Radiographic study of extension phase of chronic osteomyelitis of the mandible

Abstract

It is thought that the phase of inflammatory extension in osteomyelitis of the mandible varies according to the primary site of infection, that is, the causative tooth. This study was conducted to analyze the relationship between the extension phase of inflammatory bone changes and the causative tooth in patients with radiographically diagnosised osteomyelitis of the mandible. Between 1983 and 1993, a total of 219 patients with osteomyelitis of the mandible were seen in our department. In the age distribution, 135 cases occurred in men and 98 cases in women. Osteomyelitis was most prevalent in patients in their sixties (39 cases) followed by patients in their forties and fifties (38 cases each). The causative tooth was identified in 97 cases of osteomyelitis in the mandible. In the 39 cases in which the primary infection was caused by the third mandibular molar, distal extension was most prevalent (30 cases). In the 58 cases in which a tooth other than the third mandibular molar was the cause (front tooth, premolar, deciduous tooth and other molars), equal extension in the mesio-distal direction was most prevalent (40 cases). In the upper-lower extension phase, lower extension beyond the mandibular canal was most prevalent in the first, second and third molar teeth. In the cases involving teeth other than the mandibular molars, the inflammatory bone changes were rather limited to the upper part of the mandibular canal.