Abstract
Osteomyelitis (OM) of the jaw is usually caused by a chronic odontogenic infection. Decompression is the release the intraluminal pressure in the cystic cavity allowing gradual bone growth from the periphery. The aim of this study was to analyze the effectiveness of decompression in an OM jaw model. A 4-mm-diameter defect was made on mandibles of fourteen Sprague–Dawley rats and inoculated with S. aureus (20 μl of 1 × 107 CFU/ml) injection. Two weeks later, four groups were made as non-treatment (C1), only curettage (C2), curettage and decompression (E1), and curettage and decompression with normal saline irrigation (E2). After four weeks, each group was analyzed. Most micro-CT parameters, including bone mineral density [0.87 (± 0.08) g/cm3] with bone volume [0.73 (± 0.08) mm3] was higher in E2 group than that of C1 group (p = 0.04, p = 0.05, respectively). E2 group in histology showed the highest number of osteocytes than those of control groups, 91.00 (± 9.90) (p = 0.002). OPN were expressed strongly in the E1 (“5”: 76–100%) that those of other groups. Decompression drains induced advanced bone healing compared to that of curettage alone. Therefore, it could be recommended to use decompressive drain for enhancing the jaw OM management.
Highlights
Osteomyelitis (OM) of the jaw is usually caused by a chronic odontogenic infection
Three animals that died from the C2 group, which received conventional surgical curettage for jaw OM without decompression, could be explained by the development of bacterial jaw OM and the surgical intervention that can cause serious adverse burden on the body
The establishment of S. aureus-infected jaw osteomyelitis rat model were confirmed by the following parameters: clinical findings, blood test, micro-CT bone architecture findings, and histological analysis
Summary
Osteomyelitis (OM) of the jaw is usually caused by a chronic odontogenic infection. Decompression is the release the intraluminal pressure in the cystic cavity allowing gradual bone growth from the periphery. Osteomyelitis (OM) of the jaw is an inflammatory process that starts in the medullary space of the bone and progresses to cortical bone, the Haversian system, periosteum, and overlying soft tissue This is usually caused by micro-organism infection into the bone tissues due to a trauma or odontogenic infection[1]. The surgical therapy approach has three main goals, which includes decompression and drainage of intramedullary pressure and subperiosteal abscesses caused by the osteomyelitic effect, surgical treatment of infected tissue and removal of infectious foci, and grafting healthy bone tissue into the infected a rea[6]. Decompression can be applied to the treatment of jaw OM, for reducing the intraluminal pressure, removing retained pathogenic bacteria, reduce swelling, pain, trismus and aid in the bone healing and bone regeneration process
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