osteomyelitis. an acute or chronic inflammatory process in the medullary spaces or cortica l...
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OSTEOMYELITIS
an acute or chronic inflammatory process in the medullary spaces or cortical surfaces of bone ………………..the initial site of involvementmost often from a…………..
periapical abscess.
The second most common cause…..
Physical injury
Most cases are……………………… infectious
.1Acute osteomyelitis
when an acute inflammatory process spreads through the medullary spaces of the bone
2.Chronic osteomyelitis
the defensive response leads to the production of granulation tissue…….an attempt to wall off the infected area.
all ages.a strong male predominance.Most cases involve the mandible
1.More diffuse blood supply 2.The grater proportion of cancellous bone
.………In maxilla
Acute osteomyelitis.
signs and symptoms of an acute inflammatory process that has typically been less than1 month in duration. FeverleukocytosisLymphadenopathysignificant sensitivity soft-tissue swelling
an ill-defined radiolucency
Usually,no radiographic evidence
Unless
approximately 60 %Demineralizationof the bone
On occasion…………paresthesia of the lower lipdrainageexfoliation of fragments of necrotic bone (sequestrum).
Involucrumthe mass of encased nonvital bone that may become surrounded by vital bone,
central radiopaque mass ofnecrotic bone.
Chronic osteomyelits
If acute osteomyelitis is not resolved or primarily without a previous acute episode.
SwellingPainsinus formation purulent discharge,sequestrum formationtooth losspathologic fracture.
a patchy, ragged, and ill-defined radiolucencyoften contains ……..central radiopaque sequestra.
Histopathologic FeaturesGeneration of biopsy is not common ….. predominantly liquid content and lack of a soft-tissue component. When submitted, the material consists …………….necrotic bone. a loss of the osteocytes from their lacunae
acute osteomyelitis
Normal woven bone
bacterial colonization
Necrotic debries
acute inflammatory infiltrate consisting of PMNs.
Chronic osteomyelitisa significant soft-tissue component that consists of chronically or subacutely inflamed fibrous connective tissue filling the intertrabecular areas of the bone.
irregular fragment of devitalized bone surrounded by dense fibrous tissue heavily infiltrated by plasma cells, lymphocytes, and only a few granulocytes
Acute osteomyelitis…… 1.antibiotics 2. drainage.
Treatment and Prognosis
1.similar antibiotics ……..but intravenously in high doses.
Chronic osteomyelitis.
2.Surgical removal of all infected material surgical down………….. to good bleeding bone .