PP003: Actinomycosis of the mandible associated infected osteoradionecrosis – Case report

Abstract

Introduction Actinomyces sp has been related to maximilla necrosis originated from oncological treatment. Objectives To show how difficult it is to treat and to control infected osteorradionecrosis, high morbidity, negative impact upon quality of life, and increase in treatment cost. Case report D.D.O., male, 42 years of age, was submitted to a chemoradiotherapeutic treatment in 2005 (100 mg/m2 cisplatine, total dose of RT: 7200 cGys, 6 mV linear accelerator) for nasopharynx CEC (T2N2M0). Diagnosed in 2008 with osteoradionecrosis infected by Actinomyces on right jaw after exodontia and submitted to antibiotictherapy, to a medical surgery (sequestrumstomy) and standard clinical control. In 2010, it was declared that the disease had progressed, and a medical surgery took place. In 2011, necrosis recurrence was declared, and the patient showed pathological fracture advances on the jaw with serious functional and aesthetic consequences. R.S.C., female, 76 years of age, was submitted to partial glossectomy, ervial draining and radiotherapy (total dose: 6120 cGys, 6 mV linear accelerator) for tongue CEC (T2N1M0). In 2007, this patient showed infected osteoradionecrosis advances on right jaw, and was submitted to sequestrumstomy and antibiotictherapy. In 2008, 2009 and 2011 medical surgeries took place, and biopsies showed actinomiotic infecction recurrence. All dental elements of the inferior right hemiarc and alveolar edge were pulled, leaving the patient with an important functional and aesthetic consequence. Conclusion The identification of this bacteria in the histopathological discoveries is an important factor in determining the worst prognostics, and is related to the difficulties in controlling local osseous necrosis, and in the chances of the infections’ recurring.