Etiology and Pathogenesis
Pp. 8-15 (8)
Osteomyelitis of jaws is a multifactorial disease. It has various etiological
factors which lead to the inflammation of the medullary portion of the bone. The
various predisposing factors for osteomyelitis include immunosuppressive conditions,
malnutrition, metabolic bone disease, tobacco, alcohol, odontogenic infections, etc.
Sometimes haematogenous dissemination of infection to healthy bones and infection
associated with peripheral vascular disease may also lead to maxillofacial
osteomyelitis. The process leading to osteomyelitis is initiated by acute inflammation
which leads to hyperaemia, increased capillary permeability and infiltration of
leukocytes which further results in destruction of bacteria and vascular thrombosis. The
process also leads to release of proteolytic enzymes which causes tissue necrosis and
accumulation of pus. This results in the rise of intramedullary pressure resulting in
vascular collapse, venous stasis and ischemia of the concerned area. The pus then
travels through the haversian and nutrient canals and accumulates beneath the
periosteum of the bone leading to its elevation from the underlying cortex which
further reduces the vascular supply to the bone. This is vascular impairment in the jaw
which is a contributory factor in the development of osteomyelitis.
Haversian and nutrient canals, Hyperaemia, Intramedullary pressure,
Odontogenic infections, Osteomyelitis of jaws, Periosteum, Vascular thrombosis.