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      Osteomielitis crónica supurativa en el maxilar superior: reporte de un caso clínico Translated title: Chronic osteomyelitis suppurative in the maxilar superior: report of a clinical case

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          Abstract

          La Osteomielitis es una infección del tejido óseo que involucra a todas las estructuras del hueso provocada por microorganismos. El cuadro clínico se caracteriza generalmente por la presencia de fístula de drenaje, dolor intenso, inflamación, movilidad de los dientes involucrados en la zona afectada, fiebre y edema. El tratamiento consiste en medicamentoso y/o quirúrgico. En este artículo se presenta un caso de Osteomielitis crónica supurativa en el maxilar superior, que acomete a un paciente del sexo femenino de 82 años, en el cual se discuten los aspectos diagnósticos e histopatológicos como el tratamiento correspondiente del caso.

          Translated abstract

          Osteomyelitis is an infection of bone tissue that involves all structures of the bone caused by microorganisms. The clinical picture is generally characterized by the presence of fistula drainage, severe pain, swelling, mobility of teeth involved in the affected area, fever and edema. Treatment involves medication and / or surgery. This article presents a case of chronic suppurative osteomyelitis in the maxilar superior of a female 82 years old patient, as well as a discussion of clinical and histopathological aspects and the treatment employed.

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          Most cited references20

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          Florid cemento-osseous dysplasia and chronic diffuse osteomyelitis Report of a simultaneous presentation and review of the literature.

          Infection, neoplasia and bone dysplasias cause alteration in bone architecture. Florid cemento-osseous dysplasia (FCOD) and chronic diffuse osteomyelitis (CDO) are two independent disease processes that may have overlapping clinical and radiographic characteristics. Differential diagnosis can be crucial, as the course of each process and its clinical management varies. A patient reported to the oral and maxillofacial radiology clinic at the University of Medicine and Dentistry of New Jersey's New Jersey Dental School with a complaint of chronic pain in the mandible. One of the authors (S.R.S.) obtained a panoramic radiograph. Later, the patient underwent computerized tomographic examination and biopsy. On the basis of the clinical, radiographic and histopathologic examinations, the authors made diagnoses of CDO and FCOD. The bilateral presentation of CDO along with the simultaneous presence of FCOD and these conditions' vivid radiographic appearances make this case highly unusual. Multiple, simultaneous processes can yield an atypical radiographic appearance seen on routine radiographic examinations. Characteristics unique to each process are used to make the differential diagnoses. FCOD can make the mandible more susceptible to osteomyelitis.
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            Treatment of chronic suppurative osteomyelitis of the mandible.

            Chronic suppurative osteomyelitis of the mandible is often considered difficult to treat and may lead to refractory osteomyelitis. Sixteen patients with chronic suppurative osteomyelitis of the mandible were treated with a relatively simple protocol, consisting of sequestrectomy or decortication and i.v. antimicrobial therapy for one week, followed by oral penicillin for three weeks. Only one case showed recurrence of symptoms, which was treated successfully in a second session. It is concluded that combined surgical and antimicrobial therapy should be sufficient to cure most cases of chronic suppurative osteomyelitis of the mandible.
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              Chronic suppurative osteomyelitis of the mandible: case report.

              Osteomyelitis of the maxillofacial skeleton is rare in developed countries such as Australia. This case report describes the successful surgical treatment of chronic suppurative osteomyelitis (CSO) of the mandible in a 75 year old man. The precipitant factor was thought to be a retained tooth root in the (right) posterior body of the mandible. Treatment included a pre-surgical course of antibiotics (clindamycin 300mg, p.o. q.i.d. for two weeks) followed by removal of the retained root, surgical débridement of the affected bone, the intra-oral draining sinus, and resection of the cutaneous sinus tract. Specimens were taken for bacterial cultures and antibiotic sensitivity testing, and the resected tissue sent for histopathological review. On clinical and radiographic review at three months, the patient was well, completely symptom free and the osteomyelitis had fully resolved. This case report demonstrates the typical features of CSO. The combination of antibiotic therapy and surgical débridement was effective in the treatment of chronic suppurative osteomyelitis of the mandible utilizing intravenous sedation, and so averting the need for a general anaesthetic.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                odonto
                Avances en Odontoestomatología
                Av Odontoestomatol
                Ediciones Avances, S.L. (Madrid, Madrid, Spain )
                0213-1285
                2340-3152
                December 2010
                : 26
                : 6
                : 295-300
                Affiliations
                [01] Belo Horizonte orgnameCentro Universitario Newton Paiva Brasil
                [02] Belo Horizonte orgnameUniversidad Federal de Minas Gerais Brasil
                Article
                S0213-12852010000600003
                10.4321/s0213-12852010000600003
                86246c1c-4a02-4257-bf2a-f3abd539d4f7

                This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 International License.

                History
                : 17 September 2009
                : 02 October 2009
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 15, Pages: 6
                Product

                SciELO Spain


                Osteomielitis,Secuestros óseos,Maxilares,Osteomyelitis,Osseous sequestrous,Jaws

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