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Revista de Cirurgia e Traumatologia Buco-maxilo-facial

versão On-line ISSN 1808-5210

Resumo

CANTANHEDE, André Luis Costa et al. Refractory mandibular osteomyelitis in a young patient with osteopetrosis: Case report. Rev. cir. traumatol. buco-maxilo-fac. [online]. 2016, vol.16, n.1, pp. 51-55. ISSN 1808-5210.

Osteopetrosis is a rare hereditary metabolic bone disorder that has its diagnosis mainly based on several clinical and radiographic findings. It is characterized by an osteoclast dysfunction which leads to an increase in skeletal bone density. In patients suffering from this condition, a key factor is the reduced bone vascularization with anemia and neutropenia often present, making them very susceptible to infections. Three variants of the disease are recognized in the literature: severe infantile malignant autosomal recessive, intermediate mild autosomal recessive, and benign autosomal dominant, with the first being the most severe. Therefore, it becomes imperative a careful management of this patient by the dentist in regards to dental extractions, given that in 10% of cases, patients may develop osteomyelitis of the jaws after these procedures. This paper illustrates a case of a patient of 15 years old, with mild recessive osteopetrosis that after extraction of a deciduous molar tooth, developed severe mandible infection, surgery and medicamentous treatment were performed. After a few years, the patient returned with refractory infectious, demonstrating on clinical examination, submandibular fistula with spontaneous drainage and reconstruction plate externalization in parasymphysis region of previous surgery. Antibiotic treatment did not show major improvements, so the patient underwent new surgical procedure through mandibulectomy, with final resolution of the infection process.

Palavras-chave : Osteopetrosis; Albers-Schoenberg disease; osteomyelitis; mandible.

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