Chronic Suppurative Osteomyelitis Research Articles

Classification of Ameloblastoma, Periapical Cyst, and Chronic Suppurative Osteomyelitis with Semi-Supervised Learning: The WaveletFusion-ViT Model Approach.

Ameloblastoma (AM), periapical cyst (PC), and chronic suppurative osteomyelitis (CSO) are prevalent maxillofacial diseases with similar imaging characteristics but different treatments, thus making preoperative differential diagnosis crucial. Existing deep learning methods for diagnosis often require manual delineation in tagging the regions of interest (ROIs), which triggers some challenges in practical application. We propose a new model of Wavelet Extraction and Fusion Module with Vision Transformer (WaveletFusion-ViT) for automatic diagnosis using CBCT panoramic images. In this study, 539 samples containing healthy (n = 154), AM (n = 181), PC (n = 102), and CSO (n = 102) were acquired by CBCT for classification, with an additional 2000 healthy samples for pre-training the domain-adaptive network (DAN). The WaveletFusion-ViT model was initialized with pre-trained weights obtained from the DAN and further trained using semi-supervised learning (SSL) methods. After five-fold cross-validation, the model achieved average sensitivity, specificity, accuracy, and AUC scores of 79.60%, 94.48%, 91.47%, and 0.942, respectively. Remarkably, our method achieved 91.47% accuracy using less than 20% labeled samples, surpassing the fully supervised approach's accuracy of 89.05%. Despite these promising results, this study's limitations include a low number of CSO cases and a relatively lower accuracy for this condition, which should be addressed in future research. This research is regarded as an innovative approach as it deviates from the fully supervised learning paradigm typically employed in previous studies. The WaveletFusion-ViT model effectively combines SSL methods to effectively diagnose three types of CBCT panoramic images using only a small portion of labeled data.

Surgical Management of Extensive Chronic Suppurative Maxillary Osteomyelitis in an Uncontrolled Diabetic Patient – A Comprehensive Case Report

Surgical Management of Extensive Chronic Suppurative Maxillary Osteomyelitis in an Uncontrolled Diabetic Patient – A Comprehensive Case Report

Radical Surgical Approach to Chronic Suppurative Osteomyelitis: Case Report

Diabetes mellitus is a systemic condition potentially related to an increased risk of progression of various infections such as chronic osteomyelitis by accelerating the inflammatory process with bone tissue necrosis and suppuration. Therefore, if there is no proper management of these infections, they can be life-threatening as they spread to deeper spaces in the head and neck. We describe the case of a 52-year-old male patient with a history of diabetes mellitus and grade III osteoarthritis who was diagnosed with chronic suppurative osteomyelitis of the mandible. He underwent a multidisciplinary surgical intervention in which he underwent a hemimandibulectomy with immediate mandibular reconstruction. The present case highlights the importance of early and radical treatment of patients with chronic suppurative osteomyelitis of the mandible and systemic comorbidities. In addition, this case presents a review of diabetes mellitus and the risk of developing odontogenic infections and complications when invading deeper spaces in the head and neck. Therefore, in this population, careful planning is required for early surgical and pharmacological treatment.

Chronic suppurative osteomyelitis secondary to endodontic treatment and posterior extraction of mandibular third molars: An uncommon case

Chronic suppurative osteomyelitis secondary to endodontic treatment and posterior extraction of mandibular third molars: An uncommon case

Diagnostic Efficacy of Diffusion-weighted Imaging in Distinguishing Chronic Diffuse Sclerosing Osteomyelitis from Suppurative Osteomyelitis of the Mandible.

Chronic diffuse sclerosing osteomyelitis (CDSO) is a non-suppurative inflammatory bone disease diagnosed based on combined clinical, histopathological, and radiological findings. Accurate diagnosis is important since CDSO is more refractory to treatment than suppurative osteomyelitis. The purpose of this study was to determine the diagnostic efficacy of diffusion-weighted imaging (DWI) in the quantitative assessment of CDSO to distinguish it from acute suppurative osteomyelitis (ASO) and chronic suppurative osteomyelitis (CSO) of the mandible. Using a retrospective cohort study design, we analyzed MRI data of 6 patients with CDSO and 34 patients with ASO and CSO. The mean apparent diffusion coefficient (ADC) values of the three groups (CDSO, ASO, and CSO groups) were calculated, and differences were analyzed using Kruskal-Wallis and post-hoc Mann-Whitney tests with Bonferroni adjustments. We performed a receiver operating characteristic (ROC) curve analysis to evaluate the ability of the ADC to predict CDSO. P < 0.05 was considered statistically significant. The mean ADCs in the CDSO, ASO, and CSO groups were 1.22 ± 0.04 × 10-3 mm2/s, 1.28 ± 0.08 × 10-3 mm2/s, and 1.06 ± 0.09 × 10-3 mm2/s, respectively. Significant differences were observed between the ASO and CSO groups (P < 0.001) and CSO and CDSO groups (P < 0.01). However, there was no significant difference between the ASO and CDSO groups (P = 0.21). The ROC analysis revealed a cut-off ADC value of 1.19 for distinguishing the CSO group from the CDSO group. Sensitivity, specificity, accuracy, and area under the ROC curve were 1.0, 0.92, 0, 95, and 0.94, respectively. The results suggest that ADC may be useful in distinguishing CDSO from mandibular suppurative osteomyelitis.

Comparison of the histopathological characteristics of diffuse sclerosing osteomyelitis of the mandible, chronic suppurative osteomyelitis, and craniofacial fibrous dysplasia.

There are relatively few reports on the histopathological characteristics of diffuse sclerosing osteomyelitis of the mandible (DSOM), which is difficult to distinguish from chronic suppurative osteomyelitis (CSO) and craniofacial fibrous dysplasia (CFD). This study aimed to summarize and compare the histopathological characteristics of DSOM, CFD, and CSO. In this study, hematoxylin and eosin-stained sections of patients with DSOM, CSO, and CFD at the Peking University Hospital of Stomatology from 2015 to 2020 were retrieved. The histopathological characteristics were summarized, including new bone formation, inflammatory cell infiltration, bone trabecular morphology, osteoclasts, sequestrum, bacterial mass, and calcified spherules, similar to cementicles. The histopathological characteristics of DSOM, CSO, and CFD were compared, and the results were statistically analyzed. In total, 50, 13, and 10 patients with DSOM, CSO, and CFD were included in this study, respectively. In terms of new bone formation, both DSOM and CSO showed reactive bone formation (p=1), whereas CFD mainly showed fiber osteogenesis (p < 0.001). The inflammatory cells of DSOM were mainly lymphocytes and plasma cells, whereas those of CSO were mainly lymphocytes and neutrophils (p < 0.001), and there was usually no inflammatory cell infiltration in the CFD specimens (p < 0.001). DSOM, CSO, and CFD showed irregular bone trabeculae (p=0.045, p=0.703) and active osteoclasts (p1=0.189, p2=0.256). DSOM showed a small amount of bacterial mass but no sequestrum; neither of which was found in CFD (p=1, p=1), but it was common in CSO (p=0.011 and p=0.025). DSOM and CSO showed smooth and regular basophilic lines (p=0.308), whereas CFD showed a rough and irregular basophilic line (p < 0.001). The histopathological characteristics of the three diseases were partly similar, but there were evident differences. The main differences are the type of new bone formation, types and distribution of inflammatory cells, and presence of sequestrum and bacterial masses. These differences will help clinicians diagnose DSOM.

CHRONIC SUPPURATIVE OSTEOMYELITIS OF MANDIBULAR CONDYLE- A RARE CASE REPORT

Osteomyelitis is dened as inammation of the bone marrow with a tendency to progression and involves the adjacent cortical plates and periosteal tissues. It develops in the jaws after a chronic odontogenic infection or from other reasons such as trauma, incomplete management of fracture, following irradiation of the Mandible. It is more common in Mandible than maxilla. However, involvement of Mandibular condyle is very rare. Hereby we report a case of chronic suppurative osteomyelitis of condyle in a 16 years old female treated with course of antibiotics followed by Sequestrectomy, condylectomy and subsequent follow up.

Chronic suppurative osteomyelitis due to dislocation of the silicone prosthesis in the chin: case report

INTRODUCTION: Osteomyelitis is one of the inflammatory processes that spread in medullary spaces or cortical surfaces, being one of the adverse effects in cases of foreign bodies. Treatment of osteomyelitis includes antibiotic therapy, drainage and surgical interventions. OBJECTIVE: The objective of this present study is to present a case report of chronic suppurative osteomyelitis, caused by the displacement of a silicone prosthesis in the chin region. MATERIALS AND METHODS: Case report, with information obtained through interviews with the patient, review of medical records, complementary diagnostic imaging exam and literature review. RESULTS: Based on the information collected with the pacient, review of medical records, complementary diagnostic imaging exam and literature review, it was possible to diagnose the presence of chronic suppurative osteomyelitis in the chin region due to displacement of the silicone prosthesis. CONCLUSION: Aesthetic procedures are increasingly common, but without planning, proper management, correct choice of materials used and good adaptation of the prostheses in the sites, they can cause serious injuries, such as osteomyelitis, bring risks and affect the individuals quality of life. Osteomyelitis treatment is usually specific to each case and depends on a correct and early diagnosis and can be performed clinically and through imaging exams, mainly cone beam computed tomography because it has more accurate images. Treatments can range from antibiotics to resection of the affected bone.

Prevalence of Osteomyelitis in Jaws among the Patients Visiting Private Dental Hospital: An Institutional Study

Introduction: Osteomyelitis is an inflammatory condition of bone that involves the medullary cavity and periosteum. The prevalence rate of this disease was found predominantly among the males than females with an incidence of 30-39 years. This condition involves one or more facial bones in the head and neck, mainly mandible, frontal bone, cervical spine, maxilla and nasal bones. Various types of osteomyelitis are acute, primary chronic suppurative and secondary chronic and fungal osteomyelitis.&#x0D; Aim: To assess the prevalence rate of osteomyelitis in jaws among the patients visiting private dental hospitals in chennai.&#x0D; Materials and Methods: This present study was carried out in a private dental hospital under a university setting, in Chennai. Sample size for the present study includes the patients who were diagnosed with osteomyelitis from Jun 2019 to Feb 2021 which was collected using the Dental hospital management system. Sample size of the study was found to be n= 5 cases of osteomyelitis in jaws among 5,35,951 patients. The data collected was verified and tabulated in excel and statistically analysed using SPSS software. Chi square test was done to compare the groups (p&lt;0.05) which shows the significance and the results were interpreted.&#x0D; Results : Among the total patients, 40 % of them were males and 60 % of them were females. It was observed that 60 % of the subjects had acute osteomyelitis, 20 % with chronic suppurative and fungus associated osteomyelitis and found to be more prevalent among the individuals who were aged between 41-50 years. Majority of the females, 40% were highly affected with acute osteomyelitis than males, 20% of them were affected. However, p value less than 0.05 is considered as statistically significant, here the chi square test p value = 0.329, as (p &gt; 0.05 ) it is insignificant.&#x0D; Conclusion: The prevalence of osteomyelitis has recently decreased in developing countries, as attributed to the improvement in the oral and dental care with standard antibiotic treatment. From the results of our study it is evident that out of 5 cases of osteomyelitis in jaws, the majority of patients 60% were diagnosed with acute osteomyelitis. This shows that there is a reliable prevalence of osteomyelitis in jaws among the patients who are visiting private dental hospitals.

Osteomyelitis of the scapula in a 2-month-old infant

Osteomyelitis is a frequent pathology in the pediatric population. It is usually located on the fertile metaphyses of the long bones. However, there are rare locations such as short and flat bones. We report a case of chronic suppurative osteomyelitis in a scapular location in a 2-month-old infant with a late diagnosis. The identified germ was Staphylococcus aureus. The X-ray showed images of osteolysis of the scapula. Treatment consisted of double antibiotic therapy and drainage of the abscess with bone sequestrectomy, supplemented by immobilisation. The evolution was favorable after 2 years.

POST-MANDIBULAR FRACTURE OSTEOMYELITIS:

Osteomyelitis represents an inflammatory entity of the bone tissue with spinal cord involvement. Its etiology is multifactorial, presenting difficult diagnosis and complex treatment, being the prognosis, in most cases, unpredictable. Therefore, it is an inflammation of the medullary spaces caused by the decrease of the blood supply, leading to an ischemia and subsequent necrosis of the bone tissue. Although odontogenic infections are the most commonly involved in the onset of osteomyelitis, other situations also play a relevant role, such as: periodontal diseases, exodontia, and facial trauma. Treatment included combination of antibiotic therapy and surgical procedures. Although correct antibiotic therapy plays an important role in the success of the treatment, the surgical procedure is essential for the removal of the cause and possible bone sequestration formed by the infectious process. The objective of this work is to perform a review of the literature on Osteomyelitis and present two cases of Chronic Suppurative Osteomyelitis that emerged as a complication of mandible fracture. We observed that OSC caused after fracture of face presents clinical characteristics similar to those from odontogenic infection and that the treatment of choice is similar.

Evaluation of Secondary Chronic Suppurative Osteomyelitis of Jaw in 15 Cases: A Retrospective Analysis

Introduction: Chronic osteomyelitis may become a refractory condition and is more difficult to treat. Therefore, for correct diagnosis and evaluation of chronic osteomylitis, primary health care practitioners must have knowledge of signs and symptoms associated with osteomyelitis for effective management. Aim: To evaluate secondary chronic suppurative osteomyelitis of jaw in 15 cases. Materials and Methods: This was a retrospective study of all patients treated for maxillo-mandibular secondary chronic osteomyelitis over a period of six years (January 2013 to December 2018) in Department of Oral and Maxillofacial Surgery, Government Dental College and Hospital, Nagpur, Maharashtra, India. This study was carried out in between November 2019 to November 2020. A total of fifteen cases were identified which were diagnosed as Secondary Chronic Suppurative Osteomyelitis (SCO) and treated for same. The cases were evaluated for demographic data, risk factors, aetiology, clinical presentation, radiological findings and the management. Data was collected through retrospective search of records and was arranged in descriptive tabular format without statistical analysis. Results: Out of 15 cases 9 (60%) were female. The patients ranged in age from 21 to 56 years with a mean age of 36.6±9.0 years. The mean age at first symptoms was 35.5 years (20-55), with a standard deviation of 9.12 years. The distribution of osteomyelitis in the jaws was dominated by the cases that occurred in the mandible i.e., 73.33% (11 cases) and the maxilla 26.66% (four cases) with most common involved site was body and angle region of mandible (eight cases) followed by premolar region two cases and anterior region one case. In this study, five cases (33.33%) had carious lesion and seven cases (46.67%) had infected extraction socket. Other causes of infection were osteoradionecrosis in one case and superimposed infection like mucormycosis in two cases. The most common causes of chronic osteomyelitis of the jaws were directly related to odontogenic infections like infected unhealed socket. Decortication and curettage was done in four cases. Decortication and sequestrectomy were performed in five cases and debridement of necrosed bone in three cases. Sinus opening, debridement of necrosed wall and packing were done in three cases of SCO involving maxilla. Duration of antibiotic therapy in all patients averaged five weeks. Conclusion: The accurate diagnosis with the help of recent imaging techniques, adequate antibiotic therapy as well as surgical treatment was keys for the success of SCO management.

A rare case report of chronic suppurative osteomyelitis of the mandible in modern era of broad spectrum antibiotics

&lt;p class="abstract"&gt;Historically, osteomyelitis of the jaw was a common complication of odontogenic infection (infections of the teeth). The term osteomyelitis refers to an inflammation of cortex and medulla of the bone that can develop in the jaw after any infection of the oral cavity. Since the introduction of potent antibiotics, the incidence of osteomyelitis has been dramatically decreasing. This case report describes an interesting presentation of chronic suppurative osteomyelitis of the mandible in a 73 years old male patient from North Eastern part of India. Investigations revealed chronic osteomyelitis of right ramus and body of mandible. The treatment included a pre surgical course of antibiotics followed by right side hemimandibulectomy and again post-operative antibiotics. The post-operative healing was uneventful. Detailed discussion of etiology, risk factor, symptoms, signs, management and prevention has been done in this case report. We conclude that surgical debridement in addition to empirical antibiotics should be considered as an early approach for treating such cases.&lt;/p&gt;

TOMOGRAPHIC EVALUATION OF A SEVERE CASE OF CHRONIC SUPPURATIVE OSTEOMYELITIS

The objective of this study is to present a case of chronic suppurative osteomyelitis, demonstrating the importance of tomographic evaluation for accurate determination of its location, expansion, and severity of bone destruction using multiplanar reconstructions and 3-dimensional reconstruction. The patient is a white 63-year-old woman who attended a dental service presenting facial infection with report of 10 months of evolution after extraction of tooth 36. Antibiotic therapy did not solve the problem. Painful symptoms and drainage of secretions led her to search for new care. Intraoral examination showed the presence of fistulas in the alveolar ridge and purulent secretion. Cone beam computed tomography showed the presence of extensive hypodense image with hyperdense fragments in the left side of the mandibular body from tooth 31 to 38. Complete blood count presented intense leukocytosis. It was concluded the diagnosis was chronic suppurative osteomyelitis. Surgical debridement for removal of bone sequestrations and antibiotic therapy were planned.

CHRONIC SUPPURATIVE OSTEOMYELITIS IN A PATIENT WITH AUTISM SPECTRUM DISORDER: CHALLENGES IN CLINICAL MANAGEMENT

The present study reports the challenges faced during the diagnosis and treatment of chronic suppurative osteomyelitis in a patient with autism spectrum disorder (ASD). A 23-year-old woman intern in a special care institution attended the special care dental clinic of the authors with an unusual periodontal lesion involving tooth 47. Tooth extraction was performed with curettage of the surrounding structures for histopathologic examination. Microscopic examination diagnosed an aggressive juvenile periodontitis leading to suppurative osteomyelitis. Based on the pathologic report, a tomographic examination was performed and revealed the extension of the bone destruction as well as bone sequestrum. The patient was referred for surgical approach under general anesthesia to remove all necrotic and infected bone. After 1 year of the diagnosis the patient still under treatment without complete resolution of the lesion.

Aspergillus terreus spondylodiscitis following an abdominal stab wound: a case report

BackgroundAspergillus terreus, a saprophytic fungus, is recognized as an emerging pathogen in various infections in humans. However, bone and joint involvement is uncommon. To the best of our knowledge, only seven cases of spondylodiscitis caused by Aspergillus terreus have been reported previously in humans. We report a case of a patient with Aspergillus terreus spondylodiscitis following an abdominal stab wound.Case presentationA 74-year-old Japanese man with no particular medical history fell from a ladder and sustained a left abdominal stab wound from an L-shaped metal peg. Computed tomography showed the trace of the L-shaped metal peg from the left abdomen to the left rib and left kidney. The scan also showed an anterolateral bone avulsion of the left side of the T12 vertebral body, as well as fractures of the L1 left transverse process and the left 10th–12th ribs. He was hospitalized and treated with conservative therapy for 6 weeks. He was readmitted to the hospital with complaints of sudden back pain, numbness of both legs, and inability to walk 13 weeks after the fall. Magnetic resonance imaging findings were typical of spondylodiscitis. Gadolinium-enhanced T1-weighted magnetic resonance imaging indicated increased signal intensity at T11–T12 vertebral bodies and severe cord compression and epidural abscess at T11–T12 associated with infiltration of soft paravertebral tissues. On the seventh day after admission, he underwent partial laminectomy at T11 and posterior fusion at T9 to L2. The result of his blood culture was negative, but Aspergillus terreus was isolated from the material of T11–T12 intervertebral disc and vertebral bodies. His Aspergillus antigen was positive in a blood examination. Histological examination showed chronic suppurative osteomyelitis. On the 35th day after admission, he underwent anterior fusion at T11 and T12 with a rib bone graft. For 5 months, voriconazole was administered, and he wore a rigid corset. Posterior partial laminectomy at T11 and anterior fusion at T11 and T12 resulted in a good clinical course. The patient’s neurological dysfunction was completely recovered, and his back pain disappeared. Two years after the operation, computed tomography was performed and showed bone fusion at T11 and T12. Magnetic resonance imaging revealed no evidence of increased signal intensity at T11–T12 vertebral bodies and severe cord compression and epidural abscess at T11–T12.ConclusionsTo our knowledge, this is the first report of spondylodiscitis caused by Aspergillus terreus after an abdominal penetrating injury. The histological finding of chronic suppurative osteomyelitis and the radiological findings strongly suggested direct inoculation of Aspergillus terreus.

Gingival carcinoma cuniculatum mimicking a reactive/inflammatory process

ABSTRACT Carcinoma cuniculatum (CC), a rare variant of oral squamous cell carcinoma, presents well-differentiated neoplastic epithelial cells infiltrating the underlying submucosal or bone tissues, forming the so-called rabbit burrows filled with keratin. A 67-year-old female patient was referred complaining of a painless tumoral mass in the left mandibular body, with several months of evolution. Previous history indicated extraction of the teeth #37 and #38 and diagnosis of chronic suppurative osteomyelitis. A deep incisional biopsy revealed CC. Due to its microscopic features, suggesting an inflammatory or reactive process, strict clinicopathological correlation is necessary for the correct diagnosis of CC.

Chronic Suppurative Osteomyelitis of the Maxilla - rare case presentation

Chronic Suppurative Osteomyelitis of the Maxilla - rare case presentation

Chronic Suppurative Osteomyelitis of the Maxilla - rare case presentation

Chronic Suppurative Osteomyelitis of the Maxilla - rare case presentation

Acute and Chronic Suppurative Osteomyelitis of the Jaws: A 10-Year Retrospective Review

Acute and Chronic Suppurative Osteomyelitis of the Jaws: A 10-Year Retrospective Review