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颌骨慢性骨髓炎。骨髓炎。

Chronic Osteomyelitis of the Jaw. Osteomyelitis.

作者信息

López-Carriches Carmen, Mateos-Moreno María Victoria, Taheri Ricardo, López-Quiles Martínez Juan, Madrigal-Martínez-Pereda Cristina

机构信息

Associate Professor. Department of Dental Clinic Specialties. School of Dentistry. Universidad Complutense de Madrid. Spain.

Doctor of Dental Surgery. DDS. Collaborator. School of Dentistry. Universidad Complutense de Madrid. Spain.

出版信息

J Clin Exp Dent. 2025 Mar 1;17(3):e324-e328. doi: 10.4317/jced.62596. eCollection 2025 Mar.

Abstract

BACKGROUND

Chronic osteomyelitis of the jaw is an inflammatory reaction of bone tissue of infectious origin that affects the medullary cavity. The main causes of osteomyelitis are odontogenic or traumatic.

MATERIAL AND METHODS

Bibliographic research, the following electronic databases have been searched: Pubmed Medline and the Chochrane Library Plus.

RESULTS

Clinical symptoms are pain, inflammation, suppuration, intraoral or extraoral drainage fistulas. Bone and soft tissues that do not respond favorably to treatment, potentially can lead to bone sequestra. Diagnosis should include a histopathological study throughout a proper biopsy. Identifying the responsible microorganisms is not easy, as the sample can be contaminated by nearby sites. However, a presumptive diagnosis can be made through clinical and radiographic evaluation. Treatment for osteomyelitis involves eliminating the source of infection and necrotic tissue, establishing drainage, restoring blood supply, and controlling the infection with appropriate antimicrobial therapy. Broad-spectrum antibiotics like penicillin or clindamycin are often prescribed initially, but the regimen may be adjusted based on the microbiological findings.

CONCLUSIONS

Long-term antibiotic therapy is generally required, ranging from 4 to 6 weeks, depending on the severity and chronicity of the infection. Chronic Osteomyelitis, antibiotic, mandible, microbiology, surgery.

摘要

背景

颌骨慢性骨髓炎是起源于感染的骨组织炎症反应,累及髓腔。骨髓炎的主要病因是牙源性或外伤性。

材料与方法

进行文献研究,检索了以下电子数据库:PubMed Medline和Cochrane图书馆加库。

结果

临床症状包括疼痛、炎症、化脓、口腔内或口腔外引流瘘。对治疗反应不佳的骨和软组织可能会导致骨死骨形成。诊断应包括通过适当的活检进行组织病理学研究。确定致病微生物并不容易,因为样本可能会被附近部位污染。然而,通过临床和影像学评估可以做出初步诊断。骨髓炎的治疗包括消除感染源和坏死组织、建立引流、恢复血供以及用适当的抗菌疗法控制感染。最初通常会开青霉素或克林霉素等广谱抗生素,但治疗方案可能会根据微生物学检查结果进行调整。

结论

根据感染的严重程度和慢性程度,通常需要进行4至6周的长期抗生素治疗。慢性骨髓炎、抗生素、下颌骨、微生物学、外科手术。

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