title: Chronic osteomyelitis of the mandible: diagnosis and management--an institution's experience over 7 years.
abstract: OBJECTIVE
  The objective of this study was to retrospectively evaluate and report the associated factors with the diagnosis and management of 24 patients with chronic osteomyelitis of the mandible seen at the authors' institution during the past several years.
  
  
  METHODS
  Only cases of chronic osteomyelitis of the mandible not associated with antiresorptive medications or radiotherapy to the maxillofacial region were included in the study. After confirmation of the diagnosis, initial clinical and radiologic findings, treatment approach, and outcome were evaluated for each patient. Fourteen male and 10 female patients (average age, 53.75 yr; range, 22 to 83 yr) were included.
  
  
  RESULTS
  The peak incidence of the disease was recorded in the fifth and sixth decades of life. An uneventful healing was observed in 20 patients (83.3%). One of 18 patients (5.5%) who underwent segmental resections developed a secondary infection and was managed with intravenously administered antibiotics. Three of 6 patients (50%) who were treated with marginal resections remained symptomatic after surgery.
  
  
  CONCLUSIONS
  Independent of the cause and presentation of the disease, complete resolution of the infection should be the main focus of management in patients with chronic osteomyelitis of the mandible, and findings of this retrospective study indicate that a conservative surgical approach is more likely to result in a less than ideal outcome.
authors.affiliation: Associate Professor and Chair, Department of Oral and Maxillofacial Surgery, Case Western Reserve University, School of Dental Medicine, Cleveland, OH. Electronic address: dale.baur@case.edu.
authors.forename: Dale A
authors.initials: DA
authors.lastname: Baur
authors.affiliation: Doctor, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Akdeniz University, Antalya, Turkey; currently Research Fellow, Department of Oral and Maxillofacial Surgery, Case Western Reserve University, School of Dental Medicine, Cleveland, OH.
authors.forename: Mehmet Ali
authors.initials: MA
authors.lastname: Altay
authors.affiliation: Research Fellow, Department of Oral and Maxillofacial Surgery, Case Western Reserve University, School of Dental Medicine, Cleveland, OH.
authors.forename: Andres
authors.initials: A
authors.lastname: Flores-Hidalgo
authors.affiliation: Resident, Department of Oral and Maxillofacial Surgery, Case Western Reserve University, School of Dental Medicine, Cleveland, OH.
authors.forename: Yirae
authors.initials: Y
authors.lastname: Ort
authors.affiliation: Associate Professor, Department of Oral and Maxillofacial Surgery, Residency Program Director, Case Western Reserve University, School of Dental Medicine, Cleveland, OH.
authors.forename: Faisal A
authors.initials: FA
authors.lastname: Quereshy
mesh_terms: D061605:Administration, Intravenous; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000658:Amoxicillin / Q000627:therapeutic use; D019980:Amoxicillin-Potassium Clavulanate Combination / Q000627:therapeutic use; D000667:Ampicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D002908:Chronic Disease; D002981:Clindamycin / Q000627:therapeutic use; D004318:Doxycycline / Q000627:therapeutic use; D000077727:Ertapenem; D005260:Female; D005500:Follow-Up Studies; D005598:Fractures, Spontaneous / Q000175:diagnosis; D006801:Humans; D008297:Male; D008336:Mandibular Diseases / Q000175:diagnosis* / Q000601:surgery; D008337:Mandibular Fractures / Q000175:diagnosis; D008875:Middle Aged; D010019:Osteomyelitis / Q000175:diagnosis* / Q000601:surgery; D010026:Osteosclerosis / Q000175:diagnosis; D012189:Retrospective Studies; D013407:Sulbactam / Q000627:therapeutic use; D016896:Treatment Outcome; D014640:Vancomycin / Q000627:therapeutic use; D055815:Young Adult; D047090:beta-Lactams / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D047090:beta-Lactams; D002981:Clindamycin; D014640:Vancomycin; D019980:Amoxicillin-Potassium Clavulanate Combination; D000667:Ampicillin; D000658:Amoxicillin; D000077727:Ertapenem; D004318:Doxycycline; D013407:Sulbactam