Temporomandibular Joint Septic Arthritis and Mandibular Osteomyelitis Arising From an Odontogenic Infection: A Case Report and Review of the Literature

Gams, Kevin; Freeman, Phillip N

doi:10.1016/j.joms.2015.11.003

Cited by 18 publications

(14 citation statements)

References 15 publications

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“…Septic arthritis of the TM joint most often occurs in male adults, but it has been reported in infants and children [1] There are three routes of bacteria to the TMJ: hematogenous dissemination from a distant site, local spread and direct inoculation [5] [6] [7] [8] [9]. The TMJ might be inherently vulnerable to hematogenous dissemination from a distant site because the high vascularity of its synovial membrane allows greater exposure to bacteria [11].…”

Section: Discussionmentioning

confidence: 99%

“…Risk factors for the development of septic arthritis can be divided into local and systemic factors [9]. Local factors include blunt trauma, previous joint disease (osteoarthritis, internal derangement), and burn wounds.…”

Section: Discussionmentioning

confidence: 99%

“…During the acute phase of infection, the TMJ should be rested. Jaw opening exercise should be started after the acute phase of infection has passed [1] [9].…”

Section: Discussionmentioning

confidence: 99%

“…The pathogeneses of the infections include hematogenous dissemination from a distant site, local spread and direct inoculation [5] [6] [7] [8] [9]. In this paper, a case of septic arthritis of the TMJ without an apparent source of infection is described.…”

Section: Introductionmentioning

confidence: 99%

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Septic Arthritis of the Temporomandibular Joint without an Apparent Source of Infection: A Case Report

Suda¹,

Takatsuji²,

Saito³

et al. 2017

OJST

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Septic arthritis of the temporomandibular joint (TMJ) is a rare disease that is characterized by preauricular pain, edema, malocclusion, trismus and abscess formation in the TMJ region. An 85-year-old male visited our hospital with the complaint of left-sided TMJ swelling, pain and trismus. Septic arthritis of the left TMJ was diagnosed on the basis of considerable elevation of CRP (Creactive proteins) and CT imaging findings. The patient was treated with oral Faropenem at 450 mg daily, but CRP increased three days after the initial visit. He was hospitalized and treated with intravenous administration of cefazolin at 2 g and clindamycin at 1.2 g daily for six days. Propionibacterium species and Veillonella species grew in a culture of the joint aspirate, but there was no apparent source of infection. After acute infectious symptoms had passed, the patient was treated with oral amoxicillin at 750 mg daily for eight weeks and was instructed to do jaw opening exercise. The patient was discharged on the 11th hospital day. After three weeks of the hospital discharge, the patient healed completely. To avoid serious complications, clinicians should include septic arthritis of the TMJ in the differential diagnosis of preauricular pain, trismus and swelling.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…During the acute phase of infection, the TMJ should be rested. Jaw opening exercise should be started after the acute phase of infection has passed [1] [9].…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Septic Arthritis of the Temporomandibular Joint without an Apparent Source of Infection: A Case Report

Suda¹,

Takatsuji²,

Saito³

et al. 2017

OJST

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“…2 Temporomandibular joint infections can also be caused by contiguous spread from periauricular, odontogenic or masticator infections. 3 Staphylococcus aureus and Streptococci are the leading causes of TMJ septic arthritis 1 ; however, TMJ OM is most commonly caused by Pseudomonas aeruginosa and rarely by fungal pathogens like Candida and Aspergillus species especially in immunocompromised patients. 4 Hematogenous spread to the TMJ was described in some cases with Streptococci being the implicated organism.…”

mentioning

confidence: 99%

Mastoiditis, Osteomyelitis, and Septic Arthritis of Temporomandibular Joint

2020

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A 58-year-old homeless male was brought to emergency department with altered mental status, lethargy, right ear pain, and right ear discharge for the past few days. His past medical history was significant for acquired immunodeficiency syndrome (AIDS) noncompliant with antiretroviral therapy, chronic hepatitis C, chronic kidney disease, and polysubstance abuse especially snorting cocaine. On physical examination, the patient appeared cachectic, in no acute distress. There was tenderness to palpation over the right periauricular area with a visible abscess measured 2 cm Â 3 cm just anterior to the tragus, grossly visible right nasal perforation measuring 1 cm Â 1 cm (Figure 1). Ear, nose, and throat evaluation showed right otorrhea, intact right tympanic membrane, opaque, anterior canal wall erythematous with significant prolapse of the right temporomandibular joint (TMJ) into canal, there was pain with palpation of right TMJ, left external auditory canal was occluded by cerumen. The rest of the physical examination was not contributory. An initial noncontrast computed tomography scan of the head showed possible right mastoiditis and TMJ osteomyelitis (OM) (Figure 2). Magnetic resonance imaging of the head without contrast confirmed these findings along with OM involving the mandibular condyle and septic arthritis of the TMJ (Figure 3). Blood and right ear drainage fluid cultures grew methicillin-sensitive Staphylococcus aureus. The patient was placed on intravenous nafcillin 2 gram every 4 hours. Transesophageal echocardiogram did not reveal any vegetation on the cardiac valves. The patient underwent incision and drainage of the right infected TMJ, arthrotomy, and a biopsy of the mandibular right condyle. During the procedure, pus was noted in the right TMJ space, the right condyle was partially eroded, debris was removed and the joint space was thoroughly irrigated. Bone biopsy pathology showed limited fragments of bone with marrow fibrosis and spindle cells without acute inflammation. Bone biopsy culture isolated rare growth of Candida glabrata after 2 weeks thought to be a contaminant.

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Antibacterial calcium phosphate cement with human periodontal ligament stem cell‐microbeads to enhance bone regeneration and combat infection

Qiu

Huang

Jin

et al. 2021

J Tissue Eng Regen Med

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Infectious bone defects remain a significant challenge in orthopedics and dentistry. Calcium phosphate cement (CPC) have attracted significant interest in use as local drug delivery system, which with great potential to control release of antibiotics for the treatment of infectious bone defects. Within the current study, a novel antibacterial scaffold of chitosan‐reinforced calcium phosphate cement delivering doxycycline hyclate (CPCC + DOX) was developed. Furthermore, the capacity of CPCC + DOX scaffolds for bone regeneration was enhanced by the human periodontal ligament stem cells (hPDLSCs) encapsulated in alginate beads. CPCC + DOX scaffolds were fabricated to contain different concentrations of DOX. Flexural strength of CPCC + DOX ranged from 5.56 ± 0.70 to 6.2 ± 0.72 MPa, which exceeded the reported strength of cancellous bone. Scaffolds exhibited continual DOX release, reaching 80% at 21 days. Scaffold with 5 mg/ml DOX (CPCC + DOX5mg) had a strong antibacterial effect, with a 4‐log colony forming unit reduction against S. aureus and P. gingivalis. The proliferation and osteogenic differentiation of hPDLSCs encapsulated in alginate hydrogel microbeads were investigated in culture with CPCC + DOX scaffolds. CPCC + DOX5mg had no negative effect on proliferation of hPDLSCs. Alkaline phosphatase activity, mineral synthesis, and osteogenic gene expressions for CPCC + DOX5mg group were much higher than control group. DOX did not compromise the osteogenic induction. In summary, the novel CPCC + DOX scaffold exhibited excellent mechanical properties and strong antibacterial activity, while supporting the proliferation and osteogenic differentiation of hPDLSCs. The CPCC + DOX + hPDLSCs construct is promising to enhance bone regeneration and combat bone infections in dental, craniofacial, and orthopedic applications.

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Temporomandibular Joint Septic Arthritis and Mandibular Osteomyelitis Arising From an Odontogenic Infection: A Case Report and Review of the Literature

Cited by 18 publications

References 15 publications

Septic Arthritis of the Temporomandibular Joint without an Apparent Source of Infection: A Case Report

Septic Arthritis of the Temporomandibular Joint without an Apparent Source of Infection: A Case Report

Mastoiditis, Osteomyelitis, and Septic Arthritis of Temporomandibular Joint

Antibacterial calcium phosphate cement with human periodontal ligament stem cell‐microbeads to enhance bone regeneration and combat infection

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