Histologic examination of condensing osteitis in cadaver specimens

Condensing osteitis is a radiographic finding, but with no reported histologic investigations in humans. The objectives of this study were to evaluate and describe histologically condensing osteitis in human cadaver jaws. Patterns of bone formation and presence/absence and nature of inflammation were examined.

Specimens of mandibles and maxillas were obtained from cadavers and examined radiographically. Those periapical areas with characteristics of condensing osteitis were removed en bloc, decalcified, and processed for light microscopy. For comparison, specimens that showed normal apical radiographic anatomy were also removed for examination.

Normal apical regions showed an intact periodontal ligament and a thin layer of alveolar bone proper surrounded by cancellous bone with fatty marrow. In contrast, areas of condensing osteitis exhibited areas of inflammation or no inflammation, occupied by connective tissue. This area was bordered by a rim of varying widths of dense lamellar-type bone replacing the cancellous bone and marrow.

The histologic changes of condensing osteitis consisted of the replacement of cancellous bone with compact bone. Areas of fibrosis and an inflammatory infiltrate were seen in some but not all specimens. All teeth exhibiting condensing osteitis had an identifiable etiology that likely resulted in degenerative pulp disease.