Osteomyelitis of the jaw: pictures, causes, symptoms, treatment
Osteomyelitis of the jaws — what is it? What are the causes of the disease, what are symptoms and what methods produce the treatment?
Osteomyelitis of the jaw is a serious disease involving inflammation process with the accession of infection that affects not only the jaw, but in General the entire skeletal system. It is more common in persons 20 to 40 years old, usually male. As a rule, addressed the lower jaw.
► Classification of pathological condition takes into account several criteria:
- the etiology of inflammation;
- the severity of the disease;
- the localization of the source;
- pathways of the pathogen.
► The type of the causative agent of osteomyelitis of the jaw is divided into:
- Nonspecific (pathogens — pathogenic microorganisms that are living in normal conditions of mucous membranes, and skin. These include staphylococcal and streptococcal flora);
- Specific (caused by a specific bacteria, these include the following types: syphilitic, or tuberculous actinomycetaceae).
► According to the method of penetration of an infection into organism we can distinguish the following types of pathology:
- traumatic osteomyelitis develops in wounds or fractures of the jaw. In the damaged area penetrates bacteria and various viruses. This pathology is quite rare, usually a complication of fractures of the facial bones;
- odontogenic — the most common cause are the complications of dental disease (deep caries, stomatitis, alveolitis either. Open the gates for infection become affected tissue, then she gets into the pulp, reaches the root and moves to the tissue of the jaw. This type of osteomyelitis can occur in adults and in children;
- hematogenous (divided, in turn, toxic, septikopiemicheskoy, local). Caused by blood poisoning that spread the virus throughout the body. Develops most often due to osteomyelitis in the chronic form;
- radiation — occurs when tissue damage the jaw bone malignant tumor. Can also be caused by a course of radiation or chemical therapy. The infection, once in the hearth, provokes the development of purulent and necrotic processes;
- due to the removal of tooth with partial removal of the tooth nerve is irritation and further suppuration of the cavity, resulting in serious consequences.
► The nature of the flow klassificeret osteomyelitis:
- In the acute stage.
- Chronic (it can be primary or secondary).
► At the location of the lesion distinguish osteomyelitis of the upper jaw and lower.
Video: what is osteomyelitis?
Why there is osteomyelitis of the jaw? For penetration of an infection into organism with a favourable for the progression of the disease conditions there are not too many chances. Here are the main ones:
- disease infectious and viral nature with protracted chronic course;
- not fully cured periodontitis with various complications;
- infection with the acute course and concomitant inflammatory process;
- various injuries (fractures, wounds);
- after removal of the tooth;
- entering through the blood plasma (maybe if transfusions or injections).
The signs of the disease are determined by its form.
Acute osteomyelitis of the jaw
Usually characterized by sudden onset of sharp temperature rise. Marked headache, feeling of weakness and weakness, disturbed sleep, lost appetite. Increased lymph nodes.
✦ Acute odontogenic osteomyelitis is characterized by pain around the affected tooth. Gradually it spreads, giving in the temple, the ear or the eye socket. Painful tooth and neighbouring gain mobility, revealed swelling of the oral mucosa. It is also possible asymmetry of the face.
✦ Such symptomatology is characteristic for the most common types of acute osteomyelitis — local and septikopiemicheskoy.
✦ It is also possible the development of more dangerous and rare form is toxic, in which there is a temperature to 40 degrees and disturbances of consciousness.
The pain of osteomyelitis, damaging the lower jaw, is concentrated in the region of the lower teeth. Increased lymph nodes in the neck, lower part of the face may be numb.
During the acute stage in urgent need of diagnosis and treatment, as otherwise the possible complications. In particular, can hurt the liver and spleen.
The human condition in this period is improved, decrease pain. Fistulas are formed, through which the outflow of purulent content. May increase tooth mobility. The patient may seem that the disease is receding, but in fact, inflammatory processes are gaining momentum.
This form can develop as a primary process or as a result of acute osteomyelitis. This kind of disease difficult to cure and is threatened by various complications, although for some time the patient may appear to be., he made a full recovery.
Chronic osteomyelitis of the jaw is atypical or primary (this form develops without significant acute period) and secondary (a consequence of the acute form).
✦ Causes the development of secondary infection are:
- delayed treatment in a hospital or self-treatment;
- weakened immunity due to injuries, stress, infections;
- incorrect diagnosis and wrong treatment.
✦ Primary chronic osteomyelitis
History of the disease is characterized by atypical patterns of manifestations. Represented by several fairly rare atypical forms, which are often observed in children and rarely affect the bones of the jaw.
- multifocal relapsing — more common in young children, the pathogenesis and etiology of the disease has not been elucidated. In bone tissue many forms of destructive lesions without sequestration and abscesses. There are signs of inflammation, but bacterial infection is not joining. The disease is protracted, periods of remission alternating with exacerbations;
- the Garre osteomyelitis (sclerosing) — there is sluggish inflammatory process in the bone tissue. The symptoms are mild, signs of inflammation and purulent infection present, but the formation of cavities and sequesters. Also, there is a compaction of bone tissue, x-ray study noted osteosclerosis;
- Brodie abscess in the bone tissue is formed bounded by a cavity containing liquid pus and granulation. The disease may last for years, and since no real complaints, it is difficult to diagnose. Typically assigned to the conservative treatment;
- albuminuria osteomyelitis, Ollie is a rare form of the disease caused by Staphylococcus aureus. In the tissue there are small sizes of the cavity, but without suppuration, serous fluid, in which there is a high concentration of protein. Few pronounced clinical signs;
- dysmorphology osteomyelitis occurs among injecting drug users. Observed slowly advancing suppurative destruction of the jaw bone, caused by the influence of drugs and deterioration of blood supply to the tissues. Often the destruction is spread over a vast region of the jaw, causing deformation of the face and disfigurement.
Osteomyelitis of the maxilla is much less frequent. Its symptoms are the same for adults and children: discomfort, swelling, and deformity of the face, a sharp rise of temperature.
Video: more on osteomyelitis.
Symptoms in children
The disease is extremely dangerous for kids an early age, as it develops rapidly, all the symptoms are pronounced. It is very important not to miss time to put the correct diagnosis and appoint adequate treatment.
Osteomyelitis in young children manifests itself is often secondary on the background of sepsis, and rarely the development pattern of sepsis occurs against SARS. Main symptoms of the disease for kids and adults the same, but in infants the symptoms are pronounced, and the symptoms are growing rapidly:
- disease begins with a sharp rise in temperature to 39 — 40 degrees;
- the child has lost appetite, he’s cranky, crying;
- swells the face (cheeks, nose, eyes);
- the swelling increases during the day, eyes closed, smoothed nasolabial folds, there is asymmetry of face;
- edematous skin is bright pink, in the touch painful;
- with the affected hand increased lymph nodes;
- over the next three days the swelling spread to the neck;
- in the beginnings of baby teeth develops suppuration, marked separation of the sequestrum;
- overlaps due to swelling of the nasal passage, preventing the child to breathe fully, there is discharge of purulent content;
- on alveolar bone formed in local infiltrates, softens mucosa appear redness and fluctuation;
- by about the fifth day in the sky, and the rudiments of teeth in the nasal cavity formed fistulas;
- inflammation quickly spread to the eye socket, causing severe pain and abscesses of the eyelids. May develop abscess of the orbit.
When failure to provide timely care may experience many serious complications (pneumonia, meningitis, pleurisy, sepsis, etc.).
Photos and x-rays
At the first signs of the disease need to seek medical care in dental clinic. Diagnosis is based:
- On the clinical picture.
- Data on visual inspection.
- X-ray pattern.
- Blood tests.
In the acute phase x-ray examination is uninformative. Only a week later in the picture you can see a blurry speck, indicating changes in tissue structure jaw bone resulting in the formation of a purulent focus.
Osteomyelitis of the jaw: treatment
How to treat the disease? The main task is to stop the suppuration and necrosis, recovery of bone tissue and its functions. Because osteomyelitis is a pathology not a local, and in generalization of infection the malfunction of many organs, reduced immunity and deteriorate, along with surgical intervention is relief of inflammation and restoration of the affected organs.
The appointment of treatment must take into account the individual characteristics and the extent of the disease. For example, specific varieties of pathology treatable only in combination with treatment of the underlying disease (e.g., tuberculosis, syphilis, etc.).
When hematogenous and traumatic form eliminated the main reason: removed a tooth, located in the gap of the fracture or its fragments, produced debridement of purulent wounds and is infectiony therapy.
In the diagnosis of odontogenic form is the removal of a tooth, which was the source of infection, autopsy and treatment of purulent cavities, providing conditions for the outflow of exudate.
Treatment, in adults and in children includes antibiotics, detoxication therapy, appointed physiotherapy.
As already mentioned, osteomyelitis of the jaw serious disease that requires serious treatment with medicines. Traditional recipes can be used only as helper methods.
- chamomile is an effective antiseptic. The decoction can be prepared, Bay, 100 g of flowers 2 cups boiling water, after cooling to filter. Broth soaked gauze or cheesecloth and remove purulent accumulations. However, in the acute phase this method is not recommended;
- infusion of lilac dried flowers to fill a quart jar up to the top, pour vodka and put it in 14 days in a dark place. Can be used in the form of compresses, as well as inside (30 drops three times a day);
- Laundry soap (72%) — also used for compresses. Grate it and mix with a large onion. The obtained mixture is superimposed on the sore place;
- tincture of ginseng is suitable for the recovery of the immune system, which suffers from osteomyelitis. 100g fresh minced root pour a liter of vodka and insist month in a dark place. To drink means 15 drops twice a day half an hour before meals.
Video: how to treat osteomyelitis?
For prevention you need to follow some simple rules:
- personal hygiene (teeth brushing, etc.);
- when any diseases of the teeth not to postpone the visit to the dentist;
- time to start the treatment of infectious processes of the upper respiratory tract;
- try to avoid any facial injuries.
► What complications can occur with maxillary osteomyelitis?
It can be:
- abscess (local inflammation of tissue with the formation of purulent cavity);
- cellulitis (diffuse purulent inflammation of soft tissues that do not have clear boundaries);
- sepsis (a severe condition where the infection is carried by blood throughout the body);
- pulmonary failure.
It can also cause pathologic fractures of the jaw, the formation of contractures (loss of mobility).