Jaw osteomyelitis - this is purulent necrotic process infectious nature, which develops in the bone, as well as in the tissues surrounding it. The inflammatory process begins to develop actively after an infection enters the bone tissue.
Several types of jaw osteomyelitis are distinguished, taking into account the source of infection. Odontogenic osteomyelitisjaw is a serious complication of neglected tooth decay. According to statistics, this type of osteomyelitis is diagnosed in about 75% of cases. The disease develops after the infection from the cavity penetrates into the pulp, and then into the root of the tooth. Further, it also captures bone tissue. In approximately 70% of cases, osteomyelitis affects the lower jaw, in other cases the upper jaw is affected. The main reason for the development of this disease is the effect of microorganisms of three groups: staphylococcus, streptococcus, anaerobic bacteria. Pathogenic microbes enter the bone tissue through the lymphatic vessels and through the bone tubules.
Hematogenous osteomyelit - a consequence of infection of bone tissue with an infection transferred by a blood stream from the primary focus in which the inflammatory process developed. This form of the disease may develop due to chronic tonsillitis, as well as other foci of chronic infection. Acute infection, for example, diphtheria, scarlet fever and other diseases can also cause osteomyelitis of the jaw. With hematogenous osteomyelitis, part of the body of the bone is initially affected, and only after that inflammation can also affect the teeth. This form of the disease is less common.
Traumatic osteomyelitis manifested in a patient due to fractures or wounds through which the infection gets. The prevalence of this form of the disease is small.
Osteomyelitis of the jaw is also divided into several types, depending on the characteristics of the clinical picture. it spicy, subacute and chronic forms of osteomyelitis of the jaw. In this case, the severity of inflammatory processes is assessed.
With the development of acute jaw osteomyelitis in the patient, a general pronounced reaction of the body to infection is observed. A person is bothered by general weakness, a headache, and he does not sleep well. Body temperature rises to 38 degrees, in some cases it can rise even higher. If the body temperature indicators for osteomyelitis of the jaw remain normal, then this may indicate that the person has a weakened body, and protective forces are not acting enough. In the acute form of the disease, the patient may be in a relatively mild or serious condition.
First symptom acute forms of odontogenic osteomyelitis are manifestations of pain in the area of the tooth that has been infected. The pain is greatly aggravated by tapping the tooth. At the same time, its easy mobility is manifested. Neighboring teeth can also move. Edema of the mucous membrane next to the tooth is visible, in addition, it becomes reddish and loose. Sometimes develops subperiosteal abscess. The pain gradually passes from one affected tooth to the neighboring ones; signs of the inflammatory process of periodontal teeth appear. In this case, pain can be given to the ear, temple, orbit. With osteomyelitis of the lower jaw, the sensitivity of part of the lower lip, oral mucosa, and chin skin may be impaired. If the patient develops a purulent inflammatory process in the periandibular soft tissues, then the pain goes beyond the jaw.
The lymph nodes enlarged in the neck, palpation manifests their soreness. Signs of intoxication of the body are also manifested in the appearance of a person: the skin acquires a gray tint, facial features are sharpened. If the liver and spleen are drawn into the intoxication process, yellowness of the sclera of the eyes may be noted. Kidney damage leads to the appearance in the urine of protein and red blood cells. There may be fluctuations in blood pressure - both rise and decrease. At first, it is difficult to diagnose jaw osteomyelitis due to the fact that general symptoms prevail over local symptoms.
Subacute osteomyelitisusually develops after the acute form subsides. In this state, a person feels that his condition is improving, since pus breaks out of bone tissue. In this case, the inflammatory process continues, and the destruction of bone tissue does not stop.
Chronic osteomyelitis can occur for a long period - for several months. Against the background of an external improvement in the patient's condition, osteomyelitis exacerbates, a new fistula forms, dead sections of bone tissue are rejected, and sequesters appear. The jaw is flattened at the site of the pathological focus, the teeth remain mobile. With this development of the disease, an independent cure does not always occur.
In the process of diagnosing jaw osteomyelitis, the doctor initially studies the clinical picture of the disease by examining and interviewing the patient. Next, an X-ray examination is performed. But in the osteomyelitis process, the spongy bone is mainly affected, so the information obtained during the X-ray examination is not always complete. If the pathological process develops rapidly, then the destruction of the cortical layer of the bone occurs, which can be determined by x-rays. The identification of sequestration is of great diagnostic value.
Treatment of osteomyelitis of the jaw is carried out immediately after the diagnosis and determination of the form of the disease. If the patient has obvious symptoms of jaw osteomyelitis, it is necessary to immediately take measures to prevent the spread of inflammation to areas near the lesion. Regardless of whether there is a lesion of the lower or upper jaw, with a odontogenic form of the disease, the tooth is necessarily removed, in which the inflammatory process began. With a hematogenous or traumatic form of osteomyelitis, it is initially required to eliminate the root cause of the disease. Consequently, infectious diseases and injuries are treated.
Thus, if the patient is diagnosed with acute odontogenic osteomyelitis, then the inflammatory purulent lesion in the bone and in the tissues surrounding it is initially eliminated. Drugs aimed at improving the condition of the human body as a whole are also prescribed.
Surgical intervention is also practiced: with osteomyelitis of the upper and lower jaw, the focus of infection in the bone is drained. Initially, a tooth is removed, due to infection of which the disease manifests itself. If the patient has periandibular abscesses and phlegmon, dissection of the soft tissues is carried out, as well as subsequent dialysis of the wound. If the patient is diagnosed with acute or chronic jaw osteomyelitis, anti-inflammatory treatment is necessary by prescribing antibiotics. Such therapy is carried out in parallel with surgery.
The treatment of acute jaw osteomyelitis is carried out only in a hospital. In addition to surgical and anti-inflammatory treatment, stimulating, general strengthening, symptomatic therapy is practiced.
It should be noted that the earlier the tooth is removed in the acute form of the disease, the lower the risk of further spread of the inflammatory process, and the faster the inflammation stops. In the presence of movable teeth, a special splint or braces are used to strengthen them. If a purulent wound remains after tooth extraction, it is necessary to ensure proper care for it. For this, washing, irrigation with antiseptic solutions is used.
Complex therapy involves the intake of vitamin complexes, which should include B vitamins, vitamin C. In the process of treatment, it is important to provide the patient with constant, plentiful drink, and protein and vitamin-containing products should prevail in the diet. It is important to carefully conduct the toilet of the oral cavity every time after eating.
Treatment of a chronic form of osteomyelitis of the jaw is carried out depending on the manifestation of the symptoms of the disease. If the treatment of the disease is carried out in a timely manner and correctly, then we can talk about a favorable prognosis.
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Preventive measures include general improvement, strengthening immunity, timely treatment of dental diseases, and prosthetics. It is important to visit the dentist at least once a year for routine examinations. Also should not be delayed with the treatment of infectious ailments. In this case, special attention should be paid to the treatment of infectious diseases of the upper respiratory tract. An equally important preventive measure is to ensure daily good oral hygiene, as well as protection against facial injuries.
Osteomyelitis of the jaw can cause complications that cause great harm to human health. With an advanced disease, development is possible sepsis, the inflammatory process of the soft tissues of the face and neck (phlegmon) Also, osteomyelitis can result in deformation or fracture of the jaw. If the purulent process spreads to the area of the face, this can lead to the development of sinuses of the hard shell of the brain, phlebitis of the veins of the face. With upstream propagation may develop meningitis, brain abscess. Sometimes complications lead to disability of the patient, and in especially severe cases - to death.
Diet, nutrition with osteomyelitis of the jaw
Diet 15 table
- Efficiency: therapeutic effect after 2 weeks
- Dates: constantly
- Product Cost: 1600-1800 rubles a week
List of sources
- Shargorodsky A. G. Inflammatory diseases of the maxillofacial region and neck / A. G. Shargorodsky. - M.: GEOTAR-MED, 2002;
- Tsarev V.N., Ushakov R. V. Antimicrobial therapy in dentistry: A guide. - M.: Medical News Agency, 2004;
- Robustova T.G. Odontogenic osteomyelitis of the jaws // Surgical dentistry and maxillofacial surgery. National Leadership / Ed. A.A. Kulakova. T.G. Robustova, A.I. Nerobeeva. - M.: GEOTAR-Media, 2010;
- Afanasyev V.V. Traumatology of the maxillofacial region. M .: GEOTAR-Media, 2010.