minocycline and Mandibular-Diseases

Actinomycosis is a rare, chronic, slowly progressive granulomatous disease caused by filamentous gram-positive anaerobic bacteria from the Actinomycetaceae family (genus Actinomyces). It has become a rare condition because of the widespread use of antibiotics. When clinical symptoms are not typical, diagnosis of this condition becomes difficult. This report describes a case involving an 82-year-old woman who was diagnosed with actinomycotic osteomyelitis of the mandible using matrix assisted laser desorption ionization-time-of-flight mass spectrometry (MALDI-TOF MS). The patient was referred to the authors' department with chief complaints of swelling, multiple fistulae in the left preauricular region, and trismus. The authors performed fine-needle aspiration microbiology (FNAM) and identified Actinomyces oris using MALDI-TOF MS. A diagnosis of actinomycotic osteomyelitis of the mandible was made and the patient was treated with minocycline and extraction of the culprit tooth. The findings from this case have 2 important implications. First, for patients with clinically suspected actinomycosis, bacteriologic examinations should include not only surface swab tests but also FNAM; moreover, communication with the laboratory medical technologist is important to improve detection of the causative organisms. Second, MALDI-TOF MS could be an effective tool for improving the diagnosis and treatment outcomes of actinomycosis.

Topics: Actinomycosis; Aged, 80 and over; Anti-Bacterial Agents; Female; Humans; Magnetic Resonance Imaging; Mandibular Diseases; Minocycline; Osteomyelitis; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization; Tomography, X-Ray Computed; Treatment Outcome

To monitor over 12 months clinical and radiographic changes occurring after adjunctive local delivery of minocycline microspheres for the treatment of peri-implantitis.. In 25 partially edentulous subjects, 31 implants diagnosed with peri-implantitis were treated. Three weeks after oral hygiene instruction, mechanical debridement and local antiseptic cleansing using 0.2% chlorhexidine gel, baseline (Day 0) parameters were recorded. Minocycline microspheres (Arestin) were locally delivered to each implant site with bone loss and a probing pocket depth (PPD) >or=5 mm. Rescue therapy with Arestin was allowed at Days 180 and 270 at any site exhibiting an increase in PPD>or=2 mm from the previous visit. The following clinical parameters were recorded at four sites/implant at Day 0, 10, 30, 60, 90, 180, 270 and 360: PPD, clinical attachment level (CAL), bleeding on probing (BOP) and plaque index (PlI).. Six implants in six subjects were either rescued or exited because of persisting active peri-implantitis. Successful implants showed a statistically significant reduction in both PPD and percentage of sites with BOP between baseline and Day 360 (P<0.05). At mesial implant sites, the mean PPD reduction amounted to 1.6 mm (95% CI: 0.9-2.2 mm, P<0.001) and was accompanied by a statistically significant reduction of the BOP value (P<0.001). Binary regression analysis showed that the clinical parameters and smoking history could not discriminate between successfully treated and rescued or exited implants at any observation time point.. Non-surgical mechanical treatment of peri-implantitis lesions with adjunctive local delivery of microencapsulated minocycline led to positive effects on clinical parameters up to 12 months.

Topics: Adult; Aged; Alveolar Bone Loss; Anti-Bacterial Agents; Dental Implants; Epidemiologic Methods; Female; Humans; Male; Mandibular Diseases; Maxillary Diseases; Middle Aged; Minocycline; Radiography

Pigmentation of the oral mucosa may be a sign of underlying systemic disease. An unusual case of what appeared clinically as mucosal pigmentation was shown eventually to be minocycline-related pigmentation of the underlying alveolar bone. If this manifestation of bone discoloration is recognized, unnecessary investigation may be avoided.

Topics: Adult; Alveolar Process; Diagnosis, Differential; Humans; Male; Mandibular Diseases; Minocycline; Mouth Diseases; Mouth Mucosa; Pigmentation Disorders; Tetracyclines

A 47-year-old man with chronic osteomyelitis of the mandible is described. The patient had frequent episodes of acute and subacute exacerbation at varying intervals for a period of six years in spite of extended antibiotic therapy. Intraarterial infusion of antibiotics through the superficial temporal artery also failed to cause any improvement. He was finally treated successfully by surgical intervention.

Topics: Cephalexin; Chronic Disease; Drug Resistance; Humans; Injections, Intra-Arterial; Male; Mandibular Diseases; Middle Aged; Minocycline; Necrosis; Osteomyelitis; Tetracyclines