Computed tomography findings of periostitis ossificans

Luciana Soares de Andrade Freitas Oliveira^I; Thaís Feitosa L. de Oliveira^II; Daniela Pita de Melo^III; Alynne Vieira de Menezes^IV; Ieda Crusoé-Rebello^V; Paulo Sérgio Flores Campos^III

^IDepartment of Health Sciences, Division of Pathology, Dental School, Federal University of Bahia, Brazil
^IIDepartment of Oral Diagnosis, Division of Periodontology, State University of Feira de Santana, Brazil
^IIIDepartment of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, State University of Campinas, Brazil
^IVDepartment of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, State University of Campinas, Brazil ]]> ^VDepartment of Oral Diagnosis, Division of Oral Radiology, Dental School, Federal University of Bahia, Brazil

Correspondence

ABSTRACT

Periostitis ossificans (PO) is a type of chronic osteomyelitis, an inflammation of cortical and cancellous bone. In the maxillofacial region, the mandible is most frequently affected. The cause of inflammatory subperiosteal bone production in PO is spread of infection from a bacterial focus (e.g.: odontogenic disease, pulpal or periodontal infection, and extraction wounds). This pathology is most common in younger people (mean age of 13 years). Conventional radiographs are one of the most useful tools for diagnosis, but in some cases computed tomography (CT) has a key role in both diagnosis and identification of the tissues involved. This paper reports two cases of PO in which CT helped establishing the suspicious etiology: a 12-year-old boy with PO of pulpal origin and a 14-year-old boy with PO of periodontal origin.

Keywords: osteomyelitis, tomography. 

Full text available only in PDF format.

References

1. Eyrich GKH, Baltensperger MM, Bruder E, Graetz KH. Primary chronic osteomyelitis in childhood and adolescence: a retrospective analyses of 11 cases and review of literature. J Oral and Maxillofac Surg. 2003; 61: 561-73.         [ Links ]

2. Benca PG, Mostofi R, Kuo PC. Proliferative periostitis (Garré's osteomyelitis). Oral Surg Oral Med Oral Pathol. 1987; 63: 258-60.         [ Links ]

3. Kannan SK, Sandhya G, Selvarani R. Periostitis ossificans (Garrè's osteomyelitis): radiographic study of two cases. Int J Paediatr Dent. 2006; 16: 59-64.         [ Links ]

4. Tong ACK, Ng IOL, Au Yeng KM. Osteomyelitis with proliferative periostitis: an unusual case. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006; 102: e14-9.         [ Links ]

5. Neville BW, Damm DD, Allen CM, Bouquot JE. Pulp and periapical diseases. In: Neville BW, editor. Oral and maxillofacial pathology. 2nd edn. Rio de Janeiro: W.B. Saunders; 2004. p.128-9.         [ Links ]

6. Zand V, Lofti M, Vosoughhrosseini S. Proliferative periostitis: a case report. J Endod. 2008; 34: 481-3.         [ Links ]

7. Schulze D, Blessmann M, Pohlenz P, Wagner KW, Heiland M. Diagnostic criteria for the detection of mandibular osteomyelitis using cone-beam computed tomography. Dentomaxillofac Radiol. 2006; 35: 232-5.         [ Links ]

8. Ebihara A, Yoshioka T, Suda H. Garrè's osteomyelitis managed by root canal treatment of a mandibular second molar: incorporation of computed tomography with 3D reconstruction in the diagnosis and monitoring of the disease. Int Endod J. 2005; 38: 255-61.         [ Links ]

9. Tanaka R, Hayashi T. Computed tomography findings of chronic osteomyelitis involving the mandible: correlation to histopathological findings. Dentomaxillofac Radiol. 2008; 37: 94-103.         [ Links ]

10. Nakano H, Miki T, Aota K, Sumi T, Matsumoto K, Yura Y. Garré's osteomyelitis of the mandible caused by an infected wisdom tooth. Oral Science International. 2008; 5: 150-4.         [ Links ]

11. Oulis C, Berdousis E, Vadiakas G, Goumenos G. Garre's osteomyelitis of an unusual origin in a 8-year-old child. A case report. Int J Paediatr Dent. 2000; 10: 240-4.         [ Links ]

12. Van den Bossche LH, Demeulemeester JDA, Bossuyt MH. Periodontal infection leading to periostitis ossificans ('Garrè's Osteomyelitis') of the mandible. Report of a case. J Periodontol. 1993; 64: 60-2.         [ Links ]

13. Ida M, Watanabe H, Tetsumura A, Kurabayashi T. CT findings as a significant predictive factor for the curability of mandibular osteomyelitis: multivariate analysis. Dentomaxillofac Radiol. 2005; 34: 86-90.         [ Links ]

14. Lee L. Lesões inflamatórias dos maxilares. In: White SC, Pharoah MJ, editors. Radiologia oral. Fundamentos e interpretação. 5.ed. Rio de Janeiro Elsevier; 2007. p.370-5.         [ Links ]

15. Baltensperger M, Eyrich G. Osteomyelitis of the jaws: definition and classification. In: Baltensperger M, Eyrich G, editors. Osteomyelitis of the Jaws. Springer; 2009. p. 5-56.         [ Links ]

Correspondence to:
Luciana Freitas Oliveira
Av. Araújo Pinho, 62
Disciplina de Radiologia, Faculdade de
Odontologia da UFBA, Canela. ]]> CEP:40110-150, Salvador, BA, Brasil.
E-mail: lucianafreitasoliveira@yahoo.com.br

Received for publication: November 22, 2009
Accepted: March 29, 2010