Tubercular osteomyelitis of mandible: Defining diagnostic criteria

Cases of extrapulmonary tuberculosis (TB) are being increasingly reported these days. Orofacial TB represents only 0.05-5% of total cases. Its vague and nonspecific clinical features pose a diagnostic challenge. Here, we report a series of five cases on mandibular TB and also an attempt was made to propose a diagnostic criterion for tuberculous osteomyelitis of the mandible. Positive cartridge-based nucleic acid amplification test for Mycobacterium tuberculosis, acid-fast bacilli smear test, and histopathological examination may be considered as major criteria while swelling (which gradually increases in size), noninflammatory cervical lymphadenopathy, radiographic picture of diffuse cortical erosion without reactive bone formation may be considered as minor criteria. The presence of these findings should raise a strong suspicion of TB of the mandible.