OSTEOMYELITIS

an acute or chronic inflammatory process in the medullary spaces or cortica l surfaces of bone ……………….. the initial site of involvement most often from a………….. periapical abscess. The second most common cause….. Physical injury Most cases are……………………… infectious

.1Acute osteomyelitis when an acute inflammatory process spreads through the medullary spaces of the bone 2.Chronic osteomyelitis the defensive response leads to the production of granulation tissue ……. an attempt to wall off the infected area. all ages. a strong male predominance. Most cases involve the mandible 1.More diffuse blood supply 2.The grater proportion of cancellous bone ……….In maxilla

Acute osteomyelitis. signs and symptoms of an acute inflammatory process that has typically been less than1 month in duration. Fever leukocytosis Lymphadenopathy significant sensitivity soft-tissue swelling an ill-defined radiolucency Usually,no radiographic evidence Unless approximately 60 %Demineralization of the bone

On occasion ………… paresthesia of the lower lip drainage exfoliation of fragments of necrotic bone ( sequestrum ). Involucrum the mass of encased nonvital bone that may become surrounded by vital bone, central radiopaque mass of necrotic bone.

Chronic osteomyelits If acute osteomyelitis is not resolved or primarily without a previous acute episode. Swelling Pain sinus formation purulent discharge, sequestrum formation tooth loss pathologic fracture. a patchy, ragged, and ill-defined radiolucency often contains …….. central radiopaque sequestra.

Histopathologic Features Generation of biopsy is not common ….. predominantly liquid content and lack of a soft-tissue component. When submitted, the material consists ……………. necrotic bone. a loss of the osteocytes from their lacunae acute osteomyelitis Normal woven bone

bacterial colonization Necrotic debries

acute inflammatory infiltrate consisting of PMNs.

Chronic osteomyelitis a significant soft-tissue component that consists of chronically or subacutely inflamed fibrous connective tissue filling the intertrabecular areas of the bone.

irregular fragment of devitalized bone surrounded by dense fibrous tissue heavily infiltrated by plasma cells, lymphocytes, and only a few granulocytes

Acute osteomyelitis …… 1.antibiotics 2. drainage. Treatment and Prognosi s 1.similar antibiotics ……..but intravenously in high doses. Chronic osteomyeliti s. 2.Surgical removal of all infected material surgical down………….. to good bleeding bone.