Abstract
Osteomyelitis of the jaws is osteomyelitis (which is inflammation of the bone marrow, sometimes abbreviated to OM) which occurs in the bones of the jaws (i.e. maxilla or the mandible). Historically, osteomyelitis of the jaws was a common complication of odontogenic infection (infections of the teeth). Before the antibiotic era, it was frequently a fatal condition. Today osteomyelitis of facial bones is a rare condition. Maxillary osteomyelitis is rare compared to mandible osteomyelitis because extensive blood supply & strut like bone of the maxilla make it less prone to chronic infection. We report a rare case of Osteomyelitis involving whole of the Maxilla in a 63 year old male patient, diabetic and hypertensive for the past 2 years. He presented to us with anpalatally exposed bone with offensive odour from the nose. Examination revealed a necrotic maxilla involving whole hard palate. A computerized tomography scan confirmed Osteomyelitis of whole Maxilla. Patient underwent complete surgical excision with prosthesis reconstruction. Prosthetic rehabilitation of patients with acquired defects of the maxilla present a challenging task because of inadequate retention and stability of prosthesis and these goals are even more challenging in a complete maxillectomy case. This case report describes the fabrication of prosthesis utilizing soft tissue undercuts for retention using soft liners as one technique and fabrication of a two piece prosthesis utilizing magnets to meet the goals.
Highlights
Osteomyelitis represents an inflammation of the medullary cavity, Haversian system and adjacent cortex of bone.[1]
Osteomyelitis of maxilla was originally described by Rees in 1847.3 Osteomyelitis of the jaws was relativelycommon before the era of antibiotic therapy
Maxillary osteomyelitis is rare compared to mandible osteomyelitis because extensive blood supply & strut like bone of the maxilla make it less prone to chronic infection
Summary
Osteomyelitis represents an inflammation of the medullary cavity, Haversian system and adjacent cortex of bone.[1]. Maxillectomy defects result in the formation of a communication between the oral cavity and the antrum and/or the nasopharynx This inevitably results in difficulty in mastication andswallowing, as well as impaired speech and facial aesthetics. The larger the surgical resection, the greater the loss of the mucogingival support, which in turn results in increased unfavourable forces acting on the remaining abutment teeth.[11][13]. This clinical report demonstrates, by utilizing the soft tissue defect and soft liners for retention purpose and fabrication of a two piece obturator prosthesis to attain light weight for a patient with complete maxillectomy, secondary to Osteomyelitis
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