• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.46 no.1
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• pp.19-27
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• 2020

Objectives: Pentoxifylline (PTX) is a methylxanthine derivative that has been implicated in the pathogenesis of peripheral vessel disease and intermittent lameness. The purpose of this study was to investigate the effect of PTX and tocopherol in patients diagnosed with osteoradionecrosis (ORN), bisphosphonate-related osteonecrosis of the jaw (BRONJ), and chronic osteomyelitis using digital panoramic radiographs. Materials and Methods: This study was performed in 25 patients who were prescribed PTX and tocopherol for treatment of ORN, BRONJ, and chronic osteomyelitis between January 2014 and May 2018 in Seoul National University Dental Hospital. Radiographic densities of the dental panorama were compared prior to starting PTX and tocopherol, at 3 months, and at 6 months after prescription. Radiographic densities were measured using Adobe Photoshop CS6 (Adobe System Inc., USA). Blood sample tests showing the degree of inflammation at the initial visit were considered the baseline and compared with results after 3 to 6 months. Statistical analysis was performed using the Mann-Whitney test and repeated measurement ANOVA using IBM SPSS 23.0 (IBM Corp., USA). Results: Eight patients were diagnosed with ORN, nine patients with BRONJ, and the other 8 patients with chronic osteomyelitis. Ten of the 25 patients were men, average age was 66.32±14.39 years, and average duration of medication was 151.8±80.65 days (range, 56-315 days). Statistically significant increases were observed in the changes between 3 and 6 months after prescription (P<0.05). There was no significant difference between ORN, BRONJ, and chronic osteomyelitis. Only erythrocyte sedimentation rate (ESR) was statistically significantly lower than before treatment (P<0.05) among the white blood cell (WBC), ESR, and absolute neutrophil count (ANC). Conclusion: Long-term use of PTX and tocopherol can be an auxiliary method in the treatment of ORN, BRONJ, or chronic osteomyelitis in jaw.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.3
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• pp.251-254
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• 2004

Osteomyelitis is the inflammatory disease occured in the bone, involving a bone marrow, a Harversian system and the underlying cortical bone. Osteomyelitis is divided into acute and chronic osteomyelitis. Chronic osteomyelitis. is presented as a pain, swelling, pus discharge and radiographic change. The pathogenesis of osteomyelitis occcuring in the facial bone is predominately due to odontogenic microorgarnisms, Staphylococcus, resulted in odontogenic infection or post-traumatic infection. The mandible is the most commonly involved facial bone and the bones in the middle of third of the face is rare because of a abundant blood supply. Moreover, Osteomyelitis occuring in the zygoma is extremely rare. In our department, we report the case that osteomyelitis occuring in the zygoma with diabetes is resulted by odontogenic maxillary sinusitis.

• Clinics in Shoulder and Elbow
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• v.14 no.2
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• pp.248-252
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• 2011

Purpose: We report a case of chronic recurrent multifocal osteomyelitis of the shoulder. Materials and Methods: A 16 year-old male who had suffered from chronic recurrent multifocal osteomyelitis of the shoulder was diagnosed by clinical features and biopsy and was treated with arthroscopic debridement and Naproxen. Results: Symptoms was subsided without relapse during 16 months follow up. Conclusion: Chronic recurrent multifocal osteomyelitis is rare disease and it can be misdiagnosis because of its rarity and non-specific clinical presentation. This is a report of a case of chronic recurrent multifocal osteomyelitis of the shoulder in 16 years man.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.26 no.6
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• pp.672-676
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• 2000

One of the current treatment methods for chronic osteomyelitis is removal of the infected and necrotic tissue to reduce the bacterial concentration as much as possible. This is performed concomitantly with antibiotic therapy. Chronic osteomyelitis(C.O.) implies chronic ischemia of the diseased bone. Thus, the treatment for C.O. requires high systemic level of antibiotics. In some cases, however, inherent undesirable adverse effects(for example, nephrotoxicity, ototoxicity, and others) may render this course of treatment difficult. Knowing that residual monomers are released from hardened bone cement, installation of antibiotic-impregnated PMMA(polymethyl-methacrylate) beads in situ have been one of treatment methods of C.O. When introduced into the wound, they established an exceedingly high level of local antibiotics for prolonged period without high systemic level of antibiotics. We experienced favorable results with vancomycin-impregnated PMMA beads for the treatment of C.O. of the mandible. So, we report it with literature reviews.

• Clinics in Shoulder and Elbow
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• v.19 no.4
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• pp.252-255
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• 2016

We reported the two cases of olecranon osteomyelitis secondary to the iatrogenic chronic relapsing septic olecranon bursitis. Infection was well eradicated by excision of the infected bursa and curettage of the eroded olecranon under the coverage of antibiotic therapy

• Restorative Dentistry and Endodontics
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• v.49 no.2
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• pp.13.1-13.7
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• 2024

Chronic osteomyelitis with proliferative periostitis, known as Garre's osteomyelitis, is a type of osteomyelitis characterized by a distinctive gross thickening of the periosteum of bones. Peripheral reactive bone formation can be caused by mild irritation or infection. Garre's osteomyelitis is usually diagnosed in children and young adults, and the mandible is more affected than the maxilla. The following is a case report of a 12-year-old female patient with Garre's osteomyelitis of the mandible due to an infection of a root canal-treated tooth. Without surgical intervention, the patient's symptoms were relieved through nonsurgical root canal re-treatment with long-term calcium hydroxide placement. A cone-beam computed tomography image obtained 6 months after treatment completion displayed complete healing of the periapical lesion and resolution of the peripheral reactive buccal bone. Due to the clinical features of Garre's osteomyelitis, which is characterized by thickening of the periosteum, it can be mistaken for other diseases such as fibrous dysplasia. It is important to correctly diagnose Garre's osteomyelitis based on its distinctive clinical features to avoid unnecessary surgical intervention, and it can lead to minimally invasive treatment options.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.35 no.6
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• pp.396-401
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• 2013

Chronic osteomyelitis is an infection and inflammation of the bone or bone marrow, causing ischemia in bone marrow due to lack of blood, nutrients, and oxygen supply to the bone marrow, eventually leading to necrosis of bone marrow. A current method for treatment of chronic osteomyelitis is administration of systemic antibiotics followed by removal of the infected bone and tissues. Because infected tissue of chronic osteomyelitis is surrounded by avascular necrotic bone, supply of blood and antibiotics to the infected area is diminished. For effective treatment, high plasma concentrations of antibiotics should be provided for a prolonged period. However, long term high serum level of antibiotics may result in undesirable adverse effects. For delivery of a sufficient concentration of antibiotic to the infected area while avoiding the adverse effect, implantation of a local antibiotic delivery system is suggested. One of the implantation systems that has been utilized is antibiotic impregnated polymethyl methacrylate.

• Journal of Korean Foot and Ankle Society
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• v.13 no.2
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• pp.203-206
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• 2009

We experienced a case of congenital insensitivity to pain with anhidrosis mimicking a chronic osteomyelitis of the talus, with recurrent ankle swelling and intermittent fever. He was misdiagnosed as low virulence osteomyelitis at other hospital in annual recurrence for 3 years. A Charcot joint in children is a very rare condition and diagnosis should be made in a careful approach.

• Archives of Reconstructive Microsurgery
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• v.18 no.2
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• pp.49-54
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• 2009

Purpose: To evaluate the result of muscle free flap transplantation in chronic osteomyelitis of the tibia and calcaneus occurred from open fractures and exposed bones and internal fixatives. Materials and Methods: The free muscle flap were transferred in the tibia and calcaneus and followed up average 7.3 years at the department of orthopedic surgery from March 1997 to September 2009. Six patients were male and 1 case female averaged 50.3 years of age. Two latissimus dorsi myocutaneous free flaps were transplanted to the exposed 2/3 of the tibia with soft tissue defect, one rectus abdominis muscle free flap to the mid 1/3 of the tibia and four gracilis muscle free flaps to the distal 1/3 of the tibia and calcaneus. Results: At average 7.2 years follow-up, all of the 7 cases obtained solid bone union in the X-ray and kept sound soft tissues without pus discharges. The overall result of bone union, healed soft tissues defect and normal knee and ankle joint range of motion were excellent. Conclusion: The free muscle flap transferred to the chronic osteomyelitis of the tibia and calcaneus showed excellent results in bone union and eradication of the pus forming bacteria by its abundant blood flow.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.34 no.6
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• pp.484-487
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• 2012

Skull base osteomyelitis is a very rare disease that affects the bone marrow of the temporal bone, sphenoid bone, occipital bone. It occurs typically chronic ear canal infections by malignant otitis externa, but some of atypical osteomyelitis have been reported. It most commonly presents old diabetic patients, and have high morbidity and mortality rate if diagnosis and treatment are delayed. However with respect to pain or dysfunction, it appeared similar to the initial symptoms of temporomandibular joint disorder. So frequently, definitive diagnosis is tend to delayed. We have clinical experience that a patient who presented with symptom similar to temporomandibular disorder, and differential diagnosised by skull base osteomyelitis. We will report this case with literature review.