Conservative treatment of children with chronic diffuse sclerosing osteomyelitis/tendoperiostitis of the mandible

Meent, Marieke M. van de; Meshkini, Hamid; Fiocco, Marta; Wetselaar‐Glas, Miranda J.M.; Appelman‐Dijkstra, Natasha M.; Merkesteyn, J.P.R. van

doi:10.1016/j.jcms.2017.09.024

Cited by 15 publications

(8 citation statements)

References 27 publications

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“…The management sequence uses occlusal splint therapy and physiotherapy to stabilize the muscles and the TMJ. Further clinical research supports these findings [20] that tendoperiostitis is precipitated by overworked muscles.…”

Section: Discussionmentioning

confidence: 59%

An Orthodontic Approach for Garre’s Sclerosing Osteomyelitis of the Mandible

Barbur

Bran

Băciuţ

et al. 2021

IJERPH

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The nonsuppurative osteomyelitis of the mandible is a rare condition that can occur in children due to low-grade inflammatory processes, dental cavities, periodontal lesions as well as the eruption process of the teeth. We submit a case report involving the orthodontic management of a 9-year-old female patient who presented in our service in the mixed dentition period with diagnosed Garre’s sclerosing osteomyelitis of the entire mandibular body. After a full work-up, the following symptoms and signs were noted: bilateral temporomandibular joint (TMJ) pain, loss of the leeway space, anterior open bite, distalization of the secondary maxillary right canine, nail biting and tongue thrust. Our orthodontic objectives were to relieve the TMJ pain, limit the eruption process of the teeth and to diminish the evolution of the osteomyelitis, reduce the growth of the inferior lower third of the face and to prevent further invasive treatment of the patient. In the first phase of treatment, we established a centric relationship using an orthopedic appliance (occlusal splint) and physiotherapy to deprogram the muscles and the TMJ. Throughout the second phase of treatment, we used orthopedic appliances to inhibit the overeruption of the secondary molars. After another year of treatment, the osteomyelitis lesions were under control with the permanent teeth in final position, good facial esthetic and as a functional result, no root resorption. We can conclude that by using low physiological forces to direct and control the growth pattern, good results could be obtained in stabilizing and controlling the sclerosing osteomyelitis of the mandible.

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Section: Discussionmentioning

confidence: 59%

An Orthodontic Approach for Garre’s Sclerosing Osteomyelitis of the Mandible

Barbur

Bran

Băciuţ

et al. 2021

IJERPH

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“…In the second study by Van de Meent et al . 14 , improvement was reported in all the five5 patients that received bisphosphonate therapy. However, no detailed description on how this improvement manifested was provided.…”

Section: Resultsmentioning

confidence: 88%

“…These articles were filtered for relevance and duplication, resulting in 58 articles. A subsequent full-text assessment reduced the number of articles suitable for inclusion to ten 14 , 28 – 36 . No additional articles were identified through searching bibliographies.…”

Section: Resultsmentioning

confidence: 99%

“…Within this review, six studies utilised panoramic radiographs to assess the response to bisphosphonate therapy, two studies utilised computed tomography (CT) imaging, and three studies utilised bone scintigraphy 14 , 28 – 30 , 33 , 35 .…”

Section: Resultsmentioning

confidence: 99%

“…An alternative suggested treatment option is muscle relaxation therapy due to the hypothesis that DSOM is caused by the overuse of masticatory muscles which lead to the development of chronic tendoperiostitis (TP). However, the aforementioned treatment options were not able to achieve long-term effectiveness and as a result no standard treatment protocol is recommended for cases of DSOM 10 – 14 . Bisphosphonates have been trialled as a treatment modality in recent studies as it is hypothesised they inhibit osteoclast mediated bone remodelling which decreases the inflammatory response, and as a result, a long-term reduction in pain and swelling is observed 15 – 18 .…”

Section: Introductionmentioning

confidence: 99%

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Bisphosphonate therapy in the management of diffuse sclerosing osteomyelitis of the mandible: a systematic review and narrative synthesis

Abukhder,

Nasri Elmi,

Van Der Lith

et al. 2023

Annals of Medicine &Amp; Surgery

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Background: Diffuse Sclerosing Osteomyelitis (DSO) affecting the mandible is an uncommon condition characterized by recurrent pain and functional disturbances. Traditional treatments involving antibiotics, steroids, and analgesics have generally yielded unsatisfactory results. Numerous articles have proposed the utilization of bisphosphonate therapy as an alternative approach to achieve sustained symptom relief. This study aims to consolidate the available evidence on the effectiveness of bisphosphonate therapy in managing DSO. Methods: A systematic review protocol was registered with PROSPERO and reported in accordance with the Preferred Reporting for Items for Systematic Reviews and Meta-Analyses. Comprehensive electronic search strategies were devised, and studies were screened based on predefined inclusion and exclusion criteria. Results: Ten articles met the eligibility criteria, encompassing a total of 135 patients diagnosed with DSO who received bisphosphonate treatment. All included studies consistently reported a reduction in pain levels and swelling, along with a decrease in the cumulative use of analgesics. The majority of patients reported long-lasting symptom improvement with bisphosphonate therapy. Notably, four studies documented improvements in maximal mouth opening, with one study reporting a mean increase of 9.6mm. Furthermore, six studies observed improvements in panoramic radiographs and cone beam CT scans, with one publication describing two patients exhibiting near-normal bone architecture. Importantly, all studies reported the absence of long-term complications. Conclusions: Bisphosphonate therapy emerges as a promising treatment modality for DSO, exhibiting efficacy in symptom alleviation and radiological enhancement while conferring lasting benefits. Nevertheless, further prospective studies are warranted to refine treatment protocols and substantiate these findings.

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