Chronic Osteomyelitis of the Maxilla and Mandible: Microbiological and Clinical Aspects

Secondary chronic osteomyelitis of the jaws are common in the developing countries, where these diseases are associated with trauma, surgical procedures and previous infections, such as endodontic and periapical infections. However, their incidence, clinical characteristics and etiology have not been studied in details (Prasad et al., 2007). Among the skull bones, the chronic osteomyelitis is more frequently observed in the mandible and, in fewer cases, in the maxilla, but generally limited to one anatomic site (Baltensperger et al., 2004; Lew & Waldvogel, 2004), although it may spread out to other areas, specially in diabetic, immunosuppressed and hospitalized patients (Brady et al., 2006).

The pathogenesis of these diseases may be linked to hematogenous dissemination of exogenous or commensal microorganisms living on the skin or in the digestive tract, but generally the main source of microorganisms involved in the osteomyelitis of the maxilla and mandible is the dental biofilm and oral infections, particularly endodontic infections (Brady et al., 2006), peri-implantitis, periodontitis and gingivitis (O’Sullivan et al., 2006; Coviello & Stevens, 2007).