OralandMaxillofacial

MedicalImagingRadiographicInterpretationofInfectionsofJawsPericoronitisPericoronitisEruptingorpartiallyimpactedthirdmolarsInflamedgingivaTrismusCellulitisPericoronitis(R/F)Inearlystages,minimalradiographicchangesRadiolucencyadjacenttothecrownIll-definedperipheryScleroticborderinlatestageOsteomyelitis,insevercasesNormalFollicularSpaceAcuteSuppurative

OsteomyelitisAcuteSuppurative

OsteomyelitisDentalinfection–mostcommoncauseOthercauses:fracture,wound,hematogenousspreadCommonorganisms:Staph.aureus,Staph.albus,tuberculosis,actinomycosis,syphilis,mixedorganismsSuppurative

OsteomyelitisMayinvolveeitherjawLocalizedinmaxilla,diffuseinmandibleSeverepaintemperature,WBCcountSuppurative

Osteomyelitis(R/F)Earlystages:noradiographicchangesIll-definedperipheryDecreaseinthedensityofboneFollowedbyincreasedradiolucencySclerosisatlaterstagesSequestra:nonvitalboneSuppurative

Osteomyelitis(R/F)ResorptionPeriostealnewboneformationProliferativeperiostitisFistulaformationRadiographicfeaturessimilartomalignantlesionsSequestrumIn-classExercise:Case14montholdbabyMeningitisNuclearMedicineStudyIn-classQuiz:Case2ChronicFocalSclerosing

OsteomyelitisChr.FocalSclerosing

OsteomyelitisSclerosingorcondensingosteitisYounger,<20yrsMostlymandibularfirstmolarLargecariouslesionFocalSclerosing

Osteomyelitis(R/F)Initialstage–noradiographicsignsRarefyingosteitis–radiolucentareaSclerosing

osteitis–densescleroticbone,trabeculationdifficulttoidentifyDifferencewithidiopathicosteosclerosisChronicDiffuseSclerosing

OsteomyelitisChr.DiffuseSclerosing

OsteomyelitisMaynotbeassociatedwithcariousteethIntermittent,recurrentepisodesofswelling,pain,feverAnyage,mostlyelderlypatientsPrevalenceinAfricanAmericanChroniclowgradeinfectionPain,ifpresent,isoftenmildAcuteexacerbationChronicOsteomyelitisWithProliferativePeriostitisGarre’s

PeriostitisChronicOsteomyelitisWithProliferativePeriostitis

Garre’s

Periostitis(1893)Younger,<25yrsMostlymandibleGarre’s

Periostitis(R/F)OftenassociatedwithacarioustoothMottled,predominantlylucentFocalovergrowthofbone“Onion-skin”appearance:layeringofcorticalboneIn-classexercise:Case3OsteoradionecrosisOsteoradionecrosisRadiotherapy(40to80Gy)DecreasedvascularityLowdefenseHighsusceptibilitytoextraction,perio,pulpaldisease,denturesoreOsteoradionecrosis(R/F)SimilartoosteomyelitisDiagnosisestablishedbyhistoryFloridCemento-osseousDysplasiaFloridCemento-osseousDysplasiaWide-spreadformofperiapical

cementaldysplasiaMostlyfemale,middle-aged,African,AsianMaynotbesymptomaticFloridCemento-osseousDysplasiaPoorvascularsupply–pronetoinfectionOsteomyelitis,ifinfectedPreventivemanagemen