アブストラクト（23巻2号：The Bulletin of Kanagawa Dental College）

The Bulletin of Kanagawa Dental College

English

Title　： The Treatment and Clinical Observation of Chronic Osteomyelitis of the Mandible
Subtitle　： BKDC CLINICAL AND RESEARCH TOPICS INFECTION
Authors　： Yuji Ogawa, Yuuichi Sasakura, Junichi Shindo
Authors（kana）　：
Organization　： First Department of Oral and Maxillofacial Surgery, Kanagazva Dental College
Journal　： The Bulletin of Kanagawa Dental College
Volume　： 23
Number　： 2
Page　： 129-134
Year/Month　： 1995 / 9
Article　： Report
Publisher　： Kanagawa Odontological Society
Abstract　： [Abstract] Chronic mandibular osteomyelitis (CMO) is an inflammatory disease that is resistant to treatment. This paper describes 16 cases of CMO that were treated in our hospital between 1986 and 1992. The discussion includes various methods of treatment. An insufficient inferior alveolar artery (IAA) blood supply as determined by angiography also played a role in CMO. In the above cases, CMO was caused by several different dental diseases. 1. Ten cases were diagnosed histopathologically as suppurative osteomyelitis ; the remaining six cases were determined to be sclerosing osteomyelitis. The biggest subgroup consisted of female patients in their forties. The most frequent tooth involved was the mandibular molar. 2. Patients with suppurative osteomyelitis showed characteristic symptoms : a) short duration of disease, b) local infection, c) pus discharge, and d) fistula formation. Sequestrectomy was most frequently used as a corrective procedure. Decortication combined with sequestrectomy was used in all cases with sclerotic changes of bone cortex. 3. Sclerosing osteomyelitis was clinically characterized by a long duration of the disease, diffuse sclerotic changes on X-rays, and associated trismus. Among four cases of sclerosing osteomyelitis that underwent angiography of the IAA, three cases showed deformities. Therefore, angiography seemed to be a useful procedure to forecast the prognosis because it evaluates the blood supply into the mandible. Consequently, a decreased blood supply might indicate a poor response to antibiotic therapy. In cases without IAA deformity, decorticotomy alone was sufficient for treatment. On the other hand, in the cases of IAA deformity, treatment included a combination of intra-arterial antibiotic infusion and decorticotomy or saucerization. The above procedures resulted in cure in all but one case of CMO.
Practice　： Dentistry
Keywords　： Chronic mandibular osteomyelitis, Decortication, Intra-arterial antibiotic infusion, Saucerization, Angiography