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Osteomyelitis of the Mandible

  • Tyler H. Haeffs
  • Tiffany H. Campbell
  • Meredith August
Chapter

Abstract

The term “mandibular osteomyelitis” nearly always refers to infection of the bone, and most cases arise from an odontogenic source. Some cases follow trauma, radiation, or medication-related bony necrosis. Early diagnosis of mandibular osteomyelitis can be difficult, and treatment often requires both surgical and medical management. Some cases of chronic osteomyelitis, such as chronic diffuse sclerosing osteomyelitis, SAPHO syndrome, and chronic recurrent multifocal osteomyelitis, have a non-infectious, inflammatory etiology. This review focuses on the pathophysiology, diagnosis, and treatment of various types of mandibular osteomyelitis.

Keywords

Mandibular osteomyelitis SAPHO syndrome Chronic recurrent multifocal osteomyelitis 

References

  1. 1.
    Baltensperger M, Gratz K, Bruder E, Lebeda R, Makek M, Eyrich G. Is primary chronic osteomyelitis a uniform disease? Proposal of a classification based on a retrospective analysis of patients treated in the past 30 years. J Craniomaxillofac Surg. 2000;32(1):43–50.CrossRefGoogle Scholar
  2. 2.
    Marx RE. Acute osteomyelitis of the jaws. Oral Maxillofac Surg Clin North Am. 1991;3(2):367–81.Google Scholar
  3. 3.
    Mercuri LG. Acute osteomyelitis of the jaws. Oral Maxillofac Surg Clin of North Am. 1991;3(2):355–65.Google Scholar
  4. 4.
    Baltensperger MM. A retrospective analysis of 290 osteomyelitis cases treated in the past 30 years at the Department of Carnio-Maxillofacial Surgery Zurich with special recognition of the classification. Zurich: Med Dissertation; 2003.Google Scholar
  5. 5.
    Calhoun KH, Shapiro RD, Stiernberg CM, Calhoun JH, Mader JT. Osteomyelitis of the mandible. Arch Otolaryngol Head Neck Surg. 1988;114:1157.CrossRefPubMedGoogle Scholar
  6. 6.
    Koorbusch GF, Fotos P, Terhark-Goll K. Retrospective assessment of osteomyelitis: etiology, demographics, risk factors, and management in 35 cases. Oral Surg Oral Med Oral Pathol. 1992;74(2):149–54.CrossRefPubMedGoogle Scholar
  7. 7.
    Baur DA, Altay MA, Flores-Hidalgo A, Ort Y, Quershy FA. Chronic osteomyelitis of the mandible: diagnosis and management – an institution’s experience over 7 years. J Oral Maxillofac Surg. 2015;73(4):655–65.CrossRefPubMedGoogle Scholar
  8. 8.
    Schoen R, Suarez-Cunqueiro MM, Metzger MC, Schmelzeisen R. Osteomyelitis of the mandible following third molar surgery: a regrettable consequence in a healthy patient. Quin Int. 2009;40(5):351–4.Google Scholar
  9. 9.
    Beck-Broichsittter BE, Smeets R, Hiland M. Current concepts in pathogenesis of acute and chronic osteomyelitis. Curr Opin Infect Dis. 2015;28(3):240–5.CrossRefGoogle Scholar
  10. 10.
    Topazian RG. Osteomyelitis of the jaws. In: Topazian RG, Goldberg MH, Hupp JR, editors. Oral and maxillofacial infections. 4th ed. Philadelphia: WB Saunders Company; 2002. p. 214–42.Google Scholar
  11. 11.
    Kusuyama Y, Matsumoto K, Okada S, Wakabayashi K, Takeuchi N, Yura Y. Rapidly progressing osteomyelitis of the mandible. Case Rep Dent. 2013;2013:Article ID 249615, 4 pages.Google Scholar
  12. 12.
    Koorbusch GF, Deatherage JR, Cure JK. How can we diagnose and treat osteomyelitis of the jaws as early as possible? Oral Maxillofac Surg Clin North Am. 2011;23:557–67.CrossRefPubMedGoogle Scholar
  13. 13.
    Schuknecht BF, Carls FR, Valavanis A, Sailer HF. Mandibular osteomyelitis: evaluation and staging in 18 patients, using magnetic resonance imaging, computed tomography and conventional radiographs. J Craniomaxillofac Surg. 1997;25(1):24–33.CrossRefPubMedGoogle Scholar
  14. 14.
    Tanaka R, Hagashi T. Computed tomographic findings of chronic osteomyelitis involving the mandible: correlation to histopathologic findings. Dentomaxillofac Radiol. 2008;37:94–103.CrossRefPubMedGoogle Scholar
  15. 15.
    Fukmitsu N, Utigawa K, Mori Y. What can be identified by three phase bone scintigraphy in patients with chronic osteomyelitis of the mandible? Ann Nucl Med. 2010;24:287–93.CrossRefGoogle Scholar
  16. 16.
    Weon YC, Yang S, Choi Y. Use of Tc-99m HMPAO leukocyte scans to evaluate bone infection: incremental value of additional SPECT images. Clin Nucl Med. 2000;25(7):519–26.CrossRefPubMedGoogle Scholar
  17. 17.
    Schuknecht B, Valavanis A. Osteomyelitis of the mandible. Neuroimaging Clin N Am. 2003;13:605–18.CrossRefPubMedGoogle Scholar
  18. 18.
    Marx RE, Tursun R. Suppurative osteomyelitis, bisphosphonate induced osteonecrosis, osteoradionecrosis: a blinded histopathologic comparison and its implications for the mechanism of each disease. Int J Oral Maxillofac Surg. 2012;41:283–9.CrossRefPubMedGoogle Scholar
  19. 19.
    Gaetti-Jardim E, Fardin AC, Gaetti-Jardim EC, de Castro AL, Schweitzer CM, Avila-Campos MJ. Microbiota associated with chronic osteomyelitis of the jaws. Braz J Microbiol. 2010;41:1056–64.CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Yenson A, deFries HO, Deeb ZE. Actinomycotic osteomyelitis of the facial bones and mandible. Otolaryngol Head Neck Surg. 1983;91(2):173–6.CrossRefPubMedGoogle Scholar
  21. 21.
    Prasad KC, Prasad SC, Mouli N, Agarwal S. Osteomyelitis of the head and neck. Acta Otolaryngol. 2007;127:194–205.CrossRefPubMedGoogle Scholar
  22. 22.
    Hudson JW. Osteomyelitis of the jaws: a 50 year perspective. J Oral Maxillofac Surg. 1993;51:1294–301.CrossRefPubMedGoogle Scholar
  23. 23.
    Aitasalo K, Niinikoski J, Grenman R, Virolainen E. A modified protocol for early treatment of osteomyelitis and osteoradionecrosis of the mandible. Head Neck. 1998;20(5):411–7.CrossRefPubMedGoogle Scholar
  24. 24.
    Spellberg B, Lipsky BA. Systemic antibiotic therapy or chronic osteomyelitis in adults. Clin Infect Dis. 2012;54(3):393–407.CrossRefPubMedGoogle Scholar
  25. 25.
    Kim SG, Jang HS. Treatment of chronic osteomyelitis in Korea. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001;92(4):394–8.CrossRefPubMedGoogle Scholar
  26. 26.
    Bevin R, Inwards C, Keller E. Surgical management of primary chronic osteomyelitis: a long-term retrospective analysis. J Oral Maxillofac Surg. 2008;66:2073–85.CrossRefPubMedGoogle Scholar
  27. 27.
    Yamazaki Y, Satoh C, Ishikawa M, Notani K, Katsuhiro N, Kitagawa Y. Remarkable response of juvenile diffuse sclerosing osteomyelitis of mandible to pamidronate. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007;104:67–71.CrossRefPubMedGoogle Scholar
  28. 28.
    Compeyrot-Lacassagne S, Rosenberg A, Babyn P, Laxer R. Pamidronate treatment of chronic noninfectious inflammatory lesions of the mandible in children. J Rheumatol. 2007;34:1585–9.PubMedGoogle Scholar
  29. 29.
    Marx RE, Carlson ER, Smith BR, Toraya N. Isolation of Actinomyces species and Eikenella corrodens from patients with chronic diffuse sclerosing osteomyelitis. J Oral Maxillofac Surg. 1994;52(1):26–33. discussion 33–4CrossRefPubMedGoogle Scholar
  30. 30.
    Costa-Reis P, Sullivan KE. Chronic recurrent multifocal osteomyelitis. J Clin Immunol. 2013;33(6):1043–56.CrossRefPubMedGoogle Scholar
  31. 31.
    Jacobsson S. Diffuse sclerosing osteomyelitis of the mandible. Int J Oral Surg. 1984;13:363–85.CrossRefPubMedGoogle Scholar
  32. 32.
    Urade M, Noguchi K, Takaoka K, Moridera K, Kishimoto H. Diffuse sclerosing osteomyelitis of the mandible successfully treated with pamidronate: a long-term follow-up. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012;114:e9–e12.CrossRefPubMedGoogle Scholar
  33. 33.
    Kuijpers SC, de Jong E, Hamdy NA, van Merkesteyn JP. Initial results of the treatment of diffuse sclerosing osteomyelitis of the mandible with bisphosphonates. J Craniomaxillofac Surg. 2011;39(1):65–8.CrossRefPubMedGoogle Scholar
  34. 34.
    Mari A, Morla A, Melro M, Schiovone R, Rodriguez J. Diffuse sclerosing osteomyelitis (DSO) of the mandible in SAPHO syndrome: a novel approach with anti-TNF therapy. J Craniomaxillofac Surg. 2014;42(8):1990–6.CrossRefPubMedGoogle Scholar
  35. 35.
    Zimmermann P, Curtis N. Synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome: a challenging diagnosis not to be missed. J Infect. 2016;5:72.Google Scholar
  36. 36.
    Duan N, Chen X, Liu Y, Wang J, Wang Z. Multimodal imaging findings of SAPHO syndrome with no skin lesions: a report of three cases and review of the literature. Exp Ther Med. 2016;12:2665–70.CrossRefPubMedPubMedCentralGoogle Scholar
  37. 37.
    Firinu D, Garcia-Larsen V, Manconi PE, Del Giacco SR. SAPHO syndrome: current developments and approaches to clinical treatment. Curr Rheumatol Rep. 2016;18:35.CrossRefPubMedGoogle Scholar
  38. 38.
    Assmann G, Simon P. The SAPHO syndrome – are microbes involved? Clin Rheumatol. 2011;25(3):423–34.Google Scholar
  39. 39.
    Przepiera-Będzak H, Fischer K, Brzosko M. Serum interleukin-18, fetuin-A, soluble intercellular adhesion molecule-1, and endothelin-1 in ankylosing spondylitis, psoriatic arthritis, and SAPHO syndrome. Int J Mol Sci. 2016;17:1255.CrossRefPubMedPubMedCentralGoogle Scholar
  40. 40.
    Khanna G, Sato T, Ferguson PJ. Imaging of chronic recurrent multifocal osteomyelitis. Radiographics. 2009;29(4):1159–77.CrossRefPubMedGoogle Scholar
  41. 41.
    Ferguson PJ, Sandu M. Current understanding of the pathogenesis and management of chronic recurrent multifocal osteomyelitis. Curr Rheumatol Rep. 2012;14:130–41.CrossRefPubMedPubMedCentralGoogle Scholar
  42. 42.
    Manson D, Wilmot DM, King S, Laxer RM. Physeal involvement in chronic recurrent multifocal osteomyelitis. Pediatr Radiol. 1989;20:76–9.CrossRefPubMedGoogle Scholar
  43. 43.
    Wipff J, Adamsbaumb C, Job-Deslandre C. Chronic recurrent multifocal osteomyelitis. Joint Bone Spine. 2011;78:555–60.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Tyler H. Haeffs
    • 1
  • Tiffany H. Campbell
    • 2
  • Meredith August
    • 3
  1. 1.Harvard School of Dental MedicineBostonUSA
  2. 2.Department of DentistryMassachusetts General HospitalBostonUSA
  3. 3.Department of Oral and Maxillofacial SurgeryMassachusetts General HospitalBostonUSA

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