Abstract
A study on the background factors and outcome of surgical treatment in relation to the radiographic patterns in 33 cases with chronic osteomyelitis of the mandible was performed. The results were as follows:
1) According to the radiographic patterns, 33 cases were classified into four groups, 10 cases (30.3%) as the sequestratin type, 8 cases (24.2%) as the localized osteolytic type, 8 cases (24.2%) as the diffuse osteosclerotic type, and 7 cases (21.2%) as the diffuse mixed type. 2) For gender, more males were found in the localized osteolytic type, and more females were found in the diffuse mixed type. The majority of the cases in the sequestration and localized osteolytic types were middle age or older, while in the osteosclerotic and mixed types younger patients who were ten to twenty years of age were found. 3) Four patients had diabetes mellitus, however, there was no relationship with the radiographic patterns and area of the lesion. 4) The lesions in all cases of the sequestration type were detected in the mandibular body, and 7 out of 8 cases of the localized osteolytic type had lesions in the mandibular boyd, while the lesion was extending to the angle and ramus area in 5 out of 8 cases of the diffuse osteosclerotic type and in 3 out of 7 cases of the diffuse mixed type. 5) With respect to clinical symptoms, pain occurred in 87.8% of the cases, swelling in 50.0%, trismus in 33.3%, and pus discharge in 27.3%. All cases of the diffuse osteosclerotic and mixed types had pain, but no pus discharge. 6) In 25 out of 33 cases (75.8%), the onset of disease was the result of dental disease and the majority of the dental origin was molar teeth. 7) The duration from the onset to the first visit was within one year in all cases of the localized osteolytic types, however, almost half of the cases in the sequestration type and the diffuse osteosclerotic and mixed types visited us over one year after the onset. 8) Recurrence after the operation in 33 cases was observed in 10 cases consisting of 6 out of 8 cases (75.0%) of the diffuse osteosclerotic type and 4 out of 7 cases (57.1%) of the diffuse mixed type. All the cases whose lesions were detected in the mandibular angle or ramus area recurred. 9) The majority of the isolates were Streptococcus sp. detected in 7 out of 9 cases, andStaphylococcus aureusandKlebsiellasp. were detected in 3 cases.
