This document discusses osteomyelitis, an inflammation of bone and bone marrow that can result from odontogenic infection. It describes the different types of osteomyelitis including acute suppurative, chronic suppurative, chronic focal sclerosing (condensing osteitis), and chronic diffuse sclerosing osteomyelitis. Specific details are provided on the clinical, radiographic, and histopathologic features of acute suppurative osteomyelitis as well as chronic osteomyelitis with proliferative periostitis (Garre's osteomyelitis). The pathogenesis and potential complications of acute suppurative osteomyelitis are also summarized.
Call Girls Service in Bommanahalli - 7001305949 with real photos and phone nu...
Osteomyelitis Types, Causes, Symptoms & Treatment
1. DR VINOD KUMAR R.B
PROF & HEAD
DEPT OF ORAL PATHOLOGY & MICROBIOLOGY
MALABAR DENTAL COLLEGE & RESEARCH CENTRE
2.
3. OSTEOMYELITIS
An inflammation of bone and bone marrow(medullary
bone).
- Result of odontogenic infection.
- Acute, subacute or chronic depending upon
duration.
6. ACUTE SUPPURATIVE OSTEOMYELITIS
Acute inflammatory process spreading through medullary
spaces of the bone and with insufficient time for body to
react
Well localized in maxilla ,diffuse and widespread in
mandible
7. ACUTE SUPPURATIVE OM-C/F
Severe pain and fever
Regional lymphadenopathy
Leukocytosis
Soft tissue swelling
Paresthesia/anesthesia of lip
Loose and sore tooth in the area of involvement
18. Suppurative Osteomyelitis:
Radiographic Features
Normal in early stages.
In 10-14 days, sufficient bone
resorption occurs to produce
irregular, moth-eaten areas of
radiolucency.
Sequestra may be seen.
22. Pathogenesis of Osteomyelitis
As infection is established lumina of nutrient
vessels get occluded by thrombus(dead/viable
neutrophils,bacteria & necrotic tissue debris)
Due to thrombosis of vessels and pressure from
inflammatory exudate in the confined space
,nutritional supply to bone cells is cut off
resulting in death of cancellous bony trabeculae
with formation of sequestrum
23.
24. Pathogenesis of Osteomyelitis
Infection spreads via volkmans canals to reach
external surface of bone below periosteum
resulting in periosteitis
Further extension of inflammation leads to
single or multiple sinus tracts formation
26. ACUTE SUPPURATIVE OM-H/F
Bone shows loss of osteocytes
from their lacunae,peripheral
resorption and bacterial
colonization
Periphery of bone contains
necrotic debris and acute
inflammatory infiltrate
consisting of PMNL’s
27. Suppurative Osteomyelitis:
Histopathologic Features
Suppurative osteomyelitis, note the
devitalized lamellar bone sequestrum with
scalloped edges and absence of stainable
osteocytes and osteoblasts. An osteoclast
in a resorption area is seen.
28. ACUTE SUPPURATIVE OM-PROGNOSIS
The bone that has lost its vitality separates from the
living bone.The separated fragment is called
“sequestrum”
When the sequestrum becomes surrounded by new
living bone it is called “involucrum”
Pathological #’s may occur due to weakening of the
jaw by the destructive process
32. CHRONIC FOCAL SCLEROSING OSTEOMYELITIS
(CONDENSING OSTEITIS)
Localized areas of bone sclerosis in relation to the
apices of teeth with pulpitis or pulp necrosis
Unusual reaction of bone to infection occurring in
instances of extremely high tissue resistance or in
low grade infection
33. CONDENSING OSTEITIS
More in children and young adults
Most commonly involved tooth is
mandibular 1st molar with large
carious lesion
34. CONDENSING OSTEITIS-R/F
Localized area of increased radiodensity adjacent to the apex of the
tooth that exhibits a thickened periodontal ligament space
Differential diagnosis
Benign cementoblastoma
36. CHRONIC OSTEOMYELITIS WITH PROLIFERATIVE
PERIOSTITIS (GARRE’S OSTEOMYELITIS)
Focal gross thickening of the periosteum with
peripheral reactive bone formation resulting from mild
irritation or infection
Common in children and young adults especially in
mandible
Most common cause is dental caries with periapical
infection or overlying soft tissue infection
37.
38. An occlusal radiograph of the mandible showed the enhancement in
peripheral subperiosteal bone on the right buccal and lingual sides.
39.
40. GARRE’S OSTEOMYELITIS
Toothache or pain in the jaw and
bony hard swelling on outer surface
of the jaw
Most characteristic finding is on the
radiograph
41. Chronic Osteomyelitis with Proliferative Periostitis
(Garré’s Osteomyelitis, Periostitis Ossificans)
Radigraphs show focal subperiosteal
overgrowth of bone with smooth surface on
outer cortical plate.
The subperiosteal mass consists of irregular
trabeculae of actively forming woven bone with
scattered chronic inflammatory cells in fibrous
marrow.
42. Chronic Osteomyelitis with Proliferative Periostitis
(Garré’s Osteomyelitis, Periostitis Ossificans)
Periosteal new bone formation
(periosteal reaction) / Onion-peel
appearance.
43. Other conditions showing periosteal new bone
formation(neoperiostosis)
Caffey’s disease(infantile cortical hyperostosis)
Hypervitaminosis A
Syphilitic osteomyelitis
Ewing’s sarcoma
Metastatic neuroblastoma
Fracture callus