Obligatory medical device diagnostics.
- Radiographs: Panoramic radiograph, Clementschitsch mandibular radiograph [see below “Radiological features of osteomyelitis“].
Optional medical device diagnostics.
- Dental digital volume tomography (DVT) – radiological imaging technique that provides three-dimensional representation of the anatomy of the teeth, jaws and facial skull, which can make a significant contribution to preoperative and post-traumatic diagnostics.Indications:
- For suspected diagnosis
- For therapy planning
- For progress control
- Magnetic resonance imaging (MRI): more sensitive than conventional radiography.
- Bone scintigraphy; Early stages of disease are better detected than with MRI or DVT/CTIndications:
- If blood cultures and local punctates are negative: for diagnosis of acute hematogenous (“originating in the bloodstream”) osteomyelitis.
- For the diagnosis of other peripheral foci
- For primary chronic osteomyelitis
- In acute and secondary chronic osteomyelitis
- Leukocyte scintigraphy – nuclear medicine procedure for enrichment of radiolabeled leukocytes in sites of inflammation [acute/chronic osteomyelitis].
Radiological features of osteomyelitis of the jaw bones (osteomyelitis of the jaw bones):
- No radiological changes [acute osteomyelitis – first signs after two to three weeks].
- Extensive sclerosis (tissue compaction).
- Common occurrence of hyperdense (“increased density) and hypodense (“decreased density) bone structures [secondary chronic osteomyelitis].
- Inhomogeneous radioopacity/radiolucency [primary chronic osteomyelitis]
- Subperiosteal (“below the periosteum”) new bone formation [common in primary chronic osteomyelitis]
- Bone destruction
- Bone sequestration (necrotic/dead portion of bone clearly demarcated from healthy tissue) [secondary chronic osteomyelitis].
- Implant loosening
- Pathological fractures (bone fracture during normal loading due to weakening of the bone caused by a disease).
