MANAGEMENT – General Considerations
Pp. 76-112 (37)
Deepak Gupta, Soheyl Sheikh and Shambulingappa Pallagatti
The management of osteomyelitis was an issue of great debate and research
since long. The treatment of osteomyelitis has been practiced by various clinicians.
Literature also reveals that the treatment of osteomyelitis of jaws was practiced since
the year1900. There are three treatment protocols advocated for osteomyelitis which
vary from simple non-invasive approach like antimicrobial therapy to more invasive
and radical treatment like surgical removal of the affected part. The nonsurgical
approach includes various medicinal treatment options including antibiotics,antiinflammatory
and muscle relaxants. There is evidence of certain other conservative non
surgical management approaches like hyperbaric oxygen therapy and bisphosphonate
treatment too. If the dental professional considers that the non surgical approach may
not fetch required results; then a surgical intervention is considered. This may include
decortications alone or with bone grafting and partial or segmental resection.
Unfortunately, there still exist dilemmas as to what approach to be followed in certain
cases of osteomyelitis of jaws. This is because of the evidence of multiple recurrences
of the disease. Further it is also reported that sometimes aggressive management may
lead to significant co-morbidity with subsequent need for reconstructive surgery.
Literature also reveals that symptomatic treatment may also be necessary in some
cases. Such symptomatic treatment may include debridement of necrotic tissues and
foreign materials along with skin closure of unhealed wounds. This present chapter
highlights the various treatment protocols instituted and adopted by various researchers
worldwide with recommendations for better treatment protocol for the dental
Acute Osteomyelitis, Antimicrobial therapy, Anti-inflammatory,
Bisphosphonate therapy, Chronic osteomyelitis, Conservative management of
Osteomyelitis of jaws, Decortication, Diabetes Mellitus, Hyperbaric Oxygen
therapy, Infantile Osteomyelitis, Management of Osteomyelitis of jaws,
Osteochemonecrosis, Osteonecrosis, Osteopetrosis, Primary chronic
osteomyelitis, Secondary chronic osteomyelitis, Segmental resection, Surgical
management of osteomyelitis of jaws, SAPHO syndrome.
Department of Oral Medicine and Radiology, M.M. College of Dental Sciences and Research, Mullana, Ambala, Haryana, India