Development of osteomyelitis following dental abscesses—influence of therapy and comorbidities

Abstract

Objectives

Bacterial osteomyelitis of the jaw is a severe disease potentially requiring extensive surgical treatment. We have evaluated the incidence rates of bacterial osteomyelitis following dental abscessation associated with primary or secondary tooth extraction.

Materials and methods

A retrospective cohort study was designed and included patients with dental abscesses and surgical treatment including the extraction of focus teeth. Patients were either treated with primary removal during acute infection or secondary delayed extraction within an infection-free interval. The primary outcome variable was the occurrence of bacterial osteomyelitis following the abscess. Secondary outcomes were the influence of general disease, antibiotic therapy, and surgical technique.

Results

One hundred nine patients were enrolled in the study; 4 patients (3.7%) developed osteomyelitis. Primary tooth extraction was performed on all these patients (p = 0.017). Significant associations of diabetes (p = 0.001), the use of clindamycin (p = 0.025), and transcutaneous incision (p = 0.017) with the incidence of osteomyelitis were detected.

Conclusions

More severe infections may be associated with a higher risk for the development of osteomyelitis following dental abscesses. A history of diabetes and clindamycin therapy might form further predisposing risk factors. Because of the low incidence and the small case number, our data need to be interpreted carefully.

Clinical relevance

Osteomyelitis of the jaw is a rare but severe disease that may require extensive therapy and that impairs the quality of life of affected patients. The evaluation of risk factors to enable further reduction of incidence is therefore urgently required.

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Acknowledgments

The presented data are part of the doctoral thesis of Caroline Braß. This study was supported by the medical faculty of the University of Heidelberg.

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Correspondence to Julius Moratin.

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Moratin, J., Freudlsperger, C., Metzger, K. et al. Development of osteomyelitis following dental abscesses—influence of therapy and comorbidities. Clin Oral Invest 25, 1395–1401 (2021). https://doi.org/10.1007/s00784-020-03447-6

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Keywords

  • Osteomyelitis
  • Risk factors
  • Tooth extractions
  • Abscess
  • Dental infection