Risk factors of recurrence and life-threatening complications for patients hospitalized with chronic suppurative osteomyelitis of the jaw

Abstract

BackgroundClinically, recurrence and life-threatening complications are challenging problems for chronic suppurative osteomyelitis of the jaw (CSOJ), but there is no quantitative analysis or report about the causes of or risk factors for the two problems to date. Doctors identify the causes or risk factors only through clinical experience. We performed a retrospective study of 322 patients with CSOJ to quantificationally analysed the risk factors for the abovementioned two problems by logistic regression analysis.MethodsA retrospective study of 322 patients hospitalized with CSOJ was performed. The socio-demographic and clinical characteristics were recorded. The risk factors for the above two problems were analyzed by logistic regression analysis. Frequency and percentage were used to indicate descriptive research factors. A univariate logistic regression analysis was performed to calculate the odds ratio (OR) and to identify independent risk factors. The independent risk factors were further identified by multivariate logistic regression analysis.ResultsAn age from 6–12 years or > 65 years, pre-admission antibiotic administration, a lesion at the mandibular ramus, concurrent maxillofacial space infection (MSI), and conservation of pathogenic teeth were found to be risk factors for recurrence. An age > 65 years, admission temperature > 39 degree Celsius, admission white blood cell (WBC) count >15×109/L, pre-admission antibiotic administration, concurrent MSI, pre-existing diabetes, and respiratory difficulty were found to be risk factors for life-threatening complications.ConclusionsThe results indicate that doctors should remain mindful of the risk factors listed above, and the management of CSOJ should be increasingly aggressive when the above risk factors are present, especially when the lesion is located at the mandibular ramus. In addition, pathogenic teeth must be extracted, and antibiotics should be administered properly.Trial registrationClinicaltrials.gov (NCT01670422)

Decompression Effects on Suppurative and Sclerosing Osteomyelitis in the Jaw

“…The standard regimen for jaw OM treatment has been well established in the scienti c literature, which consists of early diagnosis, elimination of infection source, establishment of surgical drainage, bacteriological identi cation, antibiotic therapy, surgical treatment, supportive treatment, and lastly reconstruction 16 . There are a variety of conventional treatment options that include antibiotics, nonsteroidal anti-in ammatory drugs, and hyperbaric oxygen therapy that is used as an adjunctive treatment, but the disease still has a high recurrence rate and life-threatening complications 1,17,18 . Therefore, it is important to establish an effective treatment method for jaw OM.…”

Multislice computed tomography demonstrating mental nerve paresthesia caused by periapical infection: A case report

“…At the 6-month follow-up appointment after the initiation of endodontic treatment, the numbness in the patient’s right lower lip had completely resolved, and the patient was asymptomatic. Given the potential for recurrence, 17 MSCT images were obtained during the follow-up visit. These images revealed no increased attenuation in the adjacent soft tissue and demonstrated the restoration of the fat plane on the buccal aspect of the right mental foramen ( Fig.…”

Osteomyelitis of the condyle secondary to pericoronitis of a third molar: a case and literature review

“…This change can be attributed to increased availability of antibiotics and improvements in oral and dental health standards. However, its incidence in developing countries is still relatively high because of limited oral health knowledge, poor oral hygiene and affordability problems . An effective treatment method for mandibular osteomyelitis is a combination of antimicrobial therapy and surgery consisting of incision and drainage, or sequestrectomy.…”