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DR.SHAHZADI TAYYABA HASHMI DNT 243. MAJOR INFECTIONS OF JAWS CYSTS OF JAWS ODONTOGENIC and NON- ODONTOGENIC TUMOURS OF JAWS.

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Presentation on theme: "DR.SHAHZADI TAYYABA HASHMI DNT 243. MAJOR INFECTIONS OF JAWS CYSTS OF JAWS ODONTOGENIC and NON- ODONTOGENIC TUMOURS OF JAWS."— Presentation transcript:

1 DR.SHAHZADI TAYYABA HASHMI DNT 243

2 MAJOR INFECTIONS OF JAWS CYSTS OF JAWS ODONTOGENIC and NON- ODONTOGENIC TUMOURS OF JAWS

3 OSTEOMYELITIS Definition: An inflammatory process within medullary ( trabecular) bone that involves the marrow spaces Osteomyelitis of jaws is mainly a disease of adults with several potential sources of infection. OSTEOMYELITIS Definition: An inflammatory process within medullary ( trabecular) bone that involves the marrow spaces Osteomyelitis of jaws is mainly a disease of adults with several potential sources of infection.

4 ACUTE OSTEOMYELITIS CHRONIC OSTEOMYELITIS GARRE OSTEOMYELITIS

5 DEFINITION A rapidly destructive inflammatory process within bone that consist of Granulation tissue, Purulent exudate and islands of non-vital bone (sequestra) DEFINITION A rapidly destructive inflammatory process within bone that consist of Granulation tissue, Purulent exudate and islands of non-vital bone (sequestra)

6 1. Caused by direct extension of untreated periapical abcess 2. Minor traumatic incident involving a mandible that has its blood supply compromised by previous high doses of radiation for the treatment of malignancy( OSTEORADIONECROSIS) 1. Caused by direct extension of untreated periapical abcess 2. Minor traumatic incident involving a mandible that has its blood supply compromised by previous high doses of radiation for the treatment of malignancy( OSTEORADIONECROSIS)

7  Commonly affects males with infection of mandible  Early complaints are Severe, Throbbing pain and swelling with external swelling due to inflammatory edema  Later distension of periosteum with pus occurs  Finally, subperiosteal bone formation causes the swelling to become firm  Associated teeth are tender and mobile  Overlying gingiva is red, swollen and tender  Paresthesia of lower lip of affected side  Regional lymph nodes are enlarged and tender  Difficulty in mouth opening and swallowing  Commonly affects males with infection of mandible  Early complaints are Severe, Throbbing pain and swelling with external swelling due to inflammatory edema  Later distension of periosteum with pus occurs  Finally, subperiosteal bone formation causes the swelling to become firm  Associated teeth are tender and mobile  Overlying gingiva is red, swollen and tender  Paresthesia of lower lip of affected side  Regional lymph nodes are enlarged and tender  Difficulty in mouth opening and swallowing

8 At boundaries between infected and healthy tissues, OSTEOCLASTS RESORBS the periphery of dead bone and become separated as SEQUESTRUM( island of dead bone) Pus formed by inflammatory cells, reaches the SUBPERIOSTEAL region by RESORPTION of bone Dead bone is recognized microscopically by lacunae, empty of OSTEOCYTES but filled with NEUTROPHILS and colonies of bacteria which proliferate in the dead tissue Thrombosis and obstruction leads to future bone necrosis Infection causes acute inflammation in the MEDULLARY soft tissues and inflammation EXUDATE spreads infection through marrow spaces. It also compress blood vessels Mandible has a relatively limited blood supply and dense bone with thick cortical plate (so pus cant drain out) Staphylococci may also cause infection when they enter from the skin through open fracture Oral bacteria particularly anaerobes such as BACTEROIDES, PORPHROMONAS or PREVOTELLA species are important causes

9  Loss of trabecular pattern and areas of radiolucency indicates bone destruction  Ill-defined margins with fluffy and moth-eaten appearance  Areas of dead bone appears as dense areas TREATMENT:  Surgical treatment to establish drainage of purulent exudates  Use of antibiotics to kill the microorganisms involved  Loss of trabecular pattern and areas of radiolucency indicates bone destruction  Ill-defined margins with fluffy and moth-eaten appearance  Areas of dead bone appears as dense areas TREATMENT:  Surgical treatment to establish drainage of purulent exudates  Use of antibiotics to kill the microorganisms involved

10 Radiographic features:  Radiographic features are variable but sometimes distinctive  Sequestra will usually separate spontaneously TREATMENT:  Antibiotics Radiographic features:  Radiographic features are variable but sometimes distinctive  Sequestra will usually separate spontaneously TREATMENT:  Antibiotics

11  Persistent low grade infection associated with bone destruction and Granulation tissue formation with little suppuration CLINICAL FEATURES: Persistent ache / pain with exposed bone  Persistent low grade infection associated with bone destruction and Granulation tissue formation with little suppuration CLINICAL FEATURES: Persistent ache / pain with exposed bone

12 It is an unusual hyperplasic reaction of the periosteum to a chronic osteomyelitis of the posterior mandible that is unique to young patients. CLINICAL FEATURES:  Most frequently associated with advanced acute caries in young patients  Occurs when free gingival margin remain above the height of contour of tooth results in food impaction It is an unusual hyperplasic reaction of the periosteum to a chronic osteomyelitis of the posterior mandible that is unique to young patients. CLINICAL FEATURES:  Most frequently associated with advanced acute caries in young patients  Occurs when free gingival margin remain above the height of contour of tooth results in food impaction

13 Radiographic appearance:  onion skin appearance TREATMENT:  Identification of source of infection  Extraction of the tooth involved in infection  Surgical treatment of tissues in molar area Radiographic appearance:  onion skin appearance TREATMENT:  Identification of source of infection  Extraction of the tooth involved in infection  Surgical treatment of tissues in molar area

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