J Can Dent Assoc. 2024 Jul;90:o6.
Osteomyelitis (OM) of the jaw is a rare medical condition. In this review, we provide a descriptive analysis of the experience with this condition at a single tertiary health care centre in Canada over 10 years.
We conducted a retrospective chart review of adult patients aged ≥ 18 years presenting with OM of the jaw at the University of Manitoba Health Sciences Centre between January 2009 and May 2019. We included cases with consistent clinical symptoms and radiographic and/or microbiologic evidence of OM of the jaw. Excluded were cases with a previous history of head and neck cancer, radiation therapy in the head and neck regions and use of anti-resorptive medications.
Of the 37 patients who met our criteria, the mean age was 44 years (standard deviation [SD] ± 16 years), 21 (56.8%) were male, 16 (43.2%) were diagnosed with acute OM and 21 (57.8%) with chronic OM. Underlying comorbidities, such as diabetes mellitus and chronic kidney diseases, were reported in 6 (16.2%) and 3 patients (8.1%), respectively. Traumatic injuries to the facial skeleton were the most common predisposing factor (11 patients [29.7%]). The most commonly isolated infective organisms were viridans group streptococci (VGS; 75.8%), followed by Prevotella spp. (45.4%). Results showed a higher level of resistance to penicillin of the isolated organisms in chronic OM compared with acute OM.
This description of acute and chronic forms of OM of the jaw will enable clinicians to better understand OM patient profiles, leading to early diagnosis, improved patient care and better outcomes.
颌骨骨髓炎（OM）是一种罕见的医学病症。在本综述中，我们对加拿大一家三级医疗保健中心 10 年来的颌骨骨髓炎病例进行了描述性分析。
我们对 2009 年 1 月至 2019 年 5 月期间在马尼托巴大学健康科学中心就诊的颌骨 OM 成年患者进行了回顾性图表审查。我们纳入了具有一致临床症状以及颌骨 OM 的影像学和/或微生物学证据的病例。排除了有头颈部癌症史、头颈部放射治疗史和使用抗吸收药物史的病例。
符合我们标准的 37 例患者中，平均年龄为 44 岁（标准差 ± 16 岁），21 例（56.8%）为男性，16 例（43.2%）诊断为急性 OM，21 例（57.8%）为慢性 OM。报告了 6 例（16.2%）和 3 例（8.1%）患者的合并症，分别为糖尿病和慢性肾脏病。面部骨骼创伤是最常见的诱发因素（11 例 [29.7%]）。最常分离的感染病原体是草绿色链球菌（VGS；75.8%），其次是普雷沃菌属（45.4%）。结果显示，慢性 OM 中分离出的病原体对青霉素的耐药性高于急性 OM。
本研究对颌骨急性和慢性骨髓炎进行了描述，有助于临床医生更好地了解 OM 患者的特征，从而实现早期诊断、改善患者护理和提高治疗效果。
