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At least 19 recordsLinked to original sources
PubMed1998

Perioperative use of 0.12% chlorhexidine gluconate for the prevention of alveolar osteitis: efficacy and risk factor analysis.

OBJECTIVES: The purposes of this study were to evaluate the use of 0.12% chlorhexidine gluconate as a prophylactic therapy for the prevention of alveolar osteitis and to further examine subject-based risk factors associated with alveolar osteitis. STUDY DESIGN: The trial was a randomized, double-blind, placebo-controlled, parallel-group study conducted among 279 subjects, each of whom required oral surgery for the removal of a minimum of one impacted mandibular third molar. Subjects were instructed to rinse twice daily with 15 ml of chlorhexidine or placebo mouthrinse for 30 seconds for 1 week before and 1 week after the surgical extractions. This regimen included a supervised presurgical rinse. Alveolar osteitis diagnosis was based on the subjective finding of increasing postoperative pain at the surgical site that was not relieved with mild analgesics, supported by clinical evidence of one or more of the following: loss of blood clot, necrosis of blood clot, and exposed alveolar bone. RESULTS: In comparison with use of the placebo mouthrinse, prophylactic use of the chlorhexidine mouthrinse resulted in statistically significant (p < 0.05) reductions in the incidence of alveolar osteitis. With chlorhexidine therapy, the subject- and extraction-based incidences of alveolar osteitis in the evaluable subset (271 subjects) were reduced, relative to placebo, by 38% and 44%, respectively. The corresponding odds ratios that describe the increased odds of experiencing alveolar osteitis in the placebo group were 1.87 and 2.05 for subject- and extraction-based analyses, respectively. In comparison with nonuse of oral contraceptives, the use of oral contraceptives in female subjects was related to a statistically significant increase in the incidence of alveolar osteitis (odds ratio = 1.92, p = 0.035). Relative to male subjects, the observed incidence of alveolar osteitis for female subjects not using oral contraceptives was not statistically significant (odds ratio = 1.18, p = 0.64). Smoking did not increase the incidence of alveolar osteitis relative to not smoking (odds ratio = 1.20, p = 0.33). CONCLUSIONS: These data confirm that the prophylactic use of 0.12% chlorhexidine gluconate mouthrinse results in a significant reduction in the incidence of alveolar osteitis after the extraction of impacted mandibular third molars. In addition, oral contraceptive use in females was confirmed to be a risk factor for the development of alveolar osteitis.

Adolescent↗
PubMed2006

Surgery for osteitis pubis.

BACKGROUND: Osteitis pubis is a rare and self-limited condition. Surgery may be necessary in 5%-10% of cases. The outcome after surgery for osteitis pubis is not known. METHODS: To determine the success of surgical intervention for osteitis pubis, we used a computerized data registry to identify patients (10 women [mean age 40 yr]) who underwent surgery for osteitis pubis. A retrospective chart review was carried out. We also searched the literature for all cases of osteitis pubis managed surgically and identified 73 cases. RESULTS: The 10 patients in our series had had symptoms for a mean of 4 years preoperatively. Onset of pain was insidious in 4 patients, it followed childbirth in 4 and it followed trauma in 2. Depending on the surgeon's preference, either a wedge resection of the symphysis pubis was performed or a symphysiodesis. At the latest follow-up (average 26 mo), although all patients had some improvement, only 6 of 10 patients were satisfied with the outcome. From the literature review, we identified 3 categories of patients with osteitis pubis: elite athletes, patients with postoperative or infectious osteitis pubis and the remainder, which would include the patients in our series. CONCLUSIONS: Four types of surgical intervention are described: curettage, arthrodesis, wedge resection and wide resection. The elite athletes respond well to curettage. Patients with osteitis pubis following urologic or gynecologic procedures or have a proven infection require surgery in roughly 50% of cases. The third group has an unpredictable outcome.

Adult↗
PubMed1977

Effect of lavage on the incidence of localized osteitis in mandibular third molar extraction sites.

Four hundred twenty-two mandibular third molars were extracted in 211 patients. After extraction, one half of the surgical sites were subjected to a 175 ml. lavage with normal saline solution, and the other half received a lavage of less than 25 ml. of normal saline solution. Comparisons revealed the following: 1. The overall incidence of localized osteitis was 8.3 per cent (thirty-five of 422 sites). 2. Localized osteitis occurred at twelve of 211 (5.7 per cent) sites which were subjected to the higher-volume lavage. 3. Localized osteitis occurred at twenty-three of 211 (10.9 per cent) sites which were subjected to minimal lavage. 4. The incidence of localized osteitis was determined in the various age groups as follows: ages 15 to 20, 5.0 per cent; ages 21 to 35, 10.4 per cent; ages 26 to 30, 14.7 per cent. 5. Localized osteitis occurred at eight of 175 (4.5 per cent) partial-impaction sites, whereas it occurred at twenty-seven of 246 (11 per cent) complete-impaction sites. 6. The incidence of localized osteitis at extraction sites in female patients taking oral contraceptives was 19.4 per cent (seven of thirty-six sites). 7. Postoperative infection occurred at seven of 422 extraction sites (1.4 per cent); six of these occurred at sites which were subjected to minimal lavage. These results indicate that the use of a 175 ml. lavage with normal saline solution after extraction of mandibular third molars will significantly reduce the incidence of localized osteitis to approximately one half of that observed when only a minimal-volume lavage is used. The results also suggest that age, type of impaction, and whether the patient is taking oral contraceptives are all important factors to be considered in the incidence of localized osteitis.

Adolescent↗
PubMed2001

Osteitis Pubis Syndrome in the Professional Soccer Athlete: A Case Report.

OBJECTIVE: To describe the pathomechanics, diagnostic procedures, classification, and conservative management of the osteitis pubis syndrome in the elite soccer athlete. BACKGROUND: Groin injuries can be the most difficult sport injuries to accurately diagnose and treat. Osteitis pubis is a painful, chronic syndrome that affects the symphysis pubis, adductor and abdominal muscles, and surrounding fascia. If misdiagnosed or mismanaged, osteitis pubis can run a prolonged and disabling course. The abdominal and adductor muscles have attachments to the symphysis pubis but act antagonistically to each other, predisposing the symphysis pubis to mechanical traction microtrauma and resulting in osteitis pubis. These antagonistic forces are most prevalent in kicking sports, such as soccer or football. DESCRIPTION: We provide a retrospective review of the demographics, diagnostic criteria and procedures, and conservative management of osteitis pubis in a professional soccer team. Osteitis pubis represented 3% to 5% of all injuries sustained by our professional soccer team between 1989 and 1997; 71.4% of those presenting with osteitis pubis were classified as having stage I disease, with a mean recovery time of 26.7 days. Midfielders were most affected by the syndrome (42.8%), whereas defenders and forwards exhibited equal incidences (25.7%) of osteitis pubis. Conservative management included nonsteroidal anti-inflammatory medication, electric stimulation, ultrasound, laser, cryomassage, and a progressive rehabilitation program. CLINICAL ADVANTAGES: Athletes who participated in this conservative management program appeared to return to full sport participation earlier and with fewer restrictions than the current literature seems to suggest. A 4-stage diagnostic criteria system was helpful in determining the course of treatment.

Journal Article↗
PubMed1989

Frequency of alveolar osteitis (dry socket) at Kenyatta National Hospital Dental Outpatient Clinic--a retrospective study.

The objectives of this study were to determine the frequency of alveolar osteitis at Kenyatta National Hospital (KNH), most affected age group and the reasons for underlying extractions. Out of 8,393 extractions 273 (3.3%) developed alveolar osteitis. 98.5% of the teeth that developed alveolar osteitis were molars and premolars. 52% of the patients that developed alveolar osteitis were females and 48% were males. The mandible was more affected than the maxilla. The percentage distribution of alveolar osteitis according to age groups 10-19 year, 30-39 years, 40-49 years, 50-59 years and 60-69 years were 6.2%, 53.1%, 23.8%, 5.5%, 4.8% and 2.9% respectively. On the average, patients reported with alveolar osteitis 5.7 days following extraction. Out of 8,393 extractions, 72.5% were due to dental caries, 18% were due to periodontitis and the rest were due to other causes. It was concluded that the frequency and average, patients reported with alveolar osteitis 5.7 days following extraction. Out of 8,393 extractions, 72.5% were due to dental caries, 18% were due to periodontitis and the rest were due to other causes. It was concluded that the frequency and pattern of development of a alveolar osteitis at KNH was similar to that reported in developed countries.

Adolescent↗
PubMedDate not supplied

The incidence of concurrent osteitis in patients with chronic rhinosinusitis: a clinicopathological study.

BACKGROUND: The pathogenesis of chronic rhinosinusitis (CRS) has been found to be multifactorial, with environmental, general host, and local anatomic factors all contributing to its development. Recent studies have indicated that local osteitis of the underlying bone also may play a critical role in the elaboration of CRS by inducing persistent inflammatory changes in the surrounding mucosa. The purpose of this study was to determine the clinical incidence rate of osteitis in patients with CRS undergoing functional endoscopic sinus surgery. METHODS: From January to July 2003, a prospective study was performed on 121 patients undergoing functional endoscopic sinus surgery for CRS. Age, number of previous surgeries, radiographic bony characteristics, and pathological findings were all documented. The presence of concurrent osteitis was assessed using both radiographic (neoosteogenesis) and pathological (bony remodeling) criteria. RESULTS: The mean age of the patients was 44.3 years. Fifty-eight percent of the cases were revision surgeries, with each patient having an average of 2.2 operative procedures in the past. Computed tomography (CT) showed neoosteogenesis in 36% of patients, and 53% showed pathological evidence of osteitis on histological analysis of surgical specimens. CONCLUSION: Concurrent osteitis can be found in 36-53% of patients with CRS, using both radiographic and pathological criteria, respectively. Although a causal relationship between osteitis and CRS can not be inferred from this data, these clinical findings correlate well with previous evidence of bone involvement in CRS found in animal models, further reaffirming the association between underlying osteitis and the pathogenesis of CRS.

Adult↗
PubMed1997

Osteitis--an under-recognised association with seronegative spondyloarthropathy?

AIM: To emphasise osteitis as a feature of the spondyloarthritides. METHOD: We describe four cases spanning a spectrum of the spondyloarthritides in which osteitis was a feature. RESULTS: One patient had psoriatic arthritis with palmar-plantar pustular psoriasis and extensive osteitis involving the tibia and fibula. This case provides a link with two cases with SAPHO syndrome (synovitis, acne, pustulosis hyperostosis, osteitis) who had palmar-plantar pustulosis and osteitis. Many now argue that this syndrome is a form of spondyloarthritis. The fourth case, which was of particular interest to us, had enteric reactive arthritis and scintigraphic changes strongly suggesting the presence of osteitis of individual bones in the wrist. CONCLUSION: We propose that these four cases demonstrate that osteitis may be another feature common to the spondyloarthritides and SAPHO. Awareness of this may facilitate better documentation of this feature of the disease.

Adult↗
PubMed1993

Postoperative pubic osteomyelitis misdiagnosed as osteitis pubis: report of four cases and review.

Osteitis pubis is a painful inflammatory process resulting in bony destruction of the margins of the symphysis pubis. Despite six decades of speculation, the pathogenesis of, criteria for diagnosis of, natural history of, and optimal therapy for osteitis pubis remain controversial. We present four cases of postoperative pubic osteomyelitis that were initially thought to be typical cases of osteitis pubis. These cases illustrate that pubic osteomyelitis can mimic the principal features of osteitis pubis including characteristic pelvic pain and gait disturbance, symmetrical bony destruction of the symphysis pubis, absence of fever, a long interval between surgery and onset of symptoms, lack of response to antimicrobial therapy, and apparent spontaneous cure. We believe that many previously reported cases of osteitis pubis were actually cases of unrecognized pubic osteomyelitis. We advise an aggressive diagnostic approach to cases of apparent postoperative osteitis pubis including biopsy and needle aspiration of the symphysis pubis guided by computer-assisted tomography. If cultures of biopsy specimens are not diagnostic, open biopsy of the symphysis pubis is recommended.

Adult↗
PubMed1995

Osteitis caused by bacille Calmette-Guérin vaccination: a retrospective analysis of 222 cases.

To evaluate the frequency, clinical features, and prognosis of patients with osteitis caused by bacille Calmette-Guérin (BCG) vaccination, medical records from Finnish children based on nationwide registration from 1960 to 1988 were retrospectively analyzed. During the study period, three different BCG vaccine preparations were used. In 222 children, diagnostic criteria of BCG osteitis were fulfilled. The age at onset of BCG osteitis varied from 0.25 to 5.7 years. The most common sites of osteitis were metaphyses of the long bones. The lower extremity (58%) was affected more often than the upper (14%). Osteitis was situated in the sternum in 36 patients (15%) and in the ribs in 27 (11%). The frequency of BCG osteitis, but not the clinical parameters, was closely associated with the vaccine preparation used. Only 6 children were left with some sequelae. With adequate treatment, the prognosis for children vaccinated with BCG is good.

BCG Vaccine↗
PubMed1995

Osteitis pubis: a review.

Osteitis pubis is a painful, noninfectious inflammatory condition that involves the pubic bone, symphysis, and surrounding structures. Initially associated with urologic procedures, osteitis pubis has been described as a complication of various obstetrical and gynecological procedures including vaginal deliveries. An incidence of approximately 2 to 3 percent has been observed after the Marshall-Marchetti-Krantz urethropexy. Although the pathogenesis of osteitis pubis is not clear, periosteal trauma seems to be an important initiating event. Pain is the primary symptom associated typically with difficulty in ambulation and the characteristic "waddling gait." A low grade fever, elevated sedimentation rate, and mild leukocytosis may be observed. Radiographic findings which include reactive sclerosis, rarefaction, and osteolytic changes lag behind the symptoms by about 4 weeks. The major differential diagnosis is osteomyelitis; however, the self-limiting nature and its response to nonantibiotic therapy indicates that osteitis pubis is a separate clinical entity. Treatment is directed at the associated inflammation with most minor cases responding to antiinflammatory agents and bedrest. Other more recalcitrant cases require more involved therapy including systemic steroids and rarely surgical resection. The diagnosis of osteitis pubis should be considered when pelvic pain is present in association with potential trauma to the symphysis pubis. Also, with more women participating in sporting activities patients may present to the physician with osteitis pubis related to athletic injury.

Diagnosis, Differential↗
PubMed1998

Osteitis pubis after Marshall-Marchetti-Krantz urethropexy: a pubic osteomyelitis.

OBJECTIVE: Our purpose was to review cases of osteitis pubis encountered at our institution after Marshall-Marchetti-Krantz retropubic urethropexy. STUDY DESIGN: The charts of patients diagnosed with osteitis pubis subsequent to Marshall-Marchetti-Krantz retropubic urethropexy from 1980 to 1994 were reviewed. RESULTS: Fifteen cases of osteitis pubis were diagnosed after 2030 Marshall-Marchetti-Krantz procedures (0.74%). Onset of symptoms related to osteitis pubis began a mean of 69.8 days postoperatively (range 10 to 459 days). Although initial plain films of the symphysis pubis were normal in 7 (54%), radiographic abnormality was eventually demonstrated in all a mean of 25.7 weeks after surgery (range 4 to 78 weeks). A variety of conservative treatments resulted in symptomatic relief in 47%. Seven of the remaining patients underwent operative therapy with partial or complete relief noted in all. Subsequent bone cultures were positive in 5 (71%). At follow-up a mean of 58 months after the Marshall-Marchetti-Krantz procedure complete resolution of symptoms was noted in 33% and continued pain or ambulatory difficulty in the remainder. There was no relationship between postoperative urinary tract infections, postoperative complications, presenting sign of fever, elevated leukocyte count or sedimentation rate, and subsequent operative intervention (P > .05). CONCLUSIONS: Osteitis pubis after urogynecologic surgery is an uncommon event requiring aggressive surgical and antibiotic therapy. When bone cultures are performed, a microbial cause may be demonstrated in as many as 71% of patients.

Aged↗