Chronic osteomyelitis (mixed) .

  • It is an inflammatory process of the jaws which involves the bone marrow, the cortex and the periosteum. Dental infection is the most common etiologic factor.
  • The acute phase of the suppurative osteomyelitis is rapid and shows no radiographic signs in the first 8-10 days.
  • Without treatment, acute osteomyelitis may progress into a chronic phase with bone destruction.
  • As the lesion progresses, an ill defined or moth-eaten radiolucency is observed.
  • In some cases scattered radiopacities within the lytic lesion become apparent due to bone sequestra, causing the mixed radiographic appearance.
  • CT and CBCT scans show perforations of the cortical plates and sometimes sub periosteal bone reaction.

Differential Diagnosis

Case 1

Three different cases of chronic osteomyelitis (mixed) .

Case 2

CBCT scans of a case of chronic osteomyelitis (mixed)

Case 3

Case of chronic osteomyelitis; Endodontic treatment was unsuccessful and the incisors were extracted. CBCT images show: moth-eaten areas of bone destruction, sclerosis of the surrounding bone and bone sequestra.

Case 4

Two different cases of chronic osteomyelitis (mixed)

Case 5

A case of mixed type chronic osteomyelitis in a female 43 years old.