Identifying Risk Factors Associated with Major Complications and Refractory Course in Patients with Osteomyelitis of the Jaw: A Retrospective Study

Abstract

Despite improved knowledge regarding the diagnosis and treatment of osteomyelitis of the jaw (OMJ), it remains a clinical challenge for oral and maxillofacial surgeons. This study aimed to identify risk factors associated with severe forms of OMJ, i.e., related to the occurrence of major complications or the refractory course of the disease. A retrospective study was performed based on the medical records of all patients diagnosed with OMJ from the past 20 years. Collected data included demographic information, medical and dental history, clinical, radiological, and bacterial findings as well as treatment modalities. The main outcome variables were the onset of major complications and treatment results. Fifty-four patients were included. Our results showed that alcohol and smoking habits, as well as malnutrition, were significantly associated with the occurrence of major complications. We also established that dental implant-induced OMJ should be considered an aggressive subtype of OMJ. Finally, clinical bone exposure was significantly associated with unfavorable outcomes, whereas dental causes or radiological evidence of periosteal reaction were predictive of successful outcomes. Identifying such factors could be useful in preventing serious complications and informing patients about the refractory course of the disease based on the presence of these factors.

Gingival Necrosis Related to Sepsis-Induced Agranulocytosis Due to Pseudomonas aeruginosa Bacteraemia: A Case Report

“…As the oral cavity provides a favourable environment for microorganisms to flourish [ 30 ], and as local intra-oral bacterial challenges could not be contained due to her neutropenia, this resulted in rapid cell and connective tissue destruction of her marginal gingiva and alveolar bone exposure [ 6 , 7 ]. Bacteria colonisation on the exposed bone may have stimulated bone necrosis [ 31 , 32 , 33 ] and, combined with possible low-grade trauma to her upper right anterior region, resulted in a localised abscess and bone sequestrum six months later.…”

Mandibular Fracture following Dental Implant Protocol: Clinical Report and One-Year Follow-Up

“…The limited literature on the subject always points to the atrophic mandible associated with age-related bone loss, peri-implantitis, and iatrogenesis as the causes of these fractures [15]. Mandibular fractures with chronic bone infection, known as osteomyelitis, are difficult to treat and carry a higher risk of local and systemic complications that disrupt and prolong any proposed treatment [17,18]. Particularly in cases of oral rehabilitation where bone healing is desired, such as dental implant surgery, the presence of a localised infectious process with necrotic bone detachment makes such treatment impossible.…”