Comparing Clinical and Radiographic Characteristics of Chronic Diffuse Sclerosing Osteomyelitis and Craniofacial Fibrous Dysplasia in the Mandible

Jia, Kuankuan; Li, Xiaoli; An, Jingang; Zhang, Yi

doi:10.1016/j.joms.2020.11.014

Cited by 9 publications

(9 citation statements)

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“…We summarized and compared the differences in the clinical, radiographic and histopathological manifestations of DSOM, CSO, and CFD based on previous studies, as shown in Table 3. 5,6 However, the diagnosis of DSOM cannot be confirmed by clinical and radiographic manifestations. In this study, we observed and summarized the histopathological characteristics of DSOM and compared them with those of CSO and CFD, hoping to provide information for the diagnosis of DSOM based on histopathological characteristics.…”

Section: Discussionmentioning

confidence: 99%

“…Its clinical manifestations include recurrent swelling, pain, and trismus, but no abscess, internal or external fistula, or sequestrum. Radiographic findings of DSOM include intermingled sclerosis and lysis in the mandible bone, subperiosteal bone formation, cortical discontinuity due to osteolysis, and blurred boundary between the cortical and medulla due to osteosclerosis 5,6 . The clinical and radiographic manifestations of DSOM are similar to those of CSO and CFD; therefore, it is easily misdiagnosed as CSO or CFD, and patients with DSOM are provided inappropriate treatment in clinical practice.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…3,4 DSOM has no accepted diagnostic criteria; thus, its diagnosis can be established based on a combination of the patient's medical history and clinical, radiographic, and histological findings. 5,6 Clinically, DSOM is often confused with chronic suppurative osteomyelitis (CSO) and craniofacial fibrous dysplasia (CFD). CSO is a suppurative lesion usually caused by an odontogenic infection and often presents with abscess and fistula formation.…”

Section: Introductionmentioning

confidence: 99%

“…It is also referred to as primary chronic osteomyelitis, chronic nonbacterial osteomyelitis, or juvenile mandibular chronic osteomyelitis 3,4 . DSOM has no accepted diagnostic criteria; thus, its diagnosis can be established based on a combination of the patient's medical history and clinical, radiographic, and histological findings 5,6 . Clinically, DSOM is often confused with chronic suppurative osteomyelitis (CSO) and craniofacial fibrous dysplasia (CFD).…”

Section: Introductionmentioning

confidence: 99%

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Comparison of the histopathological characteristics of diffuse sclerosing osteomyelitis of the mandible, chronic suppurative osteomyelitis, and craniofacial fibrous dysplasia

Jia

Zhang

et al. 2022

J Oral Pathology Medicine

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Background There are relatively few reports on the histopathological characteristics of diffuse sclerosing osteomyelitis of the mandible (DSOM), which is difficult to distinguish from chronic suppurative osteomyelitis (CSO) and craniofacial fibrous dysplasia (CFD). This study aimed to summarize and compare the histopathological characteristics of DSOM, CFD, and CSO. Materials and Methods In this study, hematoxylin and eosin‐stained sections of patients with DSOM, CSO, and CFD at the Peking University Hospital of Stomatology from 2015 to 2020 were retrieved. The histopathological characteristics were summarized, including new bone formation, inflammatory cell infiltration, bone trabecular morphology, osteoclasts, sequestrum, bacterial mass, and calcified spherules, similar to cementicles. The histopathological characteristics of DSOM, CSO, and CFD were compared, and the results were statistically analyzed. Results In total, 50, 13, and 10 patients with DSOM, CSO, and CFD were included in this study, respectively. In terms of new bone formation, both DSOM and CSO showed reactive bone formation (p = 1), whereas CFD mainly showed fiber osteogenesis (p < 0.001). The inflammatory cells of DSOM were mainly lymphocytes and plasma cells, whereas those of CSO were mainly lymphocytes and neutrophils (p < 0.001), and there was usually no inflammatory cell infiltration in the CFD specimens (p < 0.001). DSOM, CSO, and CFD showed irregular bone trabeculae (p = 0.045, p = 0.703) and active osteoclasts (p1 = 0.189, p2 = 0.256). DSOM showed a small amount of bacterial mass but no sequestrum; neither of which was found in CFD (p = 1, p = 1), but it was common in CSO (p = 0.011 and p = 0.025). DSOM and CSO showed smooth and regular basophilic lines (p = 0.308), whereas CFD showed a rough and irregular basophilic line (p < 0.001). Conclusions The histopathological characteristics of the three diseases were partly similar, but there were evident differences. The main differences are the type of new bone formation, types and distribution of inflammatory cells, and presence of sequestrum and bacterial masses. These differences will help clinicians diagnose DSOM.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%