Has anyone had experience of osteomyelitits of the upper jaw & titanium implants?

The left sinus infection I've already posted about (starting late oct early nov) won't go away. Am on 3rd week of flucloxacillin 500mg 2x per day, with at least 2 more weeks to go. Recent hospital Xray of sinus and jaw show lucency in jaw area of my upper left molar titanium implant (installed almost a year ago, following the extraction of chronically longterm infected molar that had been rootcanalled and crowned over 20 yrs ago, leaving some pain in the jaw which the dentist told ne was phantom pain but which my oral surgeon felt was actually due to lingering infection). Now my gp & rheumy feel the staph aureus infection in my L sinus is due to infection in the area of jaw bearing the molar implant.

Have found good info online re upper jaw osteomylitis, but am preparing myself for seeing maxilliofacial surgeon (at same big teaching hospital as my great rheumy: they are both in touch). So, am interested in any feedback/help anyone here can give me, especially re how being on plaquenil 400mg per day is factored in when trying to beat infections like this one. I gather that when you've got lupus, it's easier for infections to"seem" to be cleared , only for lurking bacteria to reinfect you and get stuck in again, especially when you offer bacteria a fresh wound eg via surgery putting an implant in. I guess this is what's happening to me

I also gather fungal infection can merge with any bacterial infection, cause the mouth is so full of these things

Also, it seems that others with lupus have problems with the rejection of implants of various sorts (titanium stents in arteries etc ), so I'm interested in any comments on this too

Any comments, tips, advice folks?

2 Replies

apparently biophosphonates Drugs for steroid induced osteoporosis can do the same thing i have no advice but if you on any bone treatment that should be looked at. know that my not be very helpful hope your sorted soon.


many thanks tatty

it is vvvv helpful to have your comments. makes me feel as if someone with lupus is interested and thinking things through with me

i know this is a tricky issue. the fact that on this forum, so far, no other lupus patients seem to share this particular jaw infection problem is interesting in its own right. but makes me feel more lonely

i feel sure there must be plenty lupus patients out there with experience managing long term infections, who could give me advice: eg yesterday the dental hygenist said to watch out for thrush cause due to being on antibiotics long term the way i am now...

really, this seems to me to be just another case of a lupus patient on palquenil who is vulnerable to repeated, stubborn infections, especially at sites of long term infection issues. in this case it is my jaw and sinus. these have been vulnerable for many years (i have had to have all 4 molars root get root canal/crown). i feel as if i am just having to learn more about how to manage my version of SLE etc

3 years ago a rheumy before my most recent lupus etc diagnosis, the rheumy who checks my 3 yearly bone scan results had wanted me on bisphosphonates due to the rate at which i was loosing density (i was not actually osteoporitic, but the loss was too fast, he felt - not due to steroids: osteopososis ruiins in my family & i had an early menopause, and my spine condition makes weight bearing exercise hard to do). so back then i researched bisphosphonates big time and decided instead to do what i could with diet & supplements and exercise. the jaw bone issues were one of the main reasons i made this choice (at the time i had a feeling this molar might require serious treatment). but somehow i didn't notice osteomyelitis being the bisphosphonates jaw bone issue: i got the impression the big issue is necrosis of the jaw? but i also stayed off bisphosphonates cause of my long term upper GI issues (gastroparesis etc)

anyway, now i do realise the max fac surgeon will probably have to consider various reasons i've got this infection, and i guess the 2 prime candidates are osteomyelitis (this is what my rheumy thinks we need to be sure about) but also necrosis of the jaw. yesterday my dentist said she thinks it is v unlikely the other 3 molars could do this to me too. and my hygenist is appalled and horrified: she says she has very few patients who have looked after their mouth & teeth as well as i have all my life (i am 58). oh well

so, thanks again tatty!


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