Contemporary concepts in the treatment of chronic osteomyelitis.

Although there are relatively standard treatment approaches for chronic osteomyelitis, many avenues of investigation are being pursued to reflect contemporary concerns. The mainstays of care continue to include timely and thorough surgical débridement and culture-directed antibiotics. Sensitive diagnostic screening is essential, and advances in radiology can lead to early confirmation of disease and accurate surveillance. There is potential to greatly reduce overall morbidity, chance of recurrent infection, and treatment courses by using the local delivery systems currently researched by orthopedic surgeons. The challenges posed by multidrug-resistant bacterium may be countered by sound culturing techniques and new antibiotics. The general purpose of this article is to survey the new directions in oral surgery, orthopedics, infectious disease, immunology, and radiology that may have application to the treatment of maxillofacial osteomyelitis.