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Abstract：
Despite improved knowledge regarding the diagnosis and treatment of osteomyelitis of the jaw (OMJ), it remains a clinical challenge for oral and maxillofacial surgeons. This study aimed to identify risk factors associated with severe forms of OMJ, i.e., related to the occurrence of major complications or the refractory course of the disease. A retrospective study was performed based on the medical records of all patients diagnosed with OMJ from the past 20 years. Collected data included demographic information, medical and dental history, clinical, radiological, and bacterial findings as well as treatment modalities. The main outcome variables were the onset of major complications and treatment results. Fifty-four patients were included. Our results showed that alcohol and smoking habits, as well as malnutrition, were significantly associated with the occurrence of major complications. We also established that dental implant-induced OMJ should be considered an aggressive subtype of OMJ. Finally, clinical bone exposure was significantly associated with unfavorable outcomes, whereas dental causes or radiological evidence of periosteal reaction were predictive of successful outcomes. Identifying such factors could be useful in preventing serious complications and informing patients about the refractory course of the disease based on the presence of these factors.
摘要：
尽管对颌骨骨髓炎（OMJ）的诊断和治疗有了更多的了解，它仍然是口腔颌面外科医师的临床挑战。这项研究旨在确定与严重形式的OMJ相关的危险因素，即，与主要并发症的发生或疾病的难治性过程有关。根据过去20年诊断为OMJ的所有患者的医疗记录进行了回顾性研究。收集的数据包括人口统计信息，医疗和牙科史，临床,放射学,和细菌的发现以及治疗方式。主要结果变量是主要并发症的发生和治疗结果。包括54名患者。我们的结果表明，酒精和吸烟习惯，以及营养不良，与主要并发症的发生显著相关。我们还确定，牙科植入物诱导的OMJ应被视为OMJ的侵袭性亚型。最后,临床骨暴露与不良结局显著相关,而牙科原因或骨膜反应的放射学证据可预测成功的结局。确定这些因素可能有助于预防严重的并发症，并根据这些因素的存在告知患者疾病的难治性病程。
