Summary of Treatment of Osteomyelitis
Essential Measures
Bacterial sampling and culture
Vigorous (empirical) antibiotic treatment
Drainage
Give specific antibiotics based on culture and sensitivities
Give analgesics
Debridement
Remove source of infection, if possible
Adjunctive Treatment
Sequestrectomy
Decortication if necessary
Hyperbaric oxygen*
Resection and reconstruction for extensive bone destruction
*Mainly of value for osteo-radionecrosis and possibly, anærobic infections.
Anæsthesia of the lower lip usually recovers with elimination of the infection. Rare
complications include pathological fracture caused by extensive bone destruction,
chronic osteomyelitis after inadequate treatment, cellulitis due to spread of
exceptionally virulent bacteria or septicæmia in an immuno-deficient patient.
Chronic Osteomyelitis
Chronic osteomyelitis is characterised by a clinical course lasting over a month. It
may occur after the acute phase or it may be a complication of tooth-related
infection without a preceding acute phase. The clinical presentation is milder, with
painful exacerbations and discharge of pus or sinus tracts.
