Is it osteomyelittis?

My daughter is 16 and had all 4 impacted wisdom teeth taken out 2 months ago. She had a lot of swelling and pain so the doctor ordered several different antibiotics. Finally, the doctor opened her back up and found a piece of bone about a half an inch long and he removed it. I guess he sent it in to pathology to be tested and it came back with accute osteomyelittis. He said it may have occured as a result of the bone lying there for a while, and that she may not have actually a bone infection, could that be possible? Should she have a bone scan?

[Sam Delfino]

This must be a heavy pain on your mind. I would have it tested. I have some info for you below. But CT scans, MRI's and Blood work ups need to be done to evaluate this again.
The cause of osteomyelitis is associated with Staphylococcus aureus, a skin surface bacterium.  The organism is iatrogenically introduced into the deeper tissue planes by surgery or trauma, resulting in an infectious process that is either localized or hematogenously metastatic or both.  However, the idea of S aureus as the primary pathogen of tooth-bearing bone does not hold true.  Acute osteomyelitis of the jaw is usually a polymicrobial disease, with streptococci, Bacteroides, peptostreptococci, and other organisms involved.
    Hudson (1993) wrote that “Acute osteomyelitis of the jaws may manifest itself with fever, malaise, facial cellulitis, trismus, and significant leukocytosis.  Osteomyelitis of the jaws of a chronic nature has findings consistent with swelling, pain, purulence, intraoral or extraoral draining fistulae, and nonhealing bony and overlying soft tissue wounds.” Computerized tomography gives a more definitive picture of the calcified tissue involvement, especially with regard to disruption of the cortical plates.  Diagnosis is based on the presence of painful sequestra and suppurative areas of tooth-bearing jaw bone unresponsive to debridement and conservative therapy.
     The goal of definitive therapy is to attenuate and eradicate the proliferating pathogenic microorganisms and to support healing.  Pathogenic supportive debris should be removed and vascular permeability to the infected area must be reestablished.  This will aid the host immune response in coming into contact with the offending organisms.  A typical treatment regimen for osteomyelitis of the jaws is presented in the table below.
And treatment guidelines are as follows:

   1. Disrupt the infectious foci.
   2. Debride any foreign bodies necrotic tissue, or sequestra.
   3. Culture and identify specific pathogens for eventual definitive antibiotic treatment.
   4. Drain and irrigate the region.
   5. Begin empiric antibiotics based on Gram stain.
   6. Stabilize calcified tissue regionally.
   7. Consider adjunctive treatments to enhance microvascular reperfusion (usually reserved for refractory forms only).
          *  Trephination
          *  Decortication
          *  Vascular flaps
          *  Hyperbaric oxygen therapy
   8. Reconstruction as necessary following resolution of the infection.