Related Experiment Videos
Diagnosis and classification of mandibular osteomyelitis
Yoshikazu Suei1, Akira Taguchi, Keiji Tanimoto
1Department of Oral and Maxillofacial Radiology, Graduate School of Biomedical Sciences, Hiroshima University Hospital, Hiroshima, Japan. suei@hiroshima-u.ac.jp
Summary
This study proposes a new classification for mandibular osteomyelitis, dividing it into bacterial and synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome types. This distinction aids in appropriate diagnosis and treatment strategies.
Area of Science:
- Oral and Maxillofacial Surgery
- Infectious Diseases
- Rheumatology
Background:
- Mandibular osteomyelitis lacks a unified classification system, leading to diagnostic challenges.
- Existing terminology for mandibular osteomyelitis is varied and often inappropriate for clinical classification.
Purpose of the Study:
- To establish a unified classification system for mandibular osteomyelitis.
- To differentiate bacterial osteomyelitis from osteomyelitis associated with SAPHO syndrome.
Main Methods:
- Critical assessment of various diagnostic terms for mandibular osteomyelitis.
- Review of clinicopathologic findings of mandibular osteomyelitis lesions.
Main Results:
- Recommended classification: bacterial osteomyelitis and osteomyelitis associated with SAPHO syndrome.
- Bacterial osteomyelitis criteria: suppuration and osteolytic change, responsive to antibiotics.
- SAPHO syndrome osteomyelitis criteria: nonsuppuration, mixed radiographic pattern, specific bone changes, often persistent despite antibiotics.
Conclusions:
- A dichotomous classification of mandibular osteomyelitis into bacterial and SAPHO syndrome types is proposed.
- Bacterial osteomyelitis is characterized by suppuration and responds well to antibiotics.
- SAPHO syndrome-associated osteomyelitis presents with distinct radiographic and clinical features and is often refractory to antibiotics.