Osteomyelitis of the jaws is still a very unique disease of the facial skeleton that represents a great challenge for the physician as well as the patient being treated, despite all recent advances in diagnosis and evolved treatment modalities. In the past decades the clinical appearance of osteomyelitis cases has changed dramatically. Not only has the average number of cases seen in a maxillofacial unit decreased, but also the clinical picture of the disease itself has changed significantly. Osteomyelitis of the jaws used to be an infectious disease with an often complicated course, involving multiple surgical interventions and sometimes leading to facial disfigurement as a result of loss of affected bone and teeth and the accompanying scarring. The outcome was usually all but certain; hence, prolonged treatment and frequent relapses have been associated with this disease in the past.
Osteomyelitis of the jaws is a disease that has affected mankind since prehistory. In fact, the famous 1.6 million-year-old fossil find of “Turkana Boy” documents this very well. As a 12-year-old prehuman hominid (homo erectus) his nearly complete skeleton clearly showed an osteomyelitis arising from an odontogenic infection around one of his first molar teeth. Paleontologists even conjecture that it was the most likely cause of his premature death.
Today, medical and dental specialists continue to treat osteomyelitis of various types with the recognition that osteomyelitis of the jaws differs significantly from osteomyelitis of the long bones and at other skeletal sites. These differences are due to a different group of pathogens, the presence of teeth, a different blood vessel density, an oral environment, a thin mucosa as opposed to skin, one jaw that is mobile and the other that is fixed, the more frequent presence of foreign bodies, and the commonality of head and neck radiotherapy. These differences are also reflected in the confusing array of terms used to describe the different forms of jaw osteomyelitis, e.g., chronic diffuse sclerosing osteomyelitis, Garré’s osteo-myelitis with Proliferative periostitis, periostitis ossificans, etc., as well as many entities that are not primarily infectious etiologies but develop a secondary osteomyelitis by virtue of exposed bone in the oral cavity such as osteoradionecrosis, osteopetrosis, and bisphosphonateinduced osteonecrosis.
In this book, M. Baltensperger and G. Eyrich begin with a straightforward classification and terminology system that is consistent with the scientific evidence of the different clinical forms of jaw osteomyelitis. They further coordinate the initiating factors, host local and systemic factors, and pathogenesis to the clinical presentation. In a logical manner, useful to the student, resident, and senior clinicians alike, a differential diagnostic methodology is offered, inclusive of clear descriptions of what the present imaging technology can and cannot offer. This is followed by separate chapters on the different microscopic pathologies seen with each type of osteomyelitis and the microbiology of the known pathogens. The next three chapters are focused on treatment. They logically begin with the principles of treatments including the selection of the most appropriate surgical procedure and its follow-up by the selection of the appropriate antibiotic, as well as its correct dosing and the role of adjunctive hyperbaric oxygen in selected cases. The next chapter openly discussed the uniqueness of osteomyelitis involving the temporomandibular joint and its treatment, a disease not often discussed in other texts. The final chapter underscores the practical value of this book. In an innovative manner the authors present 20 case reports of actual cases and how they were diagnosed and further managed. These cases encompass nearly the full spectrum of osteomyelitis of the jaws and support the application of the principles and techniques reviewed in the preceding chapter.
The reader should appreciate the flow of this book, from the history of osteomyelitis to its classification, diagnosis, pathology, imaging, and treatment. The reader should also appreciate that a complex disease, such as osteomyelitis of the jaws with numerous variations, can be simplified in approach while still retaining the comprehensiveness of its diagnosis and treatment. The student can use this book as a comprehensive textbook or on a chapter-by-chapter basis. The experienced clinician can use the book for general review or as a case review as he or she may be confronted with their own challenging case. Both groups will find the case reports to be the realistic element that brings everything together.
Contents
Chapter 1 Introduction
Chapter 2 Osteomyelitis of the Jaws: Definition and Classification
Chapter 3 Diagnostic Imaging – Conventional Radiology, Computed Tomography and Magnetic Resonance Imaging
Chapter 4 Diagnostic Imaging – Scintigraphy
Chapter 5 Diagnostic Imaging – Positron Emission Tomography, Combined PET/CT Imaging
Chapter 6 Pathology of Osteomyelitis
Chapter 7 Microbiology
Chapter 8 Osteomyelitis Therapy – General Considerations and Surgical Therapy
Chapter 9 Osteomyelitis Therapy – Antibiotic Therapy
Chapter 10 Osteomyelitis Therapy – Hyperbaric Oxygen as an Adjunct in Treatment of Osteomyelitis of the Jaws
Chapter 11 Osteomyelitis of the Temporomandibular Joint
Chapter 12 Case Reports
Subject Index 307
Osteomyelitis of the jaws is a disease that has affected mankind since prehistory. In fact, the famous 1.6 million-year-old fossil find of “Turkana Boy” documents this very well. As a 12-year-old prehuman hominid (homo erectus) his nearly complete skeleton clearly showed an osteomyelitis arising from an odontogenic infection around one of his first molar teeth. Paleontologists even conjecture that it was the most likely cause of his premature death.
Today, medical and dental specialists continue to treat osteomyelitis of various types with the recognition that osteomyelitis of the jaws differs significantly from osteomyelitis of the long bones and at other skeletal sites. These differences are due to a different group of pathogens, the presence of teeth, a different blood vessel density, an oral environment, a thin mucosa as opposed to skin, one jaw that is mobile and the other that is fixed, the more frequent presence of foreign bodies, and the commonality of head and neck radiotherapy. These differences are also reflected in the confusing array of terms used to describe the different forms of jaw osteomyelitis, e.g., chronic diffuse sclerosing osteomyelitis, Garré’s osteo-myelitis with Proliferative periostitis, periostitis ossificans, etc., as well as many entities that are not primarily infectious etiologies but develop a secondary osteomyelitis by virtue of exposed bone in the oral cavity such as osteoradionecrosis, osteopetrosis, and bisphosphonateinduced osteonecrosis.
In this book, M. Baltensperger and G. Eyrich begin with a straightforward classification and terminology system that is consistent with the scientific evidence of the different clinical forms of jaw osteomyelitis. They further coordinate the initiating factors, host local and systemic factors, and pathogenesis to the clinical presentation. In a logical manner, useful to the student, resident, and senior clinicians alike, a differential diagnostic methodology is offered, inclusive of clear descriptions of what the present imaging technology can and cannot offer. This is followed by separate chapters on the different microscopic pathologies seen with each type of osteomyelitis and the microbiology of the known pathogens. The next three chapters are focused on treatment. They logically begin with the principles of treatments including the selection of the most appropriate surgical procedure and its follow-up by the selection of the appropriate antibiotic, as well as its correct dosing and the role of adjunctive hyperbaric oxygen in selected cases. The next chapter openly discussed the uniqueness of osteomyelitis involving the temporomandibular joint and its treatment, a disease not often discussed in other texts. The final chapter underscores the practical value of this book. In an innovative manner the authors present 20 case reports of actual cases and how they were diagnosed and further managed. These cases encompass nearly the full spectrum of osteomyelitis of the jaws and support the application of the principles and techniques reviewed in the preceding chapter.
The reader should appreciate the flow of this book, from the history of osteomyelitis to its classification, diagnosis, pathology, imaging, and treatment. The reader should also appreciate that a complex disease, such as osteomyelitis of the jaws with numerous variations, can be simplified in approach while still retaining the comprehensiveness of its diagnosis and treatment. The student can use this book as a comprehensive textbook or on a chapter-by-chapter basis. The experienced clinician can use the book for general review or as a case review as he or she may be confronted with their own challenging case. Both groups will find the case reports to be the realistic element that brings everything together.
Contents
Chapter 1 Introduction
Chapter 2 Osteomyelitis of the Jaws: Definition and Classification
Chapter 3 Diagnostic Imaging – Conventional Radiology, Computed Tomography and Magnetic Resonance Imaging
Chapter 4 Diagnostic Imaging – Scintigraphy
Chapter 5 Diagnostic Imaging – Positron Emission Tomography, Combined PET/CT Imaging
Chapter 6 Pathology of Osteomyelitis
Chapter 7 Microbiology
Chapter 8 Osteomyelitis Therapy – General Considerations and Surgical Therapy
Chapter 9 Osteomyelitis Therapy – Antibiotic Therapy
Chapter 10 Osteomyelitis Therapy – Hyperbaric Oxygen as an Adjunct in Treatment of Osteomyelitis of the Jaws
Chapter 11 Osteomyelitis of the Temporomandibular Joint
Chapter 12 Case Reports
Subject Index 307
Book Details
- Hardcover: 338 pages
- Publisher: Springer; 1 edition
- Language: English
- ISBN-10: 3540287647
- ISBN-13: 978-3540287643
- Product Dimensions: 10.5 x 7.8 x 0.9 inches