Osteomyelitis of the mandible mimicking fibrous dysplasia: A radiographic controversy

Gupta, Deepak
March 2013
Clinical Dentistry (0974-3979);Mar2013, Vol. 7 Issue 3, p20
Academic Journal
Brief Background: Chronic Osteomyelitis is a disease that radiographically presents itself as a variety of disease entities like fibrous dysplasia and osteosarcoma. Most commonly the patient presents with periosteal new bone formation, sclerosis and bone enlargement. This presented case of chronic osteomyelitis of the mandible had unusual radiographic appearance typical of fibrous dysplasia. Materials and Methods: The conventional radiographs suggested fibrous dysplasia of the mandible which was difficult to differentiate from osteomyelitis. Incisional biopsy revealed chronically inflammed fibrous connective tissue in inter - trabecular areas with scattered sequestra and pockets of abscess formation. Surgical management included decortication of the left side of the mandible. The diagnosis was based on the clinical findings of the disease which was later proved by histopathological report. Discussion: Distinguishing between chronic osteomyelitis and fibrous dysplasia is difficult when there is no trauma and no systemic disease. In this case the previous history of extraction of grossly carious teeth pointed towards osteomyelitis. Various authors have stated that despite numerous radiographic similarities, some useful radiographic differences do exist which help distinguish osteomyelitis from fibrous dysplasia Summary and Conclusions: Early differential diagnosis between osteomyelitis and fibrous dysplasia is crucial in order to undertake prompt and appropriate management. It can be concluded that fibrous dysplasia must always be kept in mind in cases of chronic osteomyelitis of jaws. In making the diagnosis, the clinician must weigh all the available diagnostic information regarding the case.


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