Management of mandibular osteomyelitis with segmental resection, nerve preservation, and immediate reconstruction

Cancellous Tibial Bone Graft for Malunion after Mandibular Reconstruction in Head and Neck Cancer

“…Although radiation can impair wound healing and lead to nonunion, our data suggest that for very small defects, reconstruction can still be successful with cancellous bone grafts. In addition to irradiated patients, we have also corroborated that nonvascularized grafts can be successfully utilized in reconstruction after osteomyelitis debridement 34 . The most common complication presented in this previous paper was pathologic fractures however segments resected were much larger, up to 7.1 cm 34 …”

“…In addition to irradiated patients, we have also corroborated that nonvascularized grafts can be successfully utilized in reconstruction after osteomyelitis debridement. 34 The most common complication presented in this previous paper was pathologic fractures however segments resected were much larger, up to 7.1 cm. 34 Another way our cohort differs from previous studies is that 33% had ORN in addition to bony nonunion.…”

“…34 The most common complication presented in this previous paper was pathologic fractures however segments resected were much larger, up to 7.1 cm. 34 Another way our cohort differs from previous studies is that 33% had ORN in addition to bony nonunion. Current mainstays of therapy for ORN after failed conservative measures are vascularized bone containing free flaps because radiation can potentially prevent successful union to a nonvascularized graft.…”

Mandibular osteomyelitis after hyaluronic acid injection

“…First, the paresthesia of the patient's right mandibular skin and lower lip meant the function of right inferior alveolar nerve was affected, suggesting the presence of infection around the right mental foramen 12 . Also, bone destruction, sequestrum formation, and tissue calcification on CBCT scan were the characteristic manifestations of chronic osteomyelitis, thereby confirming the diagnosis 8,13 . Thorough removal of the infected bone was the critical treatment 14 .…”

Local treatment of experimental mandibular osteomyelitis with an injectable biomimetic gentamicin hydrogel using a new rabbit model

“…Diagnosis of mandibular OM is based on the clinical presentation and patient history, imaging techniques, bacterial culture, and histologic examination 6 . Surgical debridement, mandibular decortication, or resections, in parallel with a long‐term systemic antibiotic are traditionally necessary procedures for sufficient removal of necrotic tissue and for the prevention of recurrent infection 2,7 . The long term antibiotic therapy of mandibular OM is often challenged by the dynamic nature of a polymicrobial flora, ability of the antibiotic to penetrate the bone, 8 antibiotic resistance, and adverse effects that may necessitate discontinuation of therapy 9,10 .…”