Chronic suppurative osteomyelitis of the mandible mallikarjun. Garres osteomyelitis describe by carl garre in 1893. Leads to spread of pus through the medullary cavities of bone. Pdf osteomyelitis with proliferative periostitis garre.
Primary chronic osteomyelitis of the jaw has been reported in children of both sexes with a peak onset between 10 and 20 years. Staphylococ cus aureus is the most common cause of acute and chronic hematogenous osteomyelitis in adults and children. The swelling was soft in consistency, tender on palpation, and associated with draining sinus. It can be of a central, peripheral, or extra skeletal type. Garres sclerosing osteomyelitis suma r, vinay c, shashikanth m c.
Osteomyelitis oral surgery free download as powerpoint presentation. The treatment of diffuse sclerosing osteomyelitis with oral. Chronic osteomyelitis with proliferative periostitis traditionally termed garres sclerosing osteomyelitis mainly affects children and young adults. Odontogenic cysts, odontogenic tumors, fibroosseous, and. It mainly affects the region of the mandible and, in rare cases, may be located in the metaphyseal region of the long bones. Pdf garres sclerosing osteomyelitis is a specific type of chronic osteomyelitis that mainly.
The importance of decortication and removal of necrotic bone tissue in primary chronic osteomyelitis of the mandible have been discussed by several authors 2, 14, 37. The peripheral type arises from the periosteum and is rarely seen in the mandible. The long bones of the arms and legs are most commonly involved in children, while the feet, spine, and hips are most commonly involved in adults. A clear classification of osteomyelitis of the jaws is provided. However, in atypical cases with a negative history of deep carious lesions, chronic abscesses, or trauma to the area, bone biopsies are recommended in order to rule out several disease entities. Ndeb released questions set 1 the apical region of a nonvital tooth with a deep carious lesion may radiographically show 1. Osteomas are characterised by the proliferation of compact andor cancellous bone. Osteomyelitis of the jaw is a relatively uncommon inflammatory disease in developed countries.
Clinical presentation and diagnosis are meticulously described and illustrated. The lingual surface and lower border of the body are the most. The treatment of diffuse sclerosing osteomyelitis with. Pdf garres osteomyelitis is a type of chronic osteomyelitis that primarily affects children. Sclerosing osteomyelitis of garre radiology reference. Group a streptococ cus, streptococcus pneumoniae, and kingella kingae are the next most common pathogens in children. There is no macroscopically suppurative lithic area in cases of garres osteomyelitis, although histopathological examinations have detected microabscesses. Garre s sclerosing osteomyelitis actinomycotic osteomyelitis radiation osteomyelitis and necrosis.
Osteomyelitisdiagnosis osteomyelitissurgery osteomyelitistherapy a b s t r a c t the aim of this study was to report on a rare case of garres sclerosing osteomyelitis. A case of osteomyelitis with proliferative periostitis in an elevenyearold girl presented as a hard swelling extending from the left body to the ascending ramus of the mandible on the outer surface of the buccal cortex. Discover medical cases from every specialty their views and advice download now. Histological and histochemical features of a case of. Chronic focal sclerosing osteomyelitis condensing osteitis unusual reaction of bone to infection high degree of tissue reaction and tissue reactivity. Cahn garres sclerosing nonsuppurative osteomyelitis seems to be a vague term for a productive osteomyelitis or periosteitis. Primary chronic osteomyelitis of the jaws in children. It is thought to be associated with lowgrade infection and could be related to dental disease such as cavities. In children, temporomandibular joint involvement is rare and few studies have been published due to the relatively low incidence. Garres sclerosing osteomyelitis actinomycotic osteomyelitis radiation osteomyelitis and necrosis. It typically affects the mandible and is commonly associated with an odontogenic infection resulting from dental caries. Garres sclerosing osteomyelitis is a specific type of chronic osteomyelitis that mainly affects children and young adults.
Garres osteomyelitis at right mandible of a nineyearold girl. In a tabular form by numerical values representing the degree of acute a1 to a3 and chronic c1 and c2 osteomyelitis criteria semiquantitatively scale 03 in a separate form for acute and chronic changes. The histopathological examination was suggestive of chronic osteomyelitis and periostitis. As shown in the present cases, osteomyehtis varies in its radiographic appearance depending greatly on the stage of the disease at which the radiograph is taken, as well as the resistance of the tissue and the virulence of the infection. Describe the pathogenesis, clinical features and histopathology of chronic osteomyelitis10marks 2.
One case of garres osteomyelitis in volving the mandible was seen, treated and. Normal tonsillar lymphoid tissue was seen on histopathology in all the 4 cases. Primary chronic osteomyelitis pco of the jaws in children is associated with pain, trismus, and swelling. A provisional diagnosis of chronic periapical abscess in relation to 74 with a differential diagnosis of chronic suppurative osteomyelitis, garre s osteomyelitis, or infected periapical cyst was made.
Jul 08, 20 garre s osteomyelitis sclerosing, nonsuppurative jaw mandible no abcess, cortical thickening acute local pain, pyrexia subside fusiform swelling acute stagerest, antibiotics sx. The garres osteomyelitis is a welldescribed pathologic entity in the dental literature. Garres osteomyelitis at right mandible of a nineyearold girl pt tsai, yw chen abstract garres sclerosing osteomyelitis is a chronic osteomyelitis with proliferative periostitis periosteitis ossificans that mainly affects children and adolescents. Garres sclerosing osteomyelitis suma r, vinay c, shashikanth. Garres osteomyelitis of the mandible caused by an infected. The aetiology of this disease of jaw bone is associated with mild irritation or dental. Osteomyelitis in the vertebrae makes itself known through severe back pain, especially at night. Treatment under local anesthesia with controlled intravenous sedation, the lesion was completely excised using oscillating saw and chisels via an extraoral approach. Chronic osteomyelitis with proliferative periostitis in the lower jaw. A provisional diagnosis of chronic periapical abscess in relation to 74 with a differential diagnosis of chronic suppurative osteomyelitis, garres osteomyelitis, or infected periapical cyst was made.
Osteomas are benign, slowgrowing osteogenic tumours rarely occurring in the craniofacial bones. Radiographs of garres osteomyelitis show thickening of the cortex. Garres osteomyelitis of the mandible caused by an infected wisdom tooth hiroyuki nakano1, tetsuei miki2, keiko aota2, tetsuro sumi2 ken matsumoto2 and yoshiaki yura2 1department of oral and maxillofacial surgery, yamaguchi university graduate school of medicine 2department of oral and maxillofacial surgery. Pdf garres sclerosing osteomyelitis is a specific type of chronic osteomyelitis that mainly affects children and young adults. Garre osteomyelitis definition of garre osteomyelitis by. This paper describes a case of garres osteomyelitis in a 10yearold boy. The lesion was examined histopathologically, including microradiographic and histochemical studies. But histopathology gave the inal diagnosis of osteoma. Oc casionally the infectious agent localizes in the periosteum or beneath the periosteal covering of the cortex and spreads only slightly into the interior of the bone. Osteomyelitis of the jaws is the first textbook of its kind covering exclusively all aspects of this challenging disease. Therefore, when we make a radiographic diagnosis of osteomyelitis, it would be also of utmost importance to understand what type and what stage in the. Garres osteomyelitis of the mandible caused by infected tooth. Radiographic features of chronic osteomyelitis of the. The deposition of calcium salts, primarily calcium phosphate, usually occurs in the skeleton.
Garre s sclerosing osteomyelitis is a specific type of chronic osteomyelitis that mainly affects children and young adults. Garres osteomyelitis is a rare inflammatory disease of chronic nature, characterized by periosteal reactions, which induces bone neoformation. Osteomyelitis with proliferative periostitis ospp is a kind of chronic osteomyelitis that presents an inflammatory reaction, which results in periosteal new bone formation. Osteomyelitis with proliferative periostitis garres osteomyelitis report of a case affecting the mandible. Chronic suppurative osteomyelitis with proliferative. Case report a 14 year old male patient came with the chief complaint of painless swelling on left and right side of chin since 2 years.
This disease entity is welldescribed in dental literature and is commonly associated with an odontogenic infection resulting from dental caries. One was osteomyelitis of the mandibular ramus originating from the lower left third molar in a 22yearold female, the treatment of which was tooth extraction and exploration and drainage from the left submasseteric space. Radiation osteomyelitis and necrosis 22 acute suppurative osteomyelitis serious sequela of periapical infection. Structure of the histopathological osteomyelitis evaluation score hoes for standardised recording and documentation of findings the hoes is presented in two forms. Sclerosing osteomyelitis of garre is a specific type of chronic osteomyelitis. It frequently asymmetrically involves the mandible. Osteomyelitis of the jaws marc baltensperger, gerold. Garres sclerosing osteomyelitis is a chronic osteomyelitis with proliferative periostitis periosteitis ossificans that. Radiographs of garre s osteomyelitis show thickening of the cortex. Early phase of osteomyelitis and usually a suppurative pus forming condition exists when an acute inflammatory process moves away from the site of initial infection and spreads through the medullary space of the bone and, in most cases, insufficient time has passed for the body to react to the presence of the inflammatory infiltrate.
Acute osteomyelitis of the jaws is rarely seen these days due to the availability of antibiotics. The patient was a 54yearold woman with a history of treatment for lupus using corticoids for 20 years, and for osteoporosis using alendronate for. It is associated with a low grade infection, which may be due to dental caries cavities in the teeth. Osteomyelitis oral surgery inflammation immunology. Osteomyelitis treatment figuring out if a person has osteomyelitis is the first step in treatment. Diagnosis and management of osteomyelitis of osteomyelitis. Garres osteomyelitis at right mandible of a nineyearold. Based on the clinical findings of a diffuse swelling over the lower border. Garres osteomyelitis eosinophillic granuloma osteosarcoma early detection osteoblastoma complex odontoma.
Definition the word osteomyelitis originates from the ancient greek words osteon bone and muelinos marrow inflammation process of the entire bone including the cortex and the periosteum, recognizing that the pathological process is rarely confined to the endosteum. Garres sclerosing osteomyelitis article pdf available in journal of indian society of pedodontics and preventive dentistry 25 supplsuppl. When it occurs in an unorganized fashion in the soft tissue, it is referred to as heterotrophic calcification. Radiation osteomyelitis it is an infection of irradiate. Apr 24, 2014 garres osteomyelitis is a rare inflammatory disease of chronic nature, characterized by periosteal reactions, which induces bone neoformation. Pdf garres osteomyelitis of an unusual origin in a 8yearold child. Chronic osteomyelitis of the left mandibleaextraoral fistula and scar formationb large exposure of infected bone and sequestrac large sequester collected from surgery 21. This condition has been described using several terms, including proliferative periostitis, periostitis ossificans, and garres osteomyelitis. Cahn garre s sclerosing nonsuppurative osteomyelitis seems to be a vague term for a productive osteomyelitis or periosteitis.
Depending upon the main site of involvement of bone. It is associated with a low grade infection, which may be due to dental caries cavities in the teeth the body of the mandible may show irregular lucentopaque changes with. Garres sclerosing osteomyelitis is a type of chronic osteomyelitis also called periostitis ossificans and garres sclerosing osteomyelitis. The lesion was examined histopathologically, including microradiographic and. Coincidental diagnosis of tuberculous lymphadenitis. S303 may 2007 with 1,508 reads how we measure reads. Few cases have been reported regarding the treatment of primary chronic osteomyelitis of the mandibular condyle in children. Symptoms may include pain in a specific bone with overlying redness, fever, and weakness.
Garres sclerosing osteomyelitis was first described by carl garre in 1893 as. The difficulties in the diagnosis and classification of mandibular osteomyelitis have prevented clinicians and researchers from developing an improved understanding of this inflammatory condition, this has resulted in dilemmas for planning treatment strategies. Histopathological osteomyelitis evaluation score hoes. Garres osteomyelitis, periostitis ossificans, chronic. This version of chronic osteomyelitis is also known as periostitis. Clearly, in lesions of this type, histopathology plays a major role in determining. Here, we present two rare cases of an 11yearold and a 12yearold patient with suppurative chronic osteomyelitis with proliferative periostitis without any definitive infection source, such. Garres osteomyelitis of the mandible sciencedirect. Garres sclerosing osteomyelitis is a specific type of chronic osteomyelitis that.
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