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Diffuse sclerosing osteomyelitis of the mandible.
International Journal of Oral Surgery
|October 1, 1984
Summary
Diffuse sclerosing osteomyelitis (DSO) of the mandible is better understood through improved diagnostic techniques. Early antibiotic therapy and later cortisone or decortication offer effective treatment for DSO patients.
Area of Science:
- Oral and Maxillofacial Surgery
- Infectious Diseases
- Radiology
Background:
- Diffuse sclerosing osteomyelitis (DSO) of the mandible presents diagnostic and etiological challenges.
- Current medical care for DSO is often unsatisfactory due to limited knowledge.
Purpose of the Study:
- To investigate the clinical features, natural history, and etiology of DSO.
- To improve diagnostic accuracy and therapeutic strategies for mandibular DSO.
Main Methods:
- Utilized serial radiographic (orthopantomograms, intraoral views) and scintigraphic (99mTc-scintigraphy) recordings.
- Employed an improved biopsy technique with enzyme histochemistry for histopathological diagnosis.
- Conducted bacteriological and serological investigations, including antibody and lymphocyte stimulation tests.
Main Results:
- Established DSO as a distinct entity with characteristic clinical, histological, and radiographic features.
- Improved biopsy and histochemical methods facilitated diagnosis.
- Radiographic and scintigraphic findings enhanced diagnostic accuracy and treatment planning.
- Identified Propionibacterium acnes and Peptostreptococcus intermedius as potential etiological agents, though chronicity remains unexplained.
- Demonstrated efficacy of long-term antibiotics in early DSO and cortisone/decortication in chronic stages.
Conclusions:
- Enhanced understanding of DSO improves patient care.
- Specific diagnostic and therapeutic approaches are recommended based on disease stage.
- Further research is needed to fully elucidate the etiology of DSO's chronicity.