Parrish L C, Kretzschmar D P, Swan R H
Department of Periodontics, 832nd Air Division Hospital, Luke AFB, AZ.
J Periodontol. 1989 Dec;60(12):716-22. doi: 10.1902/jop.1989.60.12.716.
Correctly differentiating between periodontal abscess (localized, acute suppurative infection of the periodontium) and osteomyelitis (the extension of an infection into the bone medullary cavity) is crucial since the former may not require antibiotics for resolution, while the latter will. Initial assessment and treatment of osteomyelitis should be based on clinical examination, radiographic interpretation, and experience. Three case histories of osteomyelitis are presented, ranging from a periodontally well-localized case to one involving a hemimandible and crossing the midline. Successful early diagnosis and case management may benefit from scintigraphic interpretation and culture-and-sensitivity studies.
正确区分牙周脓肿（牙周组织局限性急性化脓性感染）和骨髓炎（感染蔓延至骨髓腔）至关重要，因为前者可能无需使用抗生素即可痊愈，而后者则需要。骨髓炎的初步评估和治疗应基于临床检查、影像学解读和经验。本文介绍了三例骨髓炎病例，范围从牙周局部病例到累及半侧下颌骨并跨越中线的病例。早期成功诊断和病例管理可能受益于闪烁扫描解读以及培养和药敏研究。
