The use of hyperbaric oxygen therapy in actinomycotic osteomyelitis associated florid cemento osseous dysplasia: report of a familial case.

Abstract

Florid Cemento-Osseous Dysplasia (FCOD) is a well recognized fibro-osseous disease of the jaws commonly seen in the middle aged African women, although it may occur in the Caucasians and Asians. There is a reported incidence of less than 2% in the Indian population. The clinical and the radiographic features of FCOD may overlap with features of chronic diffuse scle-rosing osteomyelitis, which makes diagnosis of the disease difficult in symptomatic cases. Moreover the jaws may be susceptible to osteomyelitis, which may mask the underlying FCOD in some cases. The case reported here is that of a 56 year old Indian female patient with long standing FCOD invol-ving the maxilla and the mandible, who was asymptomatic till all her teeth were extracted for fabrica-tion of complete dentures. The patient experienced symptoms of pain, swelling and purulent discharge soon after the use of dentures and was treated by surgical removal of the affected bone. The same symptoms recurred in other areas of the jaw over a period of time and these areas were treated surgica-lly. The patient subsequently presented with pain in the mandibular left posterior region of ten days duration, and was diagnosed as FCOD with superimposed Actinomycotic Osteomyelitis based on his-topathology and Gram’s stain, and was treated by surgical removal of the affected bone followed by hyperbaric oxygen therapy (HBO). The radiograph of the surgical site showed good amount of bone regeneration within six months of HBO therapy without recurrence of the FCOD in the same area till date.