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J Oral Maxillofac Surg ; 76(6): 1187-1193, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29425755

RESUMO

PURPOSE: We analyzed the data from a series of patients with dental implant-related suppurative osteomyelitis of the jaws (DIOMJ) due to Streptococcus anginosus. PATIENTS AND METHODS: The medical records of all patients seen for osteomyelitis of the jaws from 2011 to 2016 were reviewed. The primary outcome variable was Streptococcus anginosus DIOMJ. Other variables included age, gender, smoking habits, associated comorbidities, dental implant localization, type of osteomyelitis, delay between dental implant placement and DIOMJ, microbiologic examination and antibiogram, antibiotherapy, type of surgery, and final outcome. Cases from previous reports of DIOMJ were also analyzed for comparison. Finally, descriptive statistics were computed. RESULTS: A total of 26 patients had jaw osteomyelitis; in 6 patients (26%), jaw osteomyelitis had developed after dental implant placement. S. anginosus was found in 5 patients and Escherichia coli in 1. The osteomyelitis was located in the mandible and associated with a deep neck abscess in all cases. All the patients were women and were either smokers or had comorbidities affecting bone metabolism. In all 6 cases, the dental implants were removed, and several surgical debridement procedures (≥2) and prolonged antibiotherapy (average of 6 months) were needed. Of the 6 patients, 3 required a radical surgical reconstructive procedure with partial resection and bone grafting. CONCLUSIONS: The present study demonstrated that Streptococcus anginosus DIOMJ is a particularly aggressive form of osteomyelitis that has a propensity to develop in the mandible of women in their 60s who are either smokers or have comorbidities.


Assuntos
Implantação Dentária Endóssea/efeitos adversos , Implantes Dentários/microbiologia , Osteomielite/microbiologia , Osteomielite/terapia , Infecções Estreptocócicas/microbiologia , Infecções Estreptocócicas/terapia , Streptococcus anginosus/isolamento & purificação , Infecção da Ferida Cirúrgica/microbiologia , Infecção da Ferida Cirúrgica/terapia , Antibacterianos/uso terapêutico , Transplante Ósseo , Terapia Combinada , Comorbidade , Desbridamento , Remoção de Dispositivo , Feminino , Humanos , Mandíbula/cirurgia , Reconstrução Mandibular , Pessoa de Meia-Idade , Fumar , Resultado do Tratamento
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