tetracycline and Jaw-Diseases

An overview of infection as it applies to the oral and maxillofacial region has been provided. The following conclusions are drawn: odontogenic infections are caused by microbes found in the host's oral flora; cultures of purulent material generally will yield three to six anaerobes and one aerobe, (the aerobe is usually a Streptococcus species); Gram stains of purulent material can aid in therapeutic strategies; anaerobic as well as aerobic cultures are necessary to isolate all pathogens; pathogens found in infections of bite wounds reflect the oral flora of the aggressor; early postoperative wound infections are caused by the host's own flora, whereas later infections may be caused by hospital-acquired bacteria; and hepatitis B and herpes simplex virus are occupational hazards. Recommendations have been made for antimicrobial prophylaxis and for treatment. We recognize that some of these selections may be controversial. For instance, the value of prophylactic antibiotics in orthognathic surgery is not well defined; recommendations were made only in certain instances. However, in severe penetrating maxillofacial injuries with devitalized tissue, recommendations for antibiotics were for broad and prolonged coverage. In this instance, use of antibiotics is considered therapeutic and not prophylactic. In each instance, we tried to validate the selection. Our rationale has been to choose the antibiotics most active against the likely pathogens; additionally, consideration was given to drug toxicity and adverse reactions. We regard penicillin as the preferred agent for prophylaxis and treatment of most odontogenic infections. Alternative drugs include cephalosporins, doxycycline, and clindamycin. Erythoromycin and tetracycline are considered less effective than the former agents. Finally, we believe that successful treatment of infection depends as much on changing the microenvironment of the infected tissue by debridement and drainage as on appropriate antimicrobial therapy.

Topics: Actinomycosis; Anaerobiosis; Anti-Bacterial Agents; Bacterial Infections; Bacteroides Infections; Cephalosporins; Endocarditis, Bacterial; Erythromycin; Humans; Jaw Diseases; Maxillofacial Injuries; Mouth Diseases; Staphylococcal Infections; Surgical Wound Infection; Tetracycline; Tooth Diseases; Virus Diseases

To date, the therapy of bisphosphonate-associated osteonecrosis of the jaws (BONJ) has been hampered by the lack of imaging modalities that enable the extent of necrosis to be visualized. This study aims to demonstrate the feasibility of tetracycline fluorescence guided bone resection in the surgical management of BONJ.. Following a 10-day preoperative administration of doxycycline in patients suffering from BONJ, sufficient doxycycline is incorporated into viable bone to be visualized with a certified medical lamp emitting exciting light at 400 to 460 nm.. Viable and necrotic bone can be discriminated intraoperatively in a routine and reproducible manner by doxycycline bone fluorescence.. In the therapy of BONJ, conservative concepts are to be favored. The fact that necrotic bone can now be selectively resected signifies an improvement of the conservative surgical therapy of BONJ.

Topics: Aged; Bone Density Conservation Agents; Cone-Beam Computed Tomography; Diphosphonates; Feasibility Studies; Female; Fluorescence; Fluorometry; Humans; Jaw Diseases; Light; Male; Oral Surgical Procedures; Orthognathic Surgical Procedures; Osteonecrosis; Tetracycline

Topics: Bone Density Conservation Agents; Cone-Beam Computed Tomography; Diphosphonates; Fluorescent Dyes; Humans; Jaw Diseases; Osteonecrosis; Tetracycline

Osteonecrosis of the jaws (ONJ) associated with bisphosphonate therapy is being reported with increasing frequency all over the world. Pain may be the presenting symptom commonly associated with intra-oral bone exposure. The aetiology of this therapeutic complication is still not well understood. Three cases are presented and the management of the condition is discussed.

Topics: Aged; Anti-Bacterial Agents; Anti-Infective Agents, Local; Bone Density Conservation Agents; Chlorhexidine; Diphosphonates; Facial Pain; Female; Humans; Imidazoles; Jaw Diseases; Male; Middle Aged; Osteonecrosis; Osteoporosis, Postmenopausal; Tetracycline; Zoledronic Acid

Topics: Bacterial Infections; Chymotrypsin; Drug Therapy, Combination; Focal Infection, Dental; Humans; Jaw Diseases; Tetracycline; Trypsin

Topics: Anti-Bacterial Agents; Cellulitis; Chloramphenicol; Diathermy; Erythromycin; Humans; Jaw Diseases; Mouth Diseases; Osteitis; Osteomyelitis; Penicillin Resistance; Penicillins; Sulfonamides; Tetracycline

Topics: Anti-Bacterial Agents; Cellulitis; Cephalosporins; Erythromycin; Humans; Jaw Diseases; Microbial Sensitivity Tests; Mouth Diseases; Osteitis; Osteomyelitis; Penicillins; Tetracycline

Topics: Ampicillin; Anti-Infective Agents, Local; Aspirin; Blood Coagulation; Humans; Jaw Diseases; Neomycin; Penicillins; Tetracycline; Wound Healing

Topics: Adolescent; Adult; Aged; Cysts; Female; Humans; Infection Control; Infections; Jaw Diseases; Male; Middle Aged; Mouth Diseases; Osteitis; Osteomyelitis; Radiation Injuries; Salivary Gland Diseases; Tetracycline; Tonsillitis

Topics: Adolescent; Adult; Aged; Humans; Jaw Diseases; Methacycline; Middle Aged; Mouth Diseases; Tetracycline; Tooth Diseases