• Journal of Periodontal and Implant Science
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• 제32권4호
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• pp.745-752
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• 2002

Osteomyelitis is an exhaustive disease whose main feature is an inflammation of inner part of bone, bone marrow. In oral and maxillofacial area, we have maxillary and mandibular osteomyelitis and the latter is dominant because of its impaired blood supply. The main cause of osteomyelitis is a bacterial infection and the ways of infections are by periapical odontogenic infection, fracture, post-operative complication, and periodontal disease. The predominant etiologic factor is periapical odontogenic infection mostly caused by advanced dental caries. It is generally believed that periodontal disease could be a cause of osteomyelitis. But periodontal disease is usually confined to the alveolar bone area and not extends to the underlying bone marrow. Accordingly periodontal infection per se rarely cause produce oseomyelitis. Even though osteomyeltis could be occurred by periodontal disease, its virulence of infection is milder than periapical odontogenic infection. So it usually provokes sclerosing or hyperplastic osteomyelitis rather than suppurative type. We had a case of suppurative osteomyelitis caused by periodontal disease and treated it with periodontal and oral and maxillofacial surgical method.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제42권4호
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• pp.215-220
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• 2016

In prolonged chronic osteomyelitis, chronic inflammation and low-grade infections can result in new periosteal bone formation. Chronic osteomyelitis with proliferative periostitis (traditionally termed $Garr{\acute{e}^{\prime}s$ sclerosing osteomyelitis) mainly affects children and young adults. Here, we present two rare cases of an 11-year-old and a 12-year-old patient with suppurative chronic osteomyelitis with proliferative periostitis without any definitive infection source, such as dental caries or periodontitis. The source of infection was likely to be related to the development of a lower right third molar germ with follicular space widening. Management involved antibiotics and the removal of the third molar germ and surgical debridement. Disease remission and a normal appearance was observed at the six-month follow-up visit.

• 한방안이비인후피부과학회지
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• 제11권1호
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• pp.99-140
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• 1998

In the literatual studies on the suppurative osteomylitis(附骨疽), the results were as follows. Suppurative osteomylitis(附骨疽) is called 'Mudujur(無頭疽)', is concerned with Pyogenic osteomyelitis in western medicine. The pathogenic factors of Suppurative osteomylitis were caused by exposing to wind-cold-wetness evil, or body weakness, or wound a bodily injury caused by physical means. The symptoms of Suppurative osteomylitis was alternating episodes of chills and fever, pain on buttock or thigh in onset. The differential diagnosis of Suppurative osteomylitis was divided three parts. One was the stagnation of virulent fire-evil. Another was the deficiency of both vital energy & blood. The other was wind-cold-wetness evil. The treatments of Suppurative osteomylitis was clearing away heat-evil and wetness evil, removing blood stasis and promoting meridian. In the frequency of prescription, the most numerous prescription were Osintang(五神湯) and Hwangyunhaidoktang(黃連解毒湯), the next were Neitakganghwaltang(內托羌活湯), Taibangpungtang(大防風湯) etc.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제35권6호
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• pp.474-480
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• 2009

These is a cases of chronic suppurative osteomyelitis occurred in the mandibular body to condyle of 48-year-old male patient. Extensive bone destruction was noted on the right mandibular body, angle, ascending ramus, mandibular notch and condylar region. We made a treatment plan that radicular mandibular resection from body to condyle and mandibular reconstruction with vascularized fibular flap at first time. But, we could observe marked bone regeneration with only mild curettage, local wound care and massive antibiotic therapy. So we preserved the anterior ramus portion of mandible. Defected mandibular condyle was reconstructed with costochondral graft. In this paper we present the case of a patient who has chronic osteomyelitis in mandibular area.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제30권5호
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• pp.465-472
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• 2008

We experienced a rare case of oral squamous cell carcinoma arisen from gingival tissues overlying prolonged chronic osteomyelitis of the mandible. A 66 years old man complained of unhealed extraction sockets of left mandibular second premolar and first molar, and showed extensive leukoplakia in the gingival tissues of the same area. The inflammation of the socket granuloma became severe and extended into adjacent mandibular proper, resulted in diffuse suppurative chronic osteomyelitis of mandibular body, exhibiting irregular osteolytic changes of mandibular trabecular patterns in mottled radiolucent appearance. The leukoplakia was initially diagnosed under microscope, and the involved gingival tissues were radically removed. Thereafter, the gingival soft tissue inflammation involving the mandibular osteomyelitis was hardly healed for two years. During the period of repeated surgical treatments for the inflamed lesion, nine biopsies were taken sequentially. Until the eighth biopsy, there consistently showed the suppurative osteomyelitis with ingrowing gingival tissues into the bony inflammatory lesion. The gingival epithelium showed the features of leukoplakia but no evidence of malignant changes. However, the ninth biopsy, taken about 2 years after initial diagnosis, showed the early carcinomatous changes of the gingival epithelium. The neoplastic epithelial cells were relatively well differentiated with many keratin pearls, and infiltrated only into underlying connective tissues. So, we presumed that the present case of squamous cell carcinoma was caused by the persistent inflammatory condition of the mandibular osteomyelitis, and also suggest that the leukoplakia should be carefully removed in the beginning to prevent the neoplatic promotion of the chronic inflammation.

• 대한치과의사협회지
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• 제9권12호
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• pp.841-845
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• 1971

Author has made the studies on the pH of pus in the 53 suppurative disesed patients who had admitted to department of ora surgery, Infirmary of Schoo of Dentistry, Seoul National University. The results were obtained as follows; 1. The average pH of pus in the patients with suppurative oral diseases was 6.46 and the pH of pus was ranging 5.0 to 7.2. 2. The pH value of pus was not significant between the males(pH: 6.58) and females (pH: 6.40). 3. The pH vaule of pus in patients treated by antibiotics trend to slightly alkaline than that of untreated patients. 4.The pH vaule of pus in the pericoronitis, periodontal abscess and other localized oral infections were slightly alkaline than buccal abscess and osteomyelitis, and acute suppurative diseases of jaws was more acid than chronic diseases. In general, it was seemed the early stages of inflammation was alkaline, and the later stages was acid.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제41권
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• pp.6.1-6.10
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• 2019

Background: Osteomyelitis is an intraosseous inflammatory disease characterized by progressive inflammatory osteoclasia and ossification. The use of quantitative analysis to assist interpretation of osteomyelitis is increasingly being considered. The objective of this study was to perform early diagnosis of osteomyelitis on digital panoramic radiographs using basic functions provided by picture archiving and communication system (PACS), a program used to show radiographic images. Methods: This study targeted a total of 95 patients whose symptoms were confirmed as osteomyelitis under clinical, radiologic, pathological diagnosis over 11 years from 2008 to 2017. Five categorized patients were osteoradionecrosis, bisphosphonate-related osteonecrosis of jaw (BRONJ, suppurative and sclerosing type), and bacterial osteomyelitis (suppurative and sclerosing type), and the control group was 117 randomly sampled. The photographic density in a certain area of the digital panoramic radiograph was determined and compared using the "measure area rectangle," one of the basic PACS functions in INFINITT PACS^® (INFINITT Healthcare, Seoul, South Korea). A conditional inference tree, one type of decision making tree, was generated with the program R for statistical analysis with SPSS^®. Results: In the conditional inference tree generated from the obtained data, cases where the difference in average value exceeded 54.49 and the difference in minimum value was less than 54.49 and greater than 12.81 and the difference in minimum value exceeded 39 were considered suspicious of osteomyelitis. From these results, the disease could be correctly classified with a probability of 88.1%. There was no difference in photographic density value of BRONJ and bacterial osteomyelitis; therefore, it was not possible to classify BRONJ and bacterial osteomyelitis by quantitative analysis of panoramic radiographs based on existing research. Conclusions: This study demonstrates that it is feasible to measure photographic density using a basic function in PACS and apply the data to assist in the diagnosis of osteomyelitis.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제18권4호
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• pp.712-717
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• 1996

The term osteomyelitis literally means inflammation of bone marrow. It is described as an inflammatory condition of bone primarily engaging the medullary cavity extending to the periosteum. Following circulatory collapse and ischemia, the involved portions of the bone become necrotic. Cellulitis and osteomyelitis are the most frequent complications of fractures of the mandible and maxilla, because there is an abscessed tooth in the line of fracture. Since most fractures are compound fractures, infection may develop because of contact with oral secretions or outside air. The treatment of chronic osteomyelitis is still under debate. Some authors rely on antibiotics alone, while others advocate combination with surgery. But when infection occurs, establish proper drainage and administer antibiotics. Author treated a case of infected mandibular fracture with mandibular osteotomy, sequestrectomy, iliac bone graft and hyperbaric oxygen therapy, who had suffered suppurative osteomyelitis and mandibular nonunion following the open reduction of the mandibular fracture.

• Pediatric Infection and Vaccine
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• 제20권2호
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• pp.63-70
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• 2013

목 적 : 본 연구에서는 CA-MRSA로 인한 소아의 세균성 근골격계 감염의 임상양상을 연구하기로 하였다. 방 법 : 2000년 9월부터 2012년 8월까지 12년간 분당 차병원에 입원한 18세 이하의 환아 중 혈액과 관절액, 조직이나 고름의 세균 배양검사에서 S. aureus가 동정된 환아를 대상으로 의무기록을 후향적으로 분석하였다. 결 과 : 대상 환아 수는 총 31례였으며 중간값은 7세(최소 17일, 최대 18세)이다. 화농성 관절염으로 진단된 경우는 11례(35.5%), 골수염은 16례(51.6%), 화농성 관절염과 골수염이 병발된 경우는 5례(16.1%)였다. 환아의 혈액이나 관절액, 조직이나 고름 등에서 동정된 S. aureus 31례 중 MSSA는 25례(80.6%), MRSA는 6례(19.4%)였다. 검출된 균주 중 다제내성균은 관찰되지 않았다. MRSA가 배양되었던 6례는 모두 2006년 이후 발생하였다. 모든 증례에서 항생제가 투여되었으며 항생제 투여 기간은 $26.4{\pm}12.7$일이었고, 첫 항생제로 반코마이신을 동반 사용한 경우는 4례(12.9%)였으며 10례(32.3%)에서 최종 항생제로 반코마이신이 투여되었다. 결 론 : 본 연구를 통하여 최근 12년간 세균성 근골격계 감염에서 MRSA의 발생은 연구기간 후반에 편중되었다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제31권6호
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• pp.496-500
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• 2005

A 22-year-old male patient had developed a submasseteric abscess secondary to a mandibular osteomyelitis at the age of 7 years old. The initial presentation at that time seems to be acute suppurative parotitis. The computed tomographic scans taken before surgery demonstrated diffuse deformity, sclerotic change and osteolytic lesion in the mandible. There was no marrow space on both sides of mandibular ramus and thin-walled cortical bone was seen. So, from the results of the computed tomography, the surgery was performed intraoral vertical ramus osteotomy (IVRO) instead of performing the more commonly used bilateral sagittal split ramus osteotomy (BSSRO). In this report, we present a case of surgical correction of mandibular prognathism with fibrous-osseous lesion of mandible with using IVRO.