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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Chronic osteomyelitis of the mandible is an infrequently reported condition, but recent experience with six cases over a 14-month period suggests it is more common than appreciated. Chronic mandibular osteomyelitis results from odontogenic infection, postextraction complication, trauma, or irradiation to the mandible. Clinical findings include local pain and swelling and trismus, but constitutional symptoms are unusual. Radiologic examination discloses radiolucent areas, bony destruction, and sequestrum formation. Pathogenic organisms are normal oral flora, Staphylococcus aureus, and aerobic gram-negative bacilli. Chronic mandibular osteomyelitis must be differentiated from malignant disease involving the mandible. Diagnosis is accomplished by bone biopsy and culture. Treatment involves through surgical debridement and prolonged antimicrobial therapy. Osteoradionecrosis of the mandible is extremely recalcitrant to conventional therapy, but aggressive surgery and treatment have proven effective.
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PMID:Chronic mandibular osteomyelitis. 371 33

Osteoradionecrosis of the mandible is a serious complication following radiation therapy with or without surgical intervention for malignancies of the head and neck. The acknowledged clinical presentation of osteoradionecrosis is pain, fistulae of mucosa or skin, complete devitalization of bone and pathological fractures. Radiation-induced fibrosis is an irreversible pathological process, which leads to damages in lung, skin, intestine, and pelvic cavity after radiotherapy. Studies have proved that radiation-induced fibrosis is involved in the pathological onset, development, maintenance of osteoradionecrosis and there is dose-effect relationship between them, so the authors hypothesize that radiation-induced fibrosis plays an important role in osteoradionecrosis. Studies need to perform to look for more efficient methods of managing and preventing the osteoradionecrosis.
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PMID:Does radiation-induced fibrosis have an important role in pathophysiology of the osteoradionecrosis of jaw? 2145 19

Osteoradionecrosis of the mandible (MORN) is one of the most devastating complications caused by radiation therapy in the head and neck region. It is characterized by infection and chronic necrosis of the mandible as the main manifestation. Clinically, MORN-related symptoms include swelling, pain, dysphagia, trismus, masticatory or speech disorders, refractory orocutaneous fistula, bone exposure, and even pathological fracture. MORN has become a challenging clinical problem for oral and maxillofacial surgeons to deal with, but thus far, this problem has not been solved due to the lack of widely accepted treatment algorithms or guidelines. Because of the nonexistence of standardized treatment criteria, most clinical treatment against MORN nowadays is largely based on controversial empirical understandings, while recommendations on post-therapeutic evaluations are scarce. Therefore, to further unify and standardize the diagnosis and treatment of MORN, to decrease the huge waste of medical resources, and ultimately, to improve the wellbeing of the patients, the Chinese Society of Oral and Maxillofacial Surgery (CSOMS) convened an expert panel specialized in MORN from 16 domestic medical colleges and affiliated hospitals to discuss the spectrum of diagnosis and and formulate treatment. In addition, consensus recommendations were also revised with a comprehensive literature review of the previous treatment experiences and research pearls. This 'expert consensus statement on diagnosis and clinical management of MORN' is for clinical reference.
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PMID:Chinese expert group consensus on diagnosis and clinical management of osteoradionecrosis of the mandible. 3135 74