A rare case report of chronic suppurative osteomyelitis of the mandible in modern era of broad spectrum antibiotics

Shilpi Gupta, N. J. Saikia, Anurag Singh


Historically, osteomyelitis of the jaw was a common complication of odontogenic infection (infections of the teeth). The term osteomyelitis refers to an inflammation of cortex and medulla of the bone that can develop in the jaw after any infection of the oral cavity. Since the introduction of potent antibiotics, the incidence of osteomyelitis has been dramatically decreasing. This case report describes an interesting presentation of chronic suppurative osteomyelitis of the mandible in a 73 years old male patient from North Eastern part of India. Investigations revealed chronic osteomyelitis of right ramus and body of mandible. The treatment included a pre surgical course of antibiotics followed by right side hemimandibulectomy and again post-operative antibiotics. The post-operative healing was uneventful. Detailed discussion of etiology, risk factor, symptoms, signs, management and prevention has been done in this case report. We conclude that surgical debridement in addition to empirical antibiotics should be considered as an early approach for treating such cases.


Chronic osteomyelitis of mandible, Odontogenic infection, Chronic suppurative osteomyelitis, Hemimandibulectomy

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Mercuri LG. Acute osteomyelitis of the jaws. Oral Maxillofacial Surg Clin N Am -Infections Head Neck. 1991;3(2):355-65.

Hudson JW. Osteomyelitis of the jaws: a 50-year perspective. J Oral Maxillofacial Surg. 1993;51(12):1294-301.

Cierny III G, Mader JT, Penninck JJ. A clinical staging system for adult osteomyelitis. Clin Orthop Related Res. 2003;414:7-24.

Scafer WG. Osteomyelitis, in A Textbook of Oral Pathology, 3rd edition, Philadelphia, Pa, USA: Elsevier Saunders; 1974: 453.

Krutchkoff DJ, Runstad L. Unusually aggressive osteomyelitis of the jaws. A report of two cases. Oral Surg Oral Med Oral Pathol. 1989;67(5):499-507.

Mücke T, Koschinski J, Deppe H, Wagenpfeil S, Pautke C, Mitchell DA, et al. Outcome of treatment and parameters influencing recurrence in patients with bisphosphonate-related osteonecrosis of the jaws. J Cancer Res Clin Oncol. 2011;137(5):907-13.

Hansen T, Kunkel M, Weber A, James KC. Osteonecrosis of the jaws in patients treated with bisphosphonates-Histomorphologic analysis in comparison with infected osteoradionecrosis. J Oral Pathol Med. 2006;35(3):155-60.

Thumbigere-Math V, Sabino MC, Gopalakrishnan R, Huckabay S, Dudek AZ, Basu S, et al. Bisphosphonate-related Osteonecrosis of the Jaw: clinical features, risk factors, management, and treatment outcomes of 26 patients. J Oral Maxillofac Surg. 2009;67(9):1904-13.

Marx RE. Chronic osteomyelitis of the jaws. Oral Maxillofacial Surg Clin N Am- Infections Head Neck. 1991;3(2):367-81.

Robinson JL, Vaudry WL, Dobrovolsky W. Actinomycosis presenting as osteomyelitis in the pediatric population. Pediatr Infect Dis J. 2005;24(4):365-9.

Mehra H, Gupta S, Gupta H, Sinha V, Singh J. Chronic suppurative osteomyelitis of mandible: a case report. Craniomaxillofac Trauma Reconstr. 2013;6(3):197‐200.