J Korean Assoc Oral Maxillofac Surg.  2015 Aug;41(4):198-202. 10.5125/jkaoms.2015.41.4.198.

Proliferative periostitis of the mandibular ramus and condyle: a case report

• Seok H
• Kim SG
• Song JY

• KMID: 2364017
• DOI: http://doi.org/10.5125/jkaoms.2015.41.4.198

Abstract

Proliferative periostitis is a rare form of osteomyelitis that is characterized by new bone formation with periosteal reaction common causes of proliferative periostitis are dental caries, periodontitis, cysts, and trauma. While proliferative periostitis typically presents as a localized lesion, in this study, we describe an extensive form of proliferative periostitis involving the whole mandibular ramus and condyle. Because the radiographic findings were similar to osteogenic sarcoma, an accurate differential diagnosis was important for proper treatment.

Keyword

Periostitis; Osteomyelitis; Mandibular condyle

MeSH Terms

Dental Caries
Diagnosis, Differential
Mandibular Condyle
Osteogenesis
Osteomyelitis
Osteosarcoma
Periodontitis
Periostitis*

Figure

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  Fig. 1 Clinical photograph shows the swelling of the left mandibular ramus and angle.

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  Fig. 2 Panoramic radiographs show the radiolucent appearance around the unerupted third molar on the left mandible.

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  Fig. 3 Computed tomography image. Osteolytic and sclerotic bone lesion. A. The ramus and condyle. B. Mandibular angle. C. Periosteal reaction in the left mandibular ramus and condyle. D. Osteolytic change inside the newly formed bone.

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  Fig. 4 Histological examination. A. Bony trabeculae of the reactive bone arranged perpendicular to the bone surface (Masson's trichrome staining, ×100). B. Dense fibrous stroma with chronic inflammation in the intertrabecular space (H&E staining, ×100).

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  Fig. 5 At 11-months follow-up. A. Clinical photograph shows symmetrical face contour. B, C. Disappearing of newly formed bone and sclerotic change on mandibular ramus and condyle. D. Extraction socket of the third molar completely healing.

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