February 7th, 2013
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Classification
There are several types of osteomyelitis of the jaw based on the source of infection. Odontogenic osteomyelitis jaw is a serious complication of running caries . According to statistics, this type of osteomyelitis is diagnosed in about 75% of cases. The disease develops after an infection of the cavity penetrates into the pulp, and then the root of the tooth. Further, it also captures the bone tissue. Approximately 70% of osteomyelitis affects the jaw, in other cases affected the upper jaw. The primary cause of this illness becomes effects of three groups of microorganisms: staphylococci . streptococci . Anaerobic bacteria . Germs get into the bone through the lymphatic vessels and bone tubules.
Hematogenous osteomyelitis t - A consequence of the infection of the bone tissue infection, transferred bloodstream from the primary tumor, which developed inflammatory process. This form of the disease can develop as a result of chronic tonsillitis And other foci of chronic infections. Acute infectious process, for example, diphtheria . scarlet fever and other diseases can also cause osteomyelitis of the jaw. When hematogenous osteomyelitis initially affected part of the body bone, and only after that can affect inflammation and teeth. This form of the disease is less prevalent.
Traumatic osteomyelitis It manifested in a patient as a result of wounds or fractures, through which becomes infected. The prevalence of this form of the disease is low.
Osteomyelitis of the jaw is also divided into several types depending on the particular clinical picture. It acute . subacute and chronic form of osteomyelitis of the jaw. In this case, it estimated the severity of inflammation.
Symptoms
The first symptom acute form of odontogenic osteomyelitis is a manifestation of pain in the tooth that has been infected. The pain is greatly enhanced if a tooth knocked. This manifests its easy mobility. The move may also neighboring teeth. Visible swelling of the mucous membrane near the tooth, moreover, it becomes reddish and loose. Sometimes it develops subperiosteal abscess . The pain gradually from one of the affected tooth becomes adjacent, there are signs of inflammation of periodontal teeth. Pain at the same time can give ear, temple, eye socket. When osteomyelitis of the mandible may be disturbed by the sensitivity of the lower lip, oral mucosa, the skin of the chin. If the patient develops purulent inflammation of the soft tissues admaxillary, the pain beyond the jaw.
The lymph nodes in the neck enlarged, palpation manifest their pain. Signs of intoxication manifested in the appearance of a man: the skin becomes gray shade, sharpened features. If the process is drawn intoxication liver and spleen, there may be jaundice of the sclera eyes. Kidney damage leads to the appearance of protein in the urine, and erythrocyte . May experience fluctuations in blood pressure - as the rise and decline. At first diagnose osteomyelitis of the jaw is difficult due to the fact that the common symptoms predominate over local features.
Subacute osteomyelitis Usually develops after decrease in acute form. In this state, a person feels that his condition is improving, since there is a breakthrough of pus from the bone tissue. This inflammatory process continues, and the destruction of the bone tissue is not suspended.
Chronic osteomyelitis It can occur over an extended period - for several months. Against the background of the external improvement of the patient acute osteomyelitis, formed a new fistula, dead bone tissue sections are rejected, and there sequesters. Jaw in place of the pathological focus flattened teeth remain mobile. With this development of the disease is not always self-healing occurs.
Complications
Osteomyelitis of the jaw can cause complications that cause great harm to human health. With advanced disease may develop sepsis , Inflammation of the soft tissues of the face and neck ( phlegmon ). It is also a consequence of osteomyelitis can be deformation or fracture of the jaw. If purulent process extends to the face region, it may lead to sinus dura, phlebitis veins of the face. When the upward propagation may develop meningitis . brain abscess . Sometimes complications leading to disability of the patient, and in severe cases - death.
Diagnostics
In the process of diagnosis of osteomyelitis of jaws doctor initially studying the clinical picture of the disease, inspect and survey the patient. Then carried X-ray examination. But osteomyelitic process mainly affects trabecular bone, therefore, the information obtained during the radiographic examination is not always complete. If the pathological process develops quickly, it is the destruction of cortical bone, which can be determined by X-rays. Important diagnostic importance is the identification of seizures.
Treatment
Thus, if a patient diagnosed with acute odontogenic osteomyelitis, the original wound festering inflammatory lesion in the bone and surrounding tissues. Also appointed medicated preparations aimed at improving the state of the human body as a whole.
Surgery is also practiced: osteomyelitis upper and lower jaw is held draining the infection in the bone. Initially the tooth is removed, as a result of infection which manifested disease. If the patient present admaxillary abscesses and cellulitis, soft tissue dissection is performed, as well as the subsequent dialysis wounds. If a patient diagnosed with acute or chronic osteomyelitis of the jaw, necessary to carry out anti-inflammatory treatment by appointment antibiotics . Such therapy is carried out in parallel with the surgery.
Treatment of acute osteomyelitis of the jaw form is performed only in a hospital. In addition to operational and anti-inflammatory treatment is practiced stimulating, restorative, symptomatic therapy.
Keep in mind that the sooner the tooth is removed the acute form of the disease, the lower the risk of further spread of the inflammatory process, and the faster stop inflammation. In the presence of mobile teeth to strengthen them on a special bus, or braces. If after extraction remains festering wound that is necessary to ensure proper care of it. For this purpose, washing, irrigation with antiseptic solutions.
Combined therapy involves the intake of vitamin complexes, which should include B vitamins . ascorbic acid . During the treatment it is important that the patient constantly ie drinking plenty of fluids, and in the diet should prevail protein and vitamin-products. It is important after every meal to conduct thorough toilet of the mouth.
Treatment of chronic osteomyelitis of the jaw forms may be used depending on the symptoms of the disease. If the treatment of the disease is carried out in a timely and correct, then we can talk about favorable prognosis.
Prevention
Preventive measures include general health, strengthening the immune system, the timely treatment of diseases of the teeth, holding their prosthetics. It is important to not less than once a year to visit the dentist for checkups. 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. No less important preventive measure is to ensure the quality of daily oral hygiene and the protection of persons from injury.
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