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An Experimental Model for Osteomyelitis in the Mandible

Mandibular osteomyelitis is a disease that continues to defy conventional methods of management despite the wide range of chemotherapeutic agents available. NORDEN J Inf Dis 122:410, 1970) and VAN WINGERDEN (J Bone Joi'tt Surg 56A:1452, 1974) have described rabbit models for the study of osteomyelitis in long bones; however, there are no reports of a model for osteomyelitis in the mandible. Two known oral pathogens were chosen to determine if osteomyelitis in the mandible could be artificially created, and if so, which was the most effective. Staphylococcus aureus, implicated in some way in 90% of osteomyelitis (BU RNEI"I and SCHERP, Oral Micro Inf Dis, William and Wilkins, Baltimore, 1962), was chosen for one group. Bacteroi'des melaninogenicus was chosen to infect a second group because: (1) it is closer to being an overt pathogen than any other indigenous oral microorganism in man (SOKRANSKY and GIBBONS,J Inf D2s 11:247, 1965) and (2) with improved microbiological techniques it has been identified in virtually everv oral infection such as osteomyelitis in which there is a foul smelling exudate (GARROD, BritMedJ 2:1529, 1955). New Zealand White rabbits weighing 4 to 5 kg were anesthetized with 2% thiamylal sodium. An extraoral surgical approach to the right mandible was used, followed by osseous cuts to separate the medial and lateral cortical plates. This defect exposed the root surfaces of the teeth and created a compound, sagittal fracture of the mandible which communicated with the oral cavity along the roots of the teeth. The medullary tissue was thoroughly cauterized to diminish the local blood supply and to provide a coagulum for bacterial growth. An inoculum was prepared for each experimental group of animals. In one group, a 0.25 ml inoculum taken from a 24-hour culture of S aureus grown in brain heart infusion broth was injected into the medullary space of 8 rabbits. In another group, a 0.25 ml inoculum taken from a 24-hour culture of B nielani?ogenicus grown in peptone yeast glucose broth supplemented with vitamin K and heme was injected into 10 rabbits. The wounds were closed without drainage and the animals were isolated and maintained on normal diets. Another group consisted of 5 surgically treated but uninoculated control animals.