Pathological mandibular fracture caused by osteomyelitis: Case report

João Victor Silva Bett, Rubens Martins Bastos, Alvim Gustavo Fasolin Tomm, Ferdinando de Conto, Gabriela Caovilla Felin

Osteomyelitis of the jaws is an infection that mainly af- fects patients with comorbidities. Besides, smoking and poor oral hygiene are risk factors. Mandibular pathological fractures result from bone fragility remaining after treatment of intraosseous pathologies. Thus, the aim of the present paper was to report a case of surgical treatment for mandibular osteomyelitis, in a 64-year-old male patient, smoker, who attended the emergency at the Hospital de Clínicas de Passo Fundo (RS, Brazil) complaining of pain and increased mandibular volume. Physical examination showed bulging in the right mental region, hardened consistency, local hyperemia, intrabucal purulent drainage in the lower alveolar ridge, and poor oral hygiene. Antibiotic therapy was prescribed. Surgical procedure was performed for mandibular bone curettage, and the contents were sent for anatomopathological examination. The findings confirmed the diagnosis of chronic suppurative osteomyelitis. The patient returned to the postoperative consultation complaining of pain and mobility in the operated area. Physical examination revealed mandibular crackling, and a new imaging examination confirmed the pathological fracture. A new surgical pro- cedure was performed for partial mandibular resection and stabilization of the fracture with reconstruction plate, using a printed mandible prototype for the preoperative customization of the plate. The procedure was uneventful. A new tomography showed the reconstruction plate and the screws in position. The treatment sequence would follow with a new surgical procedure for oral rehabilitation. It can be concluded that the postoperative period of sequestrectomies and curettages with extensive removal of mineralized tissue requires care with diet, medication and strict postoperative follow-up, since pathological fractures are not uncommon.

Keywords: Mandibular fractures. Osteomyelitis. Surgery, oral.

How to cite: Bett JVS, Bastos RM, Tomm AGF, Conto F, Felin GC. Pathological mandibular fracture caused by osteomyelitis: Case report. J Braz Coll Oral Maxillofac Surg. 2022 Jan-Mar;8(1):36-41.

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