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Osteomyelitis of the Jaw
Osteomyelitis of the Jaw

Osteomyelitis of the Jaw


This is an inflammation of the medullary portion of the jaw bone which extends to involve the periosteum of the affected area. The infection becomes established in the bone ending up with pus formation in the medullary cavity or beneath the periosteum obstructs the blood supply. The infected bone becomes necrotic following ischemia.



Signs and symptoms

• Fever
• Jaw pain
• Facial swelling
• Tenderness to the touch
• Jaw stiffness
• Sinus drainage
• Tooth loss
• Thick, yellow-white fluid pus discharge
• A palpable swelling on the bone of the jaw
• Fatigue

Diagnostic criteria

• In the initial stage there is no swelling.
• Malaise and fever
• Enlargement of regional lymph nodes
• Teeth in the affected area become painful and loose, thus causing difficulty in chewing
• Later as the bone undergoes necrosis the area becomes very painful and swollen
• Pus ruptures through the periosteum into the muscular and subcutaneous fascia and eventually it is discharged on to the skin surface through a sinus


• X-ray

OPG (Orthopantomograph) or mandibular lateral oblique, water’s view for maxilla/midface. The x-ray will show sequestra formation in chronic stage.

In early stage features seen in x-ray include

• Widening of periodontal spaces,
• Changes in bone trabeculation
• Areas of radioluscency.

• Culture and sensitivity of the pus to detect the specific bacteria



    Incision and adequate drainage to confirmed pus accumulation which is accessible

    Removal of the sequestrum by surgical intervention (sequestrectomy) is done after the formation of sequestrum has been confirmed by X-ray


    • Amoxicillin 500mg 8 hourly for 5 days
    • Metronidazole 400mg (PO) 8 hourly for 5days.

    Note: If culture is available treat according to results.



Updated on,

4 Novemba 2020 08:34:19


2. NCBI. Osteomyelitis of the jaw. Accessed on 4.11.2020
3. Choose PT. Physical therapy guide to osteomyelitis of the jaw. Accessed on 4.11.2020

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