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Osteomyelitis

Infektionen im Kiefer- und Gesichtsbereich

Osteomyelitis

Infections in the oral and maxillofacial area

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Zusammenfassung

Die Osteomyelitis im Bereich des Kiefers unterscheidet sich signifikant von Osteomyelitiden anderer skelettaler Bereiche. Ursächlich hierfür sind die speziellen immunologischen und mikrobiologischen Gegebenheiten der oralen Kavität, die spezielle enorale Umgebung (u. a. mit dem Vorkommen von Zähnen) sowie eine andere Dichte an Blutgefäßen. Weiterhin liegt hier eine, im Vergleich zur Haut, dünne Mukosaschicht vor. Bei der Osteomyelitis des Kiefers existiert eine verwirrende Anzahl von Klassifikationen und Terminologien, wobei mit der Zürich-Klassifikation in jüngerer Zeit ein Vorschlag der Neuordnung unterbreitet wurde. Trotz der Verfügbarkeit einer antibiotischen Therapie und einer verbesserten dentalen und medizinischen Versorgung hat die Entwicklung resistenter Mikroorganismen und die steigende Anzahl immunsupprimierter Patienten sowie anderer kompromittierender Voraussetzungen zu einer wieder ansteigenden Zahl therapierefraktärer Fälle geführt. Besonders ältere Patienten mit Prädispositionsfaktoren wie vaskulären Erkrankungen, Diabetes mellitus und einer schlechten oralen Hygiene sind betroffen.

Abstract

Osteomyelitis of the jaws differs significantly from osteomyelitis at other skeletal sites. These differences are due to a different group of pathogens, the presence of teeth, a different blood vessel density, an oral environment and a thin mucosa as opposed to skin. These differences are also related in the confusing array of terms used to describe the different forms of jaw osteomyelitis. Despite the availability of an antibiotic therapy and an improved dental and medical provision, the development of microorganisms resistant to commonly used antibiotics and the increased number of immunocompromised patients have led again to an increase of cases refractory to standard treatments. Especially older patients with risk factors such as vascular diseases, diabetes mellitus and poor oral hygiene can be affected.

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  1. Klinik für Mund-, Kiefer- und Gesichtschirurgie, Johannes Gutenberg-Universität, Augustusplatz 2, 55131, Mainz, Deutschland

    B. Al-Nawas & P.W. Kämmerer

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  1. B. Al-Nawas
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  2. P.W. Kämmerer
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Correspondence to B. Al-Nawas.

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Al-Nawas, B., Kämmerer, P. Osteomyelitis. MKG-Chirurg 2, 221–232 (2009). https://doi.org/10.1007/s12285-009-0112-3

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