Actinomycotic Osteomyelitis of the Maxilla in a Patient on Phenytoin

Agha‐Hosseini, Farzaneh; Hoseini, Elaheh Ghasemzadeh; Mahdavi, Nazanin

doi:10.18502/fid.v19i3.8511

Cited by 4 publications

(8 citation statements)

References 18 publications

(55 reference statements)

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“…leads to actinomycosis infection. In addition, poor oral hygiene, non-healing extraction socket, and surgical manipulation may facilitate the entrance of Actinomyces deeper into the oral mucosal regions [ 5 , 11 ]. This is concurrent with our principle finding of ORN and MRONJ that they were further complicated by actinomycosis infection under conditions that led to deeper tissue access by this microorganism.…”

Section: Discussionmentioning

confidence: 99%

“…Within this anaerobic environment, the vascular supply is destroyed and replaced by irregular, granular tissue, or sulphur granules, which is evident microscopically and this is a very important criterion in the diagnosis. This synergistic role is important since actinomyces have low virulence and invasiveness due to the lack of hyaluronidase enzyme which is responsible for host tissue degradation [ 5 ]. The destruction of host tissue is beneficial for these “companion microbes”, in providing nutrients and Fe 2+ ions for these co-pathogen bacteria.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, the role of biofilm in this chronic infection is significant in promoting recurrence and protecting against the diffusion of antibiotic molecules. Strong biofilm production was evident involving several Actinomyces species like A. israelii, A. naeslundii , and A. viscosus [ 1 , 5 ].…”

Section: Discussionmentioning

confidence: 99%

“…Risk factors of ONJ with concomitant actinomycosis include patients with poor oral hygiene, a history of mucosal trauma post-dental extraction, male gender, diabetes, immunosuppression, and malnutrition. MRONJ patients were reported to be on antiresorptive agents like bisphosphonates or denosumab [ 4 , 5 ] or chemo-therapeutic agents and other immunosuppressive drugs [ 5 ], while the ORN patients were patients with a history of radiation therapy to the head and neck. To date, literature has described various antibiotic regimes for MRONJ as well as ORN patients.…”

Section: Introductionmentioning

confidence: 99%

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Actinomyces sp. Presence in the Bone Specimens of Patients with Osteonecrosis of the Jaw: The Histopathological Analysis and Clinical Implication

et al. 2022

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Medication-related osteonecrosis of the jaw (MRONJ) and osteoradionecrosis (ORN) are two similar bone pathologies in the jaw with different aetiologies. Actinomycosis is a relatively rare oral infection caused by the Gram-positive anaerobe Actinomyces sp. that normally colonizes the oral cavity. Actinomycosis is associated with the pathogenesis of both the MRONJ and ORN, as evident in our cases, and not just as a superficial contaminant. The clinical and histopathological aspects of the cases treated in our centre were also reported with a review of the literature. Clinical implication on the treatment of the cases was highlighted in view of the presence of this microorganism.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Actinomyces sp. Presence in the Bone Specimens of Patients with Osteonecrosis of the Jaw: The Histopathological Analysis and Clinical Implication

et al. 2022

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“…In this clinical case we observed not advanced symptoms for osteomyelitis, which was caused by the anatomic site of the disease (upper jaw that has better system of blood supply) and young age of individual. Usually severity and involving bone volume by osteomyelitis depend on the systemic condition of the patient, which deteriorates the stream of the disease (diabetes mellitus, obesity, malnutrition, blood diseases, and medicines consumption) (15)(16)(17)(18).…”

Section: Explanations Of Findingsmentioning

confidence: 99%

A case report of a rare course of secondary chronic odontogenic osteomyelitis of the upper jaw in a young patient

Skrypnyk¹,

Skikevych²,

Petrushanko³

2024

Front Oral Maxillofac Med

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Background: Chronic jaw osteomyelitis is an inflammatory disease of the entire bone which results in jaw destruction and sequestrum formation, usually it`s more common in the lower jaw. Only a few clinical cases have documented the development of chronic odontogenic osteomyelitis on the upper jaw that is why the clinical course of the disease is variable and not typical in different patients. A quite rare variant of chronic maxilla osteomyelitis manifestation in a healthy young individual that was undiagnosed for a long time is presented in this case report.Case Description: This clinical case report demonstrates a secondary chronic odontogenic osteomyelitis of the upper jaw in a young male individual. A patient has complains of the presence of the hard formation in the vestibular alveolar bone of the right upper jaw, enlargement of the cervical lymph nodes on the right side, high body temperature. On examination the face asymmetry was observed, swelling of the soft tissues on the right side, cervical lymphadenitis on the right side and poor oral hygiene. A mucosal defect and exposed bone with a diameter of 1.5 cm was detected on the vestibular surface of alveolar bone, the oral mucosae around the defect was hyperaemic and swollen. Tooth 1.6 was dark in color with a large filling on the occlusal surface, painful percussion, class 1 mobility. Cone beam computed tomography was performed to diagnose changes in the bone and maxillary sinus. The treatment of a patient was significantly complicated because of financial factor. After 10 days of postoperative treatment complete wound healing was observed, with the occurrence of alveolar bone deformation. Conclusions:A not typical clinical course for young age healthy individual of the upper jaw osteomyelitis is presented. Therefore, a disease was undiagnosed for a long time during the regular check-ups by general dentists. Taking in account a difficult financial status, young age, good health of a patient, an optimal treatment method of the upper jaw chronic osteomyelitis was provided, using minimal invasive and defectoriented approaches of surgical treatment.

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Extensive Sequestration Chronic Maxillary Osteomyelitis in an Uncontrolled Diabetic Patient: Comprehensive Case Management of a Rare Entity

El Fadhlallah,

Nugraha,

Prasetio

et al. 2023

Eur J Dent

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The hallmark of osteomyelitis was progressive bone destruction and sequestrum formation. In the underlying disease, like diabetes mellitus, osteomyelitis becomes severe and exacerbates the condition. It was essential for the oral and maxillofacial surgeon to comprehend its complex medical and surgical management to achieve complete disease eradication. The aim of this article was to report a rare case and comprehensive management of extensive sequestrating maxillary osteomyelitis with uncontrolled diabetes mellitus patients. A 58-year-old male patient with pain and swelling accompanied by discharge of pus in the sinistra maxilla region. The systemic disease was identified as uncontrolled diabetes mellitus, and had a history of unhealing wounds 1 year ago after upper left molar extraction. Computed tomography scan result showed extensive sequester formation and bony destruction in the right extending to the left maxilla. Microbial culture results were Klebsiella pneumoniae and Morganella morganii. Subsequently, extensive sequestrectomy and multiple extractions of the involved jaw and teeth were performed after diabetes mellitus was regulated. A suspension suture against oral and nasal mucosa was performed to avoid dead space formation. Comprehensive perioperative management in maxillary osteomyelitis in uncontrolled diabetes mellitus includes sequestrectomy, definitive antibiotic therapy based on culture results, and diabetes regulation to improve the successful management of this case.

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Actinomycotic Osteomyelitis of the Maxilla in a Patient on Phenytoin

Cited by 4 publications

References 18 publications

Actinomyces sp. Presence in the Bone Specimens of Patients with Osteonecrosis of the Jaw: The Histopathological Analysis and Clinical Implication

Actinomyces sp. Presence in the Bone Specimens of Patients with Osteonecrosis of the Jaw: The Histopathological Analysis and Clinical Implication

A case report of a rare course of secondary chronic odontogenic osteomyelitis of the upper jaw in a young patient

Extensive Sequestration Chronic Maxillary Osteomyelitis in an Uncontrolled Diabetic Patient: Comprehensive Case Management of a Rare Entity

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