth at least 2 times a day, morning and evening, and after each meal;
properly care for the hole after removal;
consult a doctor if you experience the slightest discomfort in your mouth;
timely treat infectious diseases of the respiratory and other body systems;
avoid injury to the jaw bones and joints.

Osteomyelitis of the jaw- This is a purulent-necrotic process of an infectious nature that develops in the bone, as well as in the tissues surrounding it. The inflammatory process begins to actively develop after an infection enters the bone tissue.

Classification

There are several types of osteomyelitis of the jaw, taking into account the source of infection. Odontogenic osteomyelitis jaw is a serious complication of advanced dental caries. According to statistics, this type of osteomyelitis is diagnosed in approximately 75% of cases. The disease develops after the infection from the carious cavity penetrates into the pulp, and then into the root of the tooth. Further, it also captures bone tissue. In about 70% of cases, osteomyelitis affects the lower jaw, in other cases the upper jaw is affected. The main cause of the development of this disease is the impact of microorganisms of three groups: staphylococci, streptococci, anaerobic bacteria. Pathogenic microbes enter the bone tissue through the lymphatic vessels and through the bone tubules.

Hematogenous osteomyelitisT- a consequence of infection of the bone tissue with an infection carried by the blood flow from the primary focus, in which the inflammatory process has developed. This form of the disease may develop due to chronic tonsillitis, as well as other foci of chronic infection. Acute infectious process, for example, diphtheria, scarlet fever and other diseases can also cause osteomyelitis of the jaw. With hematogenous osteomyelitis, a part of the body of the bone is initially affected, and only after that the inflammation can also affect the teeth. This form of the disease is less common.

Traumatic osteomyelitis manifests itself in the patient due to fractures or wounds through which the infection enters. The prevalence of this form of the disease is low.

Osteomyelitis of the jaw is also divided into several types depending on the characteristics of the clinical picture. This acute, subacute And chronic forms of osteomyelitis of the jaw. In this case, the severity of inflammatory processes is assessed.

Symptoms

With the development of acute osteomyelitis of the jaw in a patient, a general pronounced reaction of the body to infection is observed. A person is worried about general weakness, headache, he does not sleep well. Body temperature rises to 38 degrees, in some cases it can rise even higher. If the body temperature indicators for osteomyelitis of the jaw remain normal, then this may indicate that the person has a weakened body, and the protective forces are not working enough. In the acute form of the disease, the patient can be both in a relatively mild and in a serious condition.

The first symptom acute form of odontogenic osteomyelitis are manifestations of pain in the area of a tooth that has been infected. The pain is greatly aggravated by tapping on the tooth. At the same time, its easy mobility is manifested. Adjacent teeth can also move. Visible swelling of the mucous membrane next to the tooth, in addition, it becomes reddish and loose. Sometimes develops subperiosteal abscess. The pain gradually from one affected tooth passes into the neighboring ones, there are signs of the inflammatory process of periodontal teeth. Pain in this case can be given to the ear, temple, eye socket. With osteomyelitis of the lower jaw, the sensitivity of a part of the lower lip, the mucous membrane of the oral cavity, and the skin of the chin may be disturbed. If the patient develops a purulent inflammatory process in the perimaxillary soft tissues, then the pain goes beyond the jaw.

The lymph nodes enlarged in the neck, palpation manifests their soreness. Signs of intoxication of the body are also manifested in the appearance of a person: the skin acquires a gray tint, facial features are sharpened. If the liver and spleen are involved in the process of intoxication, yellowness of the sclera of the eyes may be noted. Kidney damage leads to the appearance of protein in the urine and erythrocytes. There may be fluctuations in blood pressure - both rise and fall. At first, it is difficult to diagnose osteomyelitis of the jaw due to the fact that general symptoms prevail over local signs.

Subacute osteomyelitis, as a rule, develops after subsiding of an acute form. In this state, a person feels that his condition is improving, as there is a breakthrough of pus from the bone tissue. In this case, the inflammatory process continues, and the destruction of bone tissue does not stop.

Chronic osteomyelitis can take place over a long period of time - over several months. Against the background of an external improvement in the patient's condition, osteomyelitis worsens, a new fistula forms, dead areas of bone tissue are torn off, and sequesters appear. The jaw in the place of the pathological focus is flattened, the teeth remain mobile. With such a development of the disease, an independent cure does not always occur.

Complications

Osteomyelitis of the jaw can cause complications that cause great harm to human health. With advanced disease, it is possible to develop sepsis, inflammation of the soft tissues of the face and neck ( phlegmon). Also, a consequence of osteomyelitis can be a deformation or fracture of the jaw. If the purulent process spreads to the face, this can lead to the development of the sinuses of the hard shell of the brain, phlebitis of the veins of the face. With ascending spread, it can develop meningitis, brain abscess. Sometimes complications lead to the disability of the patient, and in especially severe cases - to death.

Diagnostics

In the process of diagnosing osteomyelitis of the jaws, the doctor initially studies the clinical picture of the disease by examining and questioning the patient. Next, an X-ray examination is carried out. But in the osteomyelitic process, spongy bone is mainly affected, so the information obtained during an X-ray examination is not always complete. If the pathological process develops quickly, then the cortical layer of the bone is destroyed, which can be determined by x-rays. The identification of sequesters is of great diagnostic importance.

Treatment

Treatment of osteomyelitis of the jaw is carried out immediately after the diagnosis and determination of the form of the disease. If the patient has obvious symptoms of osteomyelitis of the jaw, measures must be taken immediately to prevent the spread of inflammation to areas near the site of the lesion. Regardless of whether there is a lesion of the lower or upper jaw, with the odontogenic form of the disease, the tooth in which the inflammatory process has begun is necessarily removed. With a hematogenous or traumatic form of osteomyelitis, it is initially required to eliminate the underlying cause of the disease. Consequently, infectious diseases and injuries are treated.

Thus, if a patient is diagnosed with acute odontogenic osteomyelitis, then the inflammatory purulent focus in the bone and in the surrounding tissues is initially eliminated. Medications are also prescribed to improve the condition of the human body as a whole.

Surgical intervention is also practiced: in osteomyelitis of the upper and lower jaws, the focus of infection in the bone is drained. Initially, the tooth is removed, due to the infection of which the disease manifested itself. If the patient has perimaxillary abscesses and phlegmon, soft tissue dissection is performed, as well as subsequent dialysis of the wound. If the patient is diagnosed with acute or chronic osteomyelitis of the jaw, it is necessary to carry out anti-inflammatory treatment by prescribing antibiotics. Such therapy is carried out in parallel with surgery.

Treatment of osteomyelitis of the jaw of an acute form is carried out only in a hospital. In addition to surgical and anti-inflammatory treatment, stimulating, restorative, symptomatic therapy is practiced.

It should be noted that the earlier a tooth is removed in an acute form of the disease, the lower the risk of further spread of the inflammatory process, and the faster the inflammation will stop. In the presence of mobile teeth, a special splint or braces are used to strengthen them. If a purulent wound remains after tooth extraction, it is necessary to ensure proper care for it. For this, washing, irrigation with antiseptic solutions is used.

Complex therapy involves taking vitamin complexes, which should include B vitamins, ascorbic acid. In the process of treatment, it is important to provide the patient with a constantly plentiful drink, and protein and vitamin-containing foods should prevail in the diet. It is important to thoroughly wash the toilet after every meal.

Treatment of the chronic form of osteomyelitis of the jaw is carried out depending on the manifestation of the symptoms of the disease. If the therapy of the disease is carried out in a timely manner and correctly, then we can talk about a favorable prognosis.

Prevention

Preventive measures include general recovery, strengthening of immunity, timely treatment of dental diseases, and their prosthetics. It is important to visit the dentist at least once a year for preventive examinations. Also, do not delay the treatment of infectious diseases. In this case, special attention should be paid to the treatment of infectious diseases of the upper respiratory tract. An equally important preventive measure is to ensure daily high-quality oral hygiene, as well as protection from facial injuries.

Osteomyelitis of the jaw is a purulent inflammation of the bone tissue, which can be caused by a bad tooth, trauma, or other damaging factors. The disease is very dangerous, leads to a significant deterioration in the condition, and it is quite difficult to treat it, the consequences for the patient's health always remain severe.

What causes osteomyelitis of the jaw?

The immediate cause of the disease is the penetration of infection into the bone tissue. The source of infection is dental pathology, damage to the gums, trauma to the face, the introduction of bacteria with blood flow (hematogenous osteomyelitis). Additional factors are weakened immunity, anatomical anomalies of the jaw arch, non-compliance with the necessary rules of oral hygiene.

Osteomyelitis of the jaw in children is associated with pathological teething, the immaturity of the child's immune system, improper oral care in newborns, and hereditary predisposition.

Symptoms of osteomyelitis of the jaw

The main signs of osteomyelitis include:

pain in the jaw and teeth that radiate to the neck, ear area;
swollen lymph nodes behind the ears and on the neck;
deterioration, high temperature, especially in childhood;
bone sequestration, fistula formation;
additional signs indicating individual forms of the pathological process.

An accurate diagnosis is made by the doctor, based on the characteristics of the course of the disease in the patient.

Types of disease

Symptoms and treatment of osteomyelitis of the jaw depend on the form of the disease, so there is a classification of the lesion in question.

Traumatic osteomyelitis of the upper and lower jaw

Post-traumatic inflammation occurs when the bones of the face are injured, and may be the result of an incorrectly performed surgical intervention. The lower jaw is more commonly affected, less often the upper jaw. With a traumatic injury to the bones, the infection penetrates from the external environment, the disease develops quickly, high fever, pain, and a sharp deterioration in the patient's condition are immediately observed.

Osteomyelitis of the jaw after tooth extraction

If, after tooth extraction, an infection enters the remaining hole, then it easily penetrates into the bone and causes its purulent inflammation. In this case, the process begins acutely, the affected area is limited to a small volume, accompanied by damage to the gingival pocket. The pain is quite intense, and patients often mistake this disease for a flux.

Hematogenous osteomyelitis of the jaw

The reason is the introduction of infection from chronic foci with blood flow, while osteomyelitis acts as a complication of the underlying disease. There is an infection with inflammatory lesions of the legs, spondylitis and trophic ulcers. The patient's condition immediately becomes severe, the radiograph reveals several foci in both jaws, the zygomatic bone, and other bones of the face at once.

Radiation osteomyelitis of the jaw

Radiation damage to bones is quite rare. Exposure to radiation is involved in the pathogenesis, including the frequent use of x-ray examinations (for example, in the treatment and prosthetics of teeth). One of the reasons is a decrease in immunity due to exposure to radiation, the prognosis for this condition is the most disappointing.

Odontogenic osteomyelitis of the jaws

The most common type of osteomyelitis of the jaws is odontogenic. The etiology of the disease is associated with a long course of caries, which remains without treatment. In this case, the infection spreads deep into the causative tooth, and if the pulp is damaged, it spreads to the blood vessels and nerves of the jaw. Especially often such a danger is created by wisdom teeth.

Acute osteomyelitis of the jaws

The acute process is distinguished by early onset and rapid development of symptoms. Among the main features:

Common symptoms (first to appear):
- Heat;
- Weakness, fatigue, malaise;
- Sleep disturbance;
Local symptoms (appear in the later stages of the disease):
- Pain in the jaw area;
- Deformation of the gums;
- Shaky teeth;
- The appearance of fistulas on the mucous membrane of the gums.

Pain and bone deformity limit the mobility of the mandibular joint, speech and eating are disturbed. A clearly visible sign is an increase in lymph nodes to the left or right of the affected area, the face looks asymmetrical.

Subacute osteomyelitis of the jaws

Subacute purulent inflammation (ICD-10 code - K10.2) is characterized by a slower development of symptoms, but more difficult treatment. The most striking sign is the pathological mobility of the teeth. A person can practically not feel pain, the complex of symptoms of an acute course - purulent discharge, deformation - is uncharacteristic. X-ray helps to recognize the disease.

Chronic osteomyelitis of the jaw

Acute and subacute process can end with chronic osteomyelitis, or it can develop as an independent disease. It proceeds with remissions and exacerbations, the lower jaw is more often affected. Constantly there is a toothache, which can affect different parts of the jaw in turn.

Chronic odontogenic osteomyelitis of the jaws

This is a rather severe dental problem. The infection spreads from a tooth that has not been cured in time, and is asymptomatic for a long time. It manifests itself by gradually increasing pathological tooth mobility, periodic pains, especially in the area of the causative tooth, sometimes purulent discharge appears. If the causative tooth is removed, the disease will not stop, but will continue to affect the jaw.

Diagnosis of osteomyelitis of the jaw

Diagnosis of osteomyelitis is carried out by a dentist using several different methods, which will be listed below, if necessary, other specialists are involved. The cause of the disease, the condition of the bone, differential diagnosis with alveolitis, periodontitis, periostitis is being determined. To carry out therapeutic measures, it is necessary to identify and eliminate the cause of inflammation.

laboratory

Laboratory diagnostics includes the following tests:

Complete blood count (increased ESR, leukocytosis);
Biochemical blood test (C-reactive protein);
General analysis of urine (erythrocytes).

All these signs indicate the presence of an inflammatory process, but do not depend on its localization.

Microbiological

This analysis is included in the mandatory examination for osteomyelitis. It allows you to establish the type of pathogen, its sensitivity to antibiotics, prescribe a future treatment regimen. When specifying a diagnosis, a separate code indicating the nature of the pathogen is placed next to the disease code according to the ICD. Modern medical articles consider the microbiological method one of the most important.

X-ray

X-ray allows you to establish the location, size and shape of the lesion, determine the condition of the bone tissue next to it. In dentistry, it is used quite often for other diseases. It is carried out in adults and children of any age strictly according to indications.

MRI

Magnetic resonance imaging allows you to identify features of the anatomy of the maxillofacial apparatus, which went unnoticed by radiography. It also reveals malformations of the jaw, structural disorders. It is considered the most accurate diagnostic method. Not recommended for infants.

ultrasound

The ultrasound method is considered safer than the X-ray method. It allows you to determine the boundaries of a healthy and destroyed bone, visualize the shape and size of the lesion. Based on this method, the doctor decides on the need for surgery and its volume.

Radionuclide

Another method used is radionuclide. It also indicates the location of the lesion. It is based on the analysis of the accumulation of radioactive isotopes in those places where the bone is most actively restored. The method is not accurate enough, since the accumulation of isotopes occurs not only in the foci of osteomyelitis, but also in other areas. The method is not recommended for children.

Treatment of osteomyelitis of the jaw

Acute osteomyelitis with a serious condition of the patient requires hospitalization in a hospital. An integrated approach is important, so before starting treatment, the doctor will briefly explain to the patient what awaits him.

Medications

An important place is occupied by antibiotics - they are the basis of treatment. Broad-spectrum drugs are used, especially for hematogenous osteomyelitis - protected beta-lactams, cephalosporins, tetracyclines, lincosamides. After determining the sensitivity of pathogens, drugs are prescribed that will be most effective. In severe clinical manifestations, antibiotics may be prescribed until results are obtained.

Hormonal and non-hormonal anti-inflammatory drugs are prescribed without fail to prevent complications. According to patients, these funds give a significant improvement in the condition. Also used are antihistamines, detoxifying drugs in solutions for intravenous administration.

Surgical intervention

Surgery remains the main treatment for osteomyelitis. With a relatively mild course of odontogenic disease, osteoperforation and removal of the causative tooth are used. If the focus of infection is large, then this is not enough, and it is necessary to carry out a large-scale sanation operation with the removal of the affected bone fragments.

With non-odontogenic osteomyelitis of the jaw, a sanitation operation is always performed. Mobile teeth, if they are not infected, are fixed with dental splints. The removed bone fragment is replaced with during plastic surgery.

Physiotherapy

Physiotherapy is carried out in a polyclinic after surgery. Medicinal electrophoresis, UHF, heating using various techniques, ultrasound therapy, magnetotherapy are used. The general purpose of these procedures is to accelerate tissue healing, reduce the intensity of the inflammatory process.

Vitamin complex

The most important vitamins for osteomyelitis are B, C and D, as well as calcium, phosphorus and magnesium. It is easier to use ready-made vitamin complexes, which contain all of these substances. If the patient keeps a food diary (for example, with diabetes), then the list of necessary vitamins is specified based on his needs.

Folk remedies (treatment at home)

Using folk remedies for such a serious illness is risky. However, they can be an addition to the main treatment - to relieve the symptoms of the disease, improve well-being.

To relieve pain and inflammation, you can rinse your mouth with decoctions of chamomile, St. John's wort, sage and mint. Each of these herbs can be used alone, but it is best to mix them in equal proportions. Eucalyptus, orange and fir oil will also be useful - they are also added to the rinse solution.

To reduce pain at home, facial compresses containing sea buckthorn oil, Vishnevsky ointment, and honey are recommended. It is also recommended to moisten a cotton swab and put it in the area of the diseased tooth after eating and leave it for 2-3 hours.

Complications

The most dangerous complication of osteomyelitis is sepsis. It provokes incorrect and untimely treatment of the disease, weakened immunity. Less dangerous general complications are lymphadenitis and the appearance of purulent foci in other areas of the body.

Local complications include bone destruction, tooth loss, the development of chronic inflammatory processes in the oral cavity, and the formation of cysts inside the jaw. If the mandibular joint is involved in the pathological process, then its contracture may develop, which does not allow opening the mouth.

Prediction and prevention of osteomyelitis of the jaw

The prognosis depends on the course of the disease, and on how quickly treatment was started. Acute osteomyelitis with timely treatment can pass with little or no consequences. With the development of complications, the prognosis worsens, sepsis can be fatal. The risk group for the development of severe complications includes people with weakened immune systems - patients with immunodeficiency conditions, drug addicts who have had acute radiation sickness, and who take immunosuppressive drugs.

The easiest way to prevent odontogenic osteomyelitis is timely treatment of teeth and gums. If signs of pathology appear, you should consult a doctor as soon as possible so that the infection can be easily and quickly eliminated. After the extraction of teeth, it is necessary to carefully monitor oral hygiene so that the infection does not penetrate into the hole.

Answers on questions

Why do a tomography of the jaw?

This examination is necessary in order to visualize the processes occurring in the jaw, take into account the anatomical features, and determine the scope of the operation.

Which doctor should be consulted for o.ch.?

The treatment of osteomyelitis of the jaw is carried out by a dentist, in severe cases, the help of a maxillofacial surgeon is required.

How likely is sepsis?

The risk of severe complications depends on the duration of the course of the disease, the effectiveness of treatment, and the state of immunity.

Conclusion

Osteomyelitis of the jaw is one of those diseases that are much easier to prevent than to treat. A small introductory article or a video lecture on the network will not replace a timely trip to the doctor to identify diseased teeth.

There is a disease that combines inflammation, infection, tissue necrosis, and occurs in the jawbone, close to the facial muscles, mucous membranes, facial skin, major arteries, respiratory tract, and a huge number of lymph nodes. This disease is called osteomyelitis of the jaw. What is this disease and why is it so dangerous?

The disease is difficult to diagnose due to symptoms adjacent to other diseases. It can lead to serious diseases of internal organs, deformation and fracture of the jaw, blood poisoning and even death.

Osteomyelitis is a process that occurs in the bone, bone marrow, soft tissues surrounding the focus of inflammation. The word "osteomyelitis" is Greek, formed from three different words - "bone", "brain" and "inflammation", which accurately conveys the essence of the disease.

Osteomyelitis is caused by pus-producing bacteria and mycobacteria. The disease is dangerous because the infectious process can capture the entire bone, bone marrow, lead to necrosis, deformation, entail many unpleasant consequences and associated diseases, go into a chronic form.

Osteomyelitis of the jaw is also called jaw necrosis. This is an extremely dangerous disease. The fact is that, unlike osteomyelitis of other bones, which is caused by only one type of bacteria introduced into the blood only through the blood (most often streptococci and staphylococci), osteomyelitis of the jaw is distinguished by a huge number of infection options and a variety of pathogens. It can be staphylococci (golden and white), pneumococci, streptococci, Escherichia coli or typhoid.

The disease affects not only the jaw, but also the entire skeletal system. Infection in the bone immediately begins to "treat" leukocytes, and the products of their treatment begin to decompose the bone. Purulent cavities form in the bone, necrosis begins, the jawbone becomes brittle, deformed and may break.

In addition to the bone, the soft tissues surrounding it can become inflamed - gums, nearby muscles, salivary glands, facial skin. In the absence of timely treatment, the infection spreads throughout the body. With osteomyelitis of the upper jaw, inflammation can quickly move to the orbits, swelling begins. Lymph nodes quickly respond to inflammation in the body. In severe cases, ulcers develop in the soft tissues of the face.

There are many ways to cause osteomyelitis. These can be protracted or chronic infectious and viral diseases, not fully cured or passing with complications of dental disease, infections with inflammation, tooth extraction, blood transfusion, severe injuries - wounds and fractures. The resulting injuries can be not only in the jaw itself, with certain types of infection, the infection can penetrate the jaw later.

Most often, osteomyelitis of the jaw affects men, but it is most dangerous for young children, in whom the disease develops rapidly, and its diagnosis is difficult. How to diagnose osteomyelitis and start the right treatment? What types of osteomyelitis of the jaw are found?

Prevention

To prevent osteomyelitis, first of all, you should carefully monitor oral hygiene. It is important to cure diseases of the upper respiratory tract in time and not get injured.

If you do not turn to the doctors in time, the disease can become chronic and give complications with irreversible changes in the body.

Types of osteomyelitis of the jaw

There are many types of osteomyelitis of the jaw, they are determined depending on where, how, for what reason and with what consequences the infection occurred.

First of all - localization. Osteomyelitis of the jaw can develop both in the upper and lower jaw. Since the mandible is mobile, it is more susceptible to infection, so mandibular osteomyelitis is more common. Judging by the statistics, osteomyelitis of the upper jaw is more common in children and more difficult to diagnose, but with proper treatment it is easier and faster.

Osteomyelitis of the jaw is diffuse and limited. Limited - if the localization of infection is only on the bone and in the bone marrow. If the infection spreads to the surrounding soft tissues, into the blood, then this is a diffuse form of the disease.

According to the mode of infection

Infectious

The cause of infection with osteomyelitis is an infection that enters the jaw bone. At this moment, cavities are formed in the bone, usually filled with pus, which deform and destroy the bone, pass to soft tissues, sometimes into the blood. Depending on the bacteria that caused the disease, infectious osteomyelitis is divided into specific and nonspecific. If the cause of osteomyelitis of the jaw is typical bacteria (streptococci and staphylococci), then such osteomyelitis is called nonspecific. Specific osteomyelitis is an infection with syphilitic, actinomycotic or tuberculosis bacteria.

Most often, infection occurs due to complications of stomatitis, and other dental diseases. Through the affected tissues, the infection penetrates into the pulp, through the root of the tooth reaches the jaw. It can also occur if benign neoplasms are not treated.

Traumatic (non-infectious)

The cause of the disease is an injury - a fracture, wounds through which bacteria-causative agents of infection penetrate into the wound. Most often this is a trauma to the facial bone.

Traumatic osteomyelitis of the jaw is especially distinguished after tooth extraction, when the dental nerve is not completely removed and suppuration of the cavity begins. The tooth may not be completely removed according to the indications of the dentist.

This also includes the radiation type of osteomyelitis - when the jawbone is damaged by a malignant tumor. It may occur due to a course of radiation or chemotherapy. Sometimes it starts with incorrectly made prosthetics.

Infection with osteomyelitis can be affected by iatrogenic causes - this is a deterioration in a person's condition, unintentionally provoked by a physician. There are many medical surgeries that can infect the jaw - both mandatory and cosmetic. Dental prosthetics, tooth extraction, filling, jaw fracture treatment, facial plastic surgery. There is always a risk of infection, but it is important to remember that osteomyelitis can only start and spread in people with a low level of immunity. Therefore, it is extremely important to maintain immunity and take care of your body.

Hematogenous

It occurs when the infection spreads through the body through the blood, most often due to purulent diseases, such as boils and tonsillitis. An infectious disease (scarlet fever, influenza, respiratory diseases, and others) can also give complications with subsequent infection. Most often it develops in the chronic form of the disease.

Sometimes allergic osteomyelitis of the jaw is also isolated, when infection begins due to an allergy attack that triggers the process of inflammation and suppuration. But this type of osteomyelitis is also directly dependent on immunity and begins only if the body is weakened.

By the nature of the flow

acute form

The acute form of the disease begins quickly, is characterized by an instant increase in temperature to high rates up to forty degrees, all signs of inflammation, swelling of the face. The patient is shaking from chills, his face turns red, the tissues swell, the headache is given in different parts of the head, mainly in the temple, eye socket, cheek. Acute osteomyelitis is the easiest to diagnose because its symptoms are the most obvious. A similar set of symptoms is characteristic of tumors - benign and malignant, various pains in the teeth, inflammation of the gums.

Preacute

Preacute osteomyelitis is the next stage after acute, the signs of inflammation begin to disappear, but the inflammatory process continues. At this point, it is necessary to continue treatment, otherwise there is a high risk that the disease will go into a chronic stage, the most dangerous.

Chronic

Chronic osteomyelitis does not necessarily follow from acute. In the event that the disease has become chronic from untreated osteomyelitis or due to weak immunity, which does not allow the disease to be defeated immediately, this type is called secondary chronic, it is secondary after acute osteomyelitis. Such a chronicle shows mild symptoms, is characterized by outbreaks of exacerbations and periods of "calm". Fistulas appear, through which pus flows from the source of inflammation, but the source of inflammation itself begins to spread throughout the body, can go to the internal organs, blood, and destroy the necrotic jawbone.

Primary chronic osteomyelitis is difficult to diagnose, since the patient has not previously experienced attacks with an exacerbation of the disease. This type of osteomyelitis is most often found in children whose milk teeth are replaced by permanent ones at the age of five.

There is a special type of osteomyelitis of the jaw, which is called desmorphine. It occurs only in drug addicts who receive the drug through injections. When the drug affects the blood supply, the jaw fester, collapses, the bone becomes brittle, easily broken, deformed, the face becomes asymmetric.

Rare forms of osteomyelitis of the jaw

recurrent

Recurrent multifocal form, in which foci of inflammation appear in the bone, but with the absence of suppuration and infection. The disease is difficult to define, because it is characterized by periods of attenuation and progress.

Osteomyelitis Garre

Osteomyelitis Garre - osteosclerosis is visible on the x-ray, the tissue is not very dense, inflammation and infection in the bone are weak. Difficult to diagnose.

Brodie's abscess

Brodie's abscess - there are practically no external symptoms of the disease, and this is why it is especially dangerous, because it is accompanied by the formation of purulent areas in the jawbone. This disease is a type of bacterial osteomyelitis in a chronic form. In this case, x-rays will not give a clear picture of the disease, because inflammation cannot always be determined on x-rays, areas filled with pus cannot be accurately diagnosed. It can start not only in the jawbone, but in any bone in the body. There are also no characteristic features of the patient - the disease can begin at any age, but more often in males and in childhood.

Osteomyelitis Ollie (Olle) is a disease caused by staphylococcus, a fairly rare form of osteomyelitis, since the non-purulent areas that form with it are characterized by a high protein content.

The disease belongs to the chronic form of osteomyelitis. A very rare, almost unique disease, most often occurs in adolescents and children.

Most often, it does not begin in the jawbone, but in the femur. Does not lead to suppuration, is characterized by a high content of protein in the cavity. It is also difficult to diagnose.

The emerging pain slowly begins to grow, intensify if the body is under stress. A swelling appears around the place with a protein-filled cavity, which increases in size, sometimes turns red.

Symptoms of osteomyelitis

Symptoms of osteomyelitis are determined depending on its type. The following symptoms are characteristic of the acute form of the disease:

a sharp increase in temperature to 39-40 degrees;
feeling of "tapered" language;
headache, weakness;
sleep problems;
loss of appetite;
ulcers appearing on the face;
discoloration of the mucosa - it becomes paler;
inability to close the jaw.

The pain may radiate to other parts of the head - the ear on the affected side, the orbit, the temple. The face swells, deforms, and the teeth on the diseased jaw begin to “stagger” in the gums when pressed. It is difficult to eat and speak, the movement of the jaw causes pain.

In an extremely rare form of acute osteomyelitis, toxic, high fever causes confusion and loss of consciousness.

In the event that acute osteomyelitis begins in the upper jaw, inflammation often passes to the cheek and orbit. Osteomyelitis of the upper jaw most often occurs in children during the change of milk teeth, and suppuration in the orbit makes the diagnosis difficult.

Symptoms of preacute osteomyelitis are less pronounced. Fistulas are formed, through which pus comes out, the pain subsides, the teeth over the focus of inflammation become more mobile. The sick person feels better and believes that the disease is going away, while the inflammation continues to increase and spread throughout the body.

Chronic osteomyelitis, especially its primary form, is even more difficult to identify by symptoms. This should be done by a specialist with the help of analyzes and x-rays.

Symptoms of osteomyelitis of the jaw in children

The symptoms of the disease are especially highlighted for children under five years of age. At this age, milk teeth are replaced by permanent ones, and children are just learning how to properly brush their teeth, so there is a high risk of a rapidly developing infection. If milk teeth become infected, the disease can spread and destroy the buds of permanent teeth. But in the diagnosis, it is important that the doctor perform a biopsy and exclude the possibility of a malignant neoplasm.

As in adults, in children, the temperature rises sharply, the face swells, the skin becomes painful, acquires a pink color. Lymph nodes increase, swelling passes to the neck and can cause the airways to close, it becomes difficult for a person to breathe. When the body is infected, the load transfers to the blood and internal organs, the liver and spleen suffer, and kidney problems begin. The disease can lead to complications and even death.

Diagnostics

X-ray examination does not always immediately help in the diagnosis: the bone becomes more transparent only after fourteen days. But immediately you can see the inflammation and start treatment.

Secondly, analyzes are collected:

blood test for inflammation, protein, white blood cells;
Analysis of urine.

Treatment

First of all, after establishing the correct diagnosis, it is necessary to hospitalize the patient. It is best to choose large clinics in which the diagnosis will be more accurate.

Treatment of osteomyelitis due to trauma or a broken tooth should begin with surgical intervention - eliminating the consequences of trauma, removing fragments of the tooth. Only after this, the patient is transferred to traditional antibiotic treatment.

The patient is prescribed antibacterial therapy, antibiotics, intoxication, prescribe vitamins and immunostimulating agents, transfusion of plasma and other blood substitutes. Often, osteomyelitis appears along with concomitant diseases or complications, in which case it is necessary to treat them in a mandatory complex. In the event that the cause of the disease is an injury, the consequences of the injury are first eliminated and only then treatment begins. It is necessary to control the condition of the internal organs, to which inflammation can go, as well as the condition of the blood, in order to prevent the possibility of sepsis.

First of all, they remove suppuration, stop the spread of tissue necrosis. Inflamed bones become brittle, can break with little effort, which deforms and disfigures the face, so treatment is started as early as possible.

To combat suppuration, hemosorption and hyperbaric oxygenation are sometimes used.

During hemosorption, blood is purified from poisons and harmful substances by passing it through sorbents that absorb poison and harmful substances from the blood. Hyperbaric oxygen therapy is a pressure chamber treatment in which the amount of oxygen in the blood is increased. The method of treatment helps to saturate soft tissues prone to necrosis with oxygen, conduct oxygen in the blood in case of onset of blood sepsis and septic shock.

Antibiotics are prescribed immediately - the sooner the fight against inflammation is started, the more effective it will be.

In the future, physiotherapy is prescribed, courses of antibiotics continue. If the symptoms disappear, it is impossible to finish the course of treatment: the disease can go into a latent chronic phase and bring much more negative consequences.

If the face is deformed, the help of a plastic surgeon may be required.

Consequences of osteomyelitis

An infection that affects the jaw gradually destroys tissues and can lead to irreversible consequences for the body. Treatment should begin with the appearance of the first signs of the disease, even if they are not clearly expressed. What are the consequences of untreated osteomyelitis?

Abscess

An abscess is a purulent inflammation of the tissues. It can develop in muscles, bones, fiber, and organs. It occurs both as an independent inflammation, and as a result of diseases. When the infection enters through the skin or mucous membrane damaged during osteomyelitis, the body reacts by encapsulating the purulent focus and thereby protecting healthy tissues.

Phlegmon

The word "phlegmon" comes from the ancient Greek word meaning "heat, inflammation." Like an abscess, it is a purulent inflammation, but, unlike an abscess, it is not clearly defined. Pathogens also penetrate into the fiber through damaged tissues or from foci of infection, sometimes through the blood.

Contracture

A contracture is a restriction of joint movement. Healed tissue does not allow to bend and unbend the joints, reduces the mobility of muscles, skin - in the case of the consequences of osteomyelitis, this reduces the mobility of the lower jaw or facial muscles. The contracture of the lower jaw is especially dangerous, because in this case a person is deprived of the opportunity to speak, to chew food on his own.

Pulmonary (and respiratory) failure

Under this name, there is a whole complex of symptoms in which respiratory functions are disturbed, enough oxygen does not enter the body. Complications after osteomyelitis can be different - swelling of the upper respiratory tract, which prevents the flow of oxygen to the lungs, infectious lesions of the spinal cord (and, as a result, paralysis), diseases of the circulatory system due to sepsis.

Renal amyloidosis

Violation of protein metabolism, which as a result can lead to edema and kidney failure. The first weeks are hidden, all the symptoms that appear are only weakness and fatigue, which may not be very noticeable against the background of inflammation.

Meningoencephalitis

Meningoencephalitis is very similar to meningitis, it is an inflammation of the brain that can cause paralysis if it spreads to the spinal cord. Headache, chills, vomiting, nausea - all this begins suddenly and develops very quickly. It is important to diagnose meningoencephalitis against the background of osteomyelitis in time and start treatment.

Phlebitis

Phlebitis is an inflammation of the veins that disrupts the circulation of blood throughout the system. It can also begin due to an infection that has entered the circulatory system.

Sepsis and septic shock

One of the most unfavorable consequences of osteomyelitis for the body. Infection of the blood and a serious condition of the body, in which oxygen and other substances are not delivered to the tissues. Children, immunosuppressed people, and the elderly are particularly at risk. Death occurs in a quarter to a half of cases.

In children, osteomyelitis of the jaw develops much faster than in adults, so it is extremely important to take children to the dentist prophylactically and be especially careful when changing milk teeth at the age of 4-6 years.

Conclusion

Osteomyelitis of the jaw is the most common, and it is also dangerous precisely because of the complications and consequences. Pain in a tooth or a slight suppuration on the gums, pain radiating to the ear or temple, general weakness and high fever - all this many people prefer to treat with painkillers without contacting a specialist. Chronic primary osteomyelitis does not give a clear picture at all, and it is impossible to identify it without analyzes and an x-ray. The symptoms are difficult to diagnose because the symptoms of osteomyelitis are in many ways similar to those of malignant tumors that appear in the jaw bones - they are also often ignored until the last moment.

Osteomyelitis of the jaw is actually a disease of a neglected and weakened organism. Inability to monitor oral hygiene, reduced immunity, untreated colds and respiratory diseases, injuries that were not disinfected in time, infection through drugs, lack of systematic visits to the dentist - all these are the best friends for the appearance of osteomyelitis of the jaw.