Suppurative mandibular osteomyelitis refers to agents that invasion of the mandible, the bone tissue as a whole, including the periosteum, cortical bone, bone marrow and the blood vessels, nerves, inflammation, alveolar abscess, periodontitis, and the third molar crown weeks go far odontogenic infection from which the highest incidence of mandibular osteomyelitis.
Suppurative mandibular osteomyelitis (a)
Suppurative mandibular osteomyelitis (two)Bone trabecular and bone marrow, known as the Central osteomyelitis lesions originating in the periosteum and cortical bone of the jaw around, known as the edge of osteomyelitis according to the nature of the lesions can be divided into acute and chronic phase, according to The scope of the validation can be divided into localized or diffuse. central mandibular osteomyelitis: the maxilla than the mandible more common in teeth with severe pain, persistent, and radiating pain along the trigeminal nerve distribution. teeth and adjacent teeth loose, percussion pain, vestibular groove fullness, cheek swelling. mandibular alveolar abscess, the pus is not easy worn develop into acute diffuse osteomyelitis and lack of drainage, the patients with systemic symptoms get worse, fever, chills, leukocyte, dehydration and other toxic manifestations. mandibular osteomyelitis refers to agents that invaded the jaw, causing the entire bone tissue, including periosteum, cortical bone, bone marrow and the blood vessels, nerve inflammation, Chinese medicine called 'bone slot wind 'or' wear gills were sharply acute onset of high fever, increased white blood cells, can shift to the left. body poisoning, and with general malaise, headache, loss of appetite and other symptoms can occur in patients toothache, and the pain along the trigeminal nerve distribution area of radiation, and can quickly spread to the adjacent teeth. the short term, there may be multiple tooth mobility, periodontal pocket pus, inferior alveolar nerve by inflammatory damage to the lower lip numbness due to the spread of inflammation to the surrounding maxillofacial swelling which can occur, such as infection spread to the masticatory muscles can be trismus such as infection control in a timely and quickly to the infraorbital, inferior temporal, the pterygopalatine concave and by the mandibular foramen caused the wing jaw space infection. systemic complications such as sepsis, and intracranial infection may also occur.
Suppurative mandibular osteomyelitis (three)2, with or without empyema sense of volatility suspicious can be used for puncture confirmed. 3, pus for bacterial culture and antibiotic sensitivity determination, with or without fistula, probes and other instruments to probe whether the sequestrum sequestrum separation. 5, X-ray, the chronic phase to identify bone destruction, with or without sequestrum formation or infection of the low toxicity of the bone cortex hyperplasia type.
Suppurative mandibular osteomyelitis (d)Decline thirsty, systemic poisoning, severe anemia, in addition to general supportive therapy, but also a small amount of multiple transfusions and enhance systemic resistance to the chronic phase sequestrum curettage and extraction of teeth lesions mainly purulent maxillary bone marrow after a course of inflammation, and generally can be divided into two phases of acute and chronic phase. to The sequestrum began to take shape used to be collectively referred to as the acute phase by the onset, generally about 3 to 4 weeks if the infection fails to be completely controlled in the acute phase, into the chronic phase. must be used in sufficient quantities and effective antimicrobial treatment. use drugs in order to control the infection in the acute phase, use of antibiotics against Staphylococcus aureus and mixed infections, the other based on bacterial culture and susceptibility to choose effective antibiotics. In the initial stages of infection, but also with the physical therapy. When the infection into the suppuration of Early incision and drainage. wait for his condition slightly eased, the mouth opening slightly improved, should try to extraction, so that the pus from the socket to get the drainage, to prevent the spread of infection in the bone of acute suppurative osteomyelitis oncoming acute, severe illness, can cause blood and brain complications, and therefore close observation, as early as the appropriate emergency treatment of acute systemic application of antibiotics, local incision and drainage removal of loose teeth mainly diffuse patient performance decline thirsty, systemic poisoning, severe anemia, in addition to general supportive therapy, but also a small amount of multiple transfusions, enhanced systemic resistance to the chronic phase to sequester scrape and lesions in tooth extraction based. 1, the disease occurred in the maxilla of infants and young children. marginal mandibular osteomyelitis: more common in young people, the acute phase is difficult to find common chronic phase. and timely treatment of pericoronitis, periapical go far odontogenic infection, on the prevention of mandibular osteomyelitis. such as formation of osteomyelitis in the acute phase should be a thorough treatment so as not to become chronic. acute phase of infection control, enhance the body resistance-based, anti- infection drugs should be selected according to the sensitivity of pathogenic bacteria. mandibular osteomyelitis more mixed bacterial infection, it is appropriate in order to use broad-spectrum antibiotics. In addition, as has been clear for odontogenic infection, early removal of the lesions teeth in order to facilitate drainage, to avoid more extensive bone destruction. case of subperiosteal abscess or infection jaw week gap, it is timely incision in chronic phase, the lesion has been limited or has been sequestrum formation, while the surgical treatment of the main supplemented by drug treatment. marginal mandibular osteomyelitis are generally large sequestrum formation, mostly for the proliferation of subperiosteal cortical bone, the texture is more loose, and should be completely clear, pus foci of cortical bone surface where infection and the granulation organizers should be scraping, postoperative use of antibiotics to control infection in 7 to 14 days to avoid relapse.
Suppurative mandibular osteomyelitis (five)Can be manifested as acute and chronic stages, and often divided into two types of central and edge (a central mandibular osteomyelitis is usually odontogenic inflammation spread to the bone marrow, spread to the bone from the jaw center around cortex and periosteum in the bone marrow of early acute inflammation is often restricted to the alveolar bone or the mandibular body, patients feel severe toothache, pain along the trigeminal nerve distribution of radiation lesions of the gingival mucosa hyperemia and edema, teeth that is, obvious pain and loose, and can gingival sulcus septic overflow or the formation of alveolar abscess. acute phase has not been timely drainage, infections continue to spread to the medullary cavity can cause disseminated osteomyelitis or perforation of cortical bone formation in subperiosteal abscess. exacerbate symptoms of systemic poisoning at this time, the body temperature to 39 ~ 40 ℃, blood test white blood cells increased significantly, local pain and soft tissue swelling the affected regions the majority of loose teeth. If the inflammation is not brought under control, the maxillary infection can cause purulent maxillary sinusitis and infraorbital, buccal, zygomatic or pterygopalatine concave, temporal concave and other areas to spread. mandibular infection can spread to the inferior alveolar nerve caused by the lower lip numbness spread to the jaw week to stimulate the open jaw muscles, causing limitation of mouth opening can be complicated by the infection of the jaw week more than the gap, so that the face was seen in the swelling, and finally inflammation in the formation of blood clots within the jaw, resulting in nutritional disorders of the jaw and necrosis, and thus transferred to the chronic phase. turn by the acute phase into the chronic phase of about two to three weeks later, pain and other systemic symptoms began to ease, but the mouth gums can form more than one fistula and pus out about a month later, the sequestrum with healthy bone between the new bone layer, causing the separation of the sequestrum with healthy bone without surgical removal of involved regional fistula pus prolonged unhealed, can sometimes have a small piece of sequestrum discharged from the fistula. osteomyelitis of the mandible can cause large piece of dead bone formation, can be pathogenic pathological fractures appear bite (occlusal disorders. Suppurative mandibular osteomyelitis (two marginal mandibular osteomyelitis spread of the infection pathway is not the first damage to bone marrow, but the basis of periostitis or subperiosteal abscess the first involving the cortical bone occurred in adolescents mandible, more limited lesions, infections originated in the mandibular third molar pericoronitis inflammation, caused by the masseter muscle space infection and subperiosteal abscess, resulting in lower jaw of the ascending branch and the corner of cortical bone nutritional barriers necrosis. clinical manifestations of chronic symptoms, the symptoms of the acute phase of infection and jaw week gap coexist but often overlooked in local mild chronic inflammatory swelling and pitting edema due to the chewing muscles and wing muscle involvement and limited mouth opening. lesions confined to the cortical bone, or to the deep development involving the bone marrow, but rarely large sequestrum formation. pericoronitis infections if not controlled, often repeatedly made by anti-inflammatory drugs after treatment, could easily lead to pathogen resistance, the formation of low toxicity and infection, no obvious purulent and sequestrum formation process and significant cortical hyperostosis, sclerosis and periosteal thickening of cortical bone lysis little part the formation of small abscess and granulation tissue. cortical hyperplasia of the mandibular ascending branch of the Ministry of mandibular angle can cause facial asymmetry, X-ray showed obvious subperiosteal hyperostosis.
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