Maxillary Osteomyelitis: A Rare Entity

Abstract

Osteomyelitis of the maxilla is now a rare event with the advent of antibiotics. The two predominant causes are odontogenic infections and sinusitis. Immunocompromised states such as diabetes, HIV, and malnutrition increase the risk of osteomyelitis. It is important to recognize this early as it is a difficult entity to treat with potentially serious consequences. We report an unusual case of right sided maxillary osteomyelitis in a lady with poorly controlled diabetes in rural Lincolnshire. Biopsy of the right maxillary bone showed features of acute osteomyelitis. This responded well to a prolonged course of oral antibiotics.

Destructive maxillary radiolucency in a 20-year-old female

“…Maxillary osteomyelitis is rare, given the widespread availability of antibiotics and the excellent vascularity of the area; however, when it does occur, it is most often caused by either dental infections or sinusitis. 2 The mandible is more frequently involved compared with the maxilla because the former is less vascular, has thicker cortical plates, and has less abundant medullary outflow. Osteomyelitis is generally seen among those with underlying immunosuppression or a tendency for poor wound healing.…”

Palatal actinomycosis osteomyelitis–Complication of impacted tooth in a diabetic

“…Osteomyelitis of the maxilla although rarer now due to the advent of antibiotics, can occur in immunocompromised states such as diabetes, HIV, and malnutrition . Note that 68% of cases of maxillary osteomyelitis are related to diabetes mellitus as hyperglycemia weakens the immune system by altering the blood flow to the maxilla .…”

“…3 Osteomyelitis of the maxilla although rarer now due to the advent of antibiotics, can occur in immunocompromised states such as diabetes, HIV, and malnutrition. 4 Note that 68% of cases of maxillary osteomyelitis are related to diabetes mellitus as hyperglycemia weakens the immune system by altering the blood flow to the maxilla. 5 The chronic hyperglycemia of uncontrolled diabetes mellitus induces a cascade of events © 2019 Special Care Dentistry Association and Wiley Periodicals, Inc. that promote changes in various tissues that are associated with wound healing problems and greater susceptibility to infections like actinomycosis.…”

Maxillary Osteomyelitis in a Patient with Pansinusitis and Recently Diagnosed Focal Segmental Glomerulosclerosis

“…In the case of osteomyelitis of the jaw, it usually results from odontogenic infections that spread contiguously and infect bone [1]. Although osteomyelitis of the jaw is a relatively uncommon phenomenon, the mandible is much more susceptible to infection as compared to the maxilla due to the fact that the cortical plates of the mandible are thin and blood supply to the tissue in the medullary area is poor [2]. When osteomyelitis of the jawbones does occur, there is usually an identifiable predisposing factor, such as fracture, history of irradiation, diabetes mellitus, human immunodeficiency virus (HIV), steroid therapy, malnutrition, chemotherapy, or other causes, leading to an immunocompromised status [2].…”

“…Although osteomyelitis of the jaw is a relatively uncommon phenomenon, the mandible is much more susceptible to infection as compared to the maxilla due to the fact that the cortical plates of the mandible are thin and blood supply to the tissue in the medullary area is poor [2]. When osteomyelitis of the jawbones does occur, there is usually an identifiable predisposing factor, such as fracture, history of irradiation, diabetes mellitus, human immunodeficiency virus (HIV), steroid therapy, malnutrition, chemotherapy, or other causes, leading to an immunocompromised status [2]. The most common presenting symptom of maxillary osteomyelitis is severe mandibular pain, which may be accompanied by anesthesia or hypoesthesia of the affected side [3].…”