Surgical management of primary chronic osteomyelitis of the jaws in children: a prospective analysis of five cases and review of the literature

Abstract

PCO of the jaws is a complex clinical entity, presenting both a diagnostic and therapeutic challenge, especially in young patients. Surgical treatment in conjunction with antibiotics and non-steroid anti-inflammatory drugs proved to be beneficial and to improve considerably the patients' quality of life. Nevertheless, exacerbation of the disease may appear and regular follow-up of the patients is required.

Unilateral enlargement of the mandible in a child

“…Clinical features include mandibular enlargement along with recurring episodes of pain, swelling, trismus and regional lymphadenopathy. 3,4,8 Hypoesthesia of the inferior alveolar nerve may also occur in some cases 8 but was absent in our patient.…”

“…3,4 In the literature, other nomenclature including "diffuse sclerosing osteomyelitis" and "chronic sclerosing osteomyelitis" have been used synonymously with PCO. 8,9,11,12,15 However, these alternate terms have also been employed more broadly to describe the radiographic changes associated with other disease processes including secondary chronic osteomyelitis, chronic tenoperiostitis and proliferative periostitis.…”

“…3 PCO is generally associated with a protracted clinical course without an acute stage and is often refractory to antibiotic treatment. 3,4 The episodes occur periodically with varying degrees of intensity and can last from a few days to several months. Unlike chronic (secondary) osteomyelitis, PCO is not associated with sequestration, fistulae formation or purulence, and there is no obvious dental source of infection.…”

“…Unlike chronic (secondary) osteomyelitis, PCO is not associated with sequestration, fistulae formation or purulence, and there is no obvious dental source of infection. 3,4 Radiographically, PCO presents as a mixed density lesion with areas of osteolysis and sclerosis with disruption of normal trabecular pattern. 3 Our patient's clinical and radiographic presentation was reminiscent of PCO.…”

Çenelerde Görülen Osteomi̇yeli̇t

“…Kronik süpüratif osteomiyelitin, primer ve sekonder olmak üzere iki alt tipi vardır. Primer kronik formda akut bir dönem gözlenmezken sekonder kronik form uzamış inflamatuar bir süreçle seyreder 3,6 .…”