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. 2022 Jun;21(2):590-598.
doi: 10.1007/s12663-020-01371-6. Epub 2020 Apr 27.

Diabetic Maxillary Osteomyelitis: A Worrisome Vulnerability-Our Experience

Pulkit Khandelwal  1 , Harish Saluja  1 , Seemit Shah  1 , Anuj Dadhich  1 , Neha Hajira  2
Affiliations

Diabetic Maxillary Osteomyelitis: A Worrisome Vulnerability-Our Experience

Pulkit Khandelwal et al. J Maxillofac Oral Surg. 2022 Jun.

Abstract

Background: Osteomyelitis is inflammation of medullary cavities, haversian system and adjacent cortex of bone. It is devastating to patients when invasive.

Aim: The purpose of this study is to retrospectively review patients diagnosed with diabetic maxillary osteomyelitis and evaluate factors relating infection & diabetes.

Methodology: Case records of patients diagnosed with diabetic maxillary osteomyelitis were studied. Patient's demographic data, predisposing factors, etiology, clinical features, culture sensitivity reports, microbiology, treatment and complications were studied. Diabetic status was confirmed by glycosylated hemoglobin (HbA1c) test. Duration of diabetes and anti-diabetic medication adherence was also studied.

Results: There were 28 patients diagnosed with diabetic maxillary osteomyelitis, (23-male; 5-female). Majority of the patients (60.7%) belonged to fourth & fifth decades. Twenty (71.4%) patients had poorly controlled diabetes (HbA1c > 8%). All patients reported with random blood sugar > 200 mg/dl. Thirteen patients (46.4%) were diagnosed for diabetes on admission and 11 patients (39.3%) had poor anti-diabetic medication adherence. Predominant etiology was odontogenic infection (50%). Cases of bacterial osteomyelitis (50%) were more frequent than those of fungal osteomyelitis (32.1%). Recurrence was observed in three cases.

Conclusion: Non-cognizance about diabetes mellitus can prove devastating for maxillofacial region and may prove fatal for the patient.

Keywords: Antibiotics; Diabetes; Infection; Maxilla; Osteomyelitis.

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Conflict of interest statement

Conflict of InterestAuthors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Definitive surgical treatment. a Typical small abscesses involving whole maxilla. b Sequestrectomy done. c Infected soft tissue and maxillary sinus lining. d Necrotic bone tissue and extracted teeth. e Primary closure by advancement of local tissue
Fig. 2
Fig. 2
Striking clinical presentation. a Case of mucormycosis with ptosis and loss of vision in left eye. b Case of Aspergillosis with extension of infection till orbital floor leading to enopthalmos of right eye. c Case of Mucormycosis with perforating ulcerative cutaneous lesion extra-orally
Fig. 3
Fig. 3
Typical clinical presentation of maxillary osteomyelitis. a Palatal swelling. b Multiple small abscesses. c Oro-antral fistula/oro-nasal fistula. d–f Exposed necrotic bone with non-healing soft tissue
Fig. 4
Fig. 4
Radiographic investigations. a Typical small abscesses involving whole maxilla. b Orthopantamogram. c Paranasal sinus view. d CT scan (axial view). e CT scan (coronal view)
Fig. 5
Fig. 5
Varying tomographic presentation of maxillary osteomyelitis
See this image and copyright information in PMC

References

    1. Topazian RG, Goldberg MH, Hupp JR. Oral and maxillofacial infections. 4. Philadelphia: Saunders; 2002. Osteomyelitis of the jaws; pp. 214–235.
    1. Reddy S, Prasad K, Chippagiri P, et al. Osteomyelitis of the maxilla: a case report of three cases. Am J Adv Med Sci. 2014;2(3):34–41.
    1. Peravali RK, Jayade B, Joshi A, Shirganvi M, Rao CB, Gopalkrishnan K. Osteomyelitis of maxilla in poorly controlled diabetics in a rural Indian population. J Maxillofac Oral Surg. 2012;11(1):57–66. doi: 10.1007/s12663-011-0283-0. - DOI - PMC - PubMed
    1. Patel V, Harwood A, McGurk M. Osteomyelitis presenting in two patients: a challenging disease to manage. Br Dent J. 2010;209:393–396. doi: 10.1038/sj.bdj.2010.927. - DOI - PubMed
    1. Hudson JW. Osteomyelitis of Jaws: a 50-year perspective. J Oral Maxillofac Surg. 1993;51:1294–1301. doi: 10.1016/S0278-2391(10)80131-4. - DOI - PubMed

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