Abstract
We have reported on the surgical therapy of patients with chronic osteomyelitis of the mandible who were treated with polymethylmethacrylate (PMMA) beads impregnated with antibiotics. In this article, we report the long-term follow-up of 13 patients (3 men and 10 women) treated in our clinic from June 1988 throuth May 1994. The mean duration of postoperative follow-up was 46.6 months. A good outcome was obtained in 11 patients. Two patients had recurrence soon after operation and underwent mandibular hemisection. Preoperative X-ray examination showed evidence of diffuse osteosclerosis in 11 patients, sequestration in 2 patients, and osteolysis in 3 patients. In 3 of the 13 patients, the lesion was localized in the mandibular body, in 9 patients the lesion spread beyond the mandibular angle toward the mandibular ramus, and in 1 patient the lesion included the mandibular ramus and spread over the midline to the opposite side. Sequestration or osteolysis was not detected radiologically in any patient during follow-up; however, osteosclerosis remained in 7 of 11 cases despite a good clinical course. We used gentamicin to impregnate the beads, and no side effect of gentamicin was seen in any patient. This treatment method was considered very useful for chronic osteomyelitis of the mandible.
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