Journal of Oral Medicine and Pain

Korean Academy of Orofacial Pain and Oral Medicine (대한안면통증구강내과학회)
권호 표지
DOI QR코드

DOI QR Code

Osteomyelitis of the Mandibular Coronoid Process Mimicking a Temporomandibular Joint Disorder: A Case Report

  • Jeong Yeop Chun (Department of Oral Medicine, Wonkwang University Daejeon Dental Hospital) ;
  • Young Joo Shim (Department of Oral Medicine, Wonkwang University Daejeon Dental Hospital)
  • Received : 2024.05.24
  • Accepted : 2024.06.13
  • Published : 2024.06.30
Download PDF
⟨ Previous Next ⟩

Abstract

Osteomyelitis of the jaw is an inflammatory process of the bone marrow that is caused by odontogenic local infection and trauma such as tooth extraction and fractures in the oral and maxillofacial region. The clinical signs include pain, swelling, pus formation, and limited mouth opening. Chronic osteomyelitis presents a diagnostic challenge because of the variability of symptoms across different disease stages and varying health conditions of the patients. This report presents a case of osteomyelitis that was misdiagnosed as a temporomandibular joint disorder (TMD) after tooth extraction. The patient was treated for inflammation after tooth extraction in the early stage; however, as the osteomyelitis progressed chronically, symptoms mimicked those of a TMD. The patient was finally diagnosed with osteomyelitis 6 months after tooth extraction. A review of this case and relevant literature revealed the necessity for a differential diagnosis of chronic osteomyelitis that mimics TMD symptoms.

Keywords

References

  1. Lew DP, Waldvogel FA. Osteomyelitis. The Lancet 2004;364:369-379.  https://doi.org/10.1016/S0140-6736(04)16727-5
  2. Gonzalez-Navarro B, Arranz-Obispo C, Albuquerque R, Jane-Salas E, Lopez-Lopez J. Osteomyelitis of the jaw (with pathological fracture) following extraction of an impacted wisdom tooth. A case report. J Stomatol Oral Maxillofac Surg 2017;118:306-309.  https://doi.org/10.1016/j.jormas.2017.05.003
  3. Humber CC, Albilia JB, Rittenberg B. Chronic osteomyelitis following an uncomplicated dental extraction. J Can Dent Assoc 2011;77:b98. 
  4. Schoen R, Suarez-Cunqueiro MM, Metzger MC, Schmelzeisen R. Osteomyelitis of the mandible following third molar surgery: a regrettable consequence in a healthy patient. Quintessence Int 2009;40:351-354. 
  5. Krakowiak PA. Alveolar osteitis and osteomyelitis of the jaws. Oral Maxillofac Surg Clin North Am 2011;23:401-413.  https://doi.org/10.1016/j.coms.2011.04.005
  6. Lee SC, Kim JH, Kim CH, Kim BJ. Temporomandibular joint disorder from skull-base osteomyelitis: a case report. Maxillofac Plast Reconstr Surg 2015;37:39. 
  7. Chattopadhyay PK, Nagori SA, Menon RP, Thanneermalai B. Osteomyelitis of the mandibular condyle: a report of 2 cases with review of the literature. J Oral Maxillofac Surg 2017;75:322-335.  https://doi.org/10.1016/j.joms.2016.08.018
  8. Gams K, Freeman P. Temporomandibular joint septic arthritis and mandibular osteomyelitis arising from an odontogenic infection: a case report and review of the literature. J Oral Maxillofac Surg 2016;74:754-763.  https://doi.org/10.1016/j.joms.2015.11.003
  9. Baltensperger M, Eyrich G. Osteomyelitis of the jaws: definition and classification. In: Baltensperger M, Eyrich G, eds. Osteomyelitis of the jaws. Springer; 2009. pp. 5-56. 
  10. Hudson JW. Osteomyelitis of the jaws: a 50-year perspective. J Oral Maxillofac Surg 1993;51:1294-1301.  https://doi.org/10.1016/S0278-2391(10)80131-4
  11. Okeson JP. Bell's oral and facial pain. 7th ed. Quintessence Publishing Co.; 2014. pp. 125-134. 
  12. Lemiere E, Maes JM, Raoul G, Caprioli F, Ruhin B, Ferri J. [Chronic diffuse osteomyelitis of the mandible. Apropos of a case]. Rev Stomatol Chir Maxillofac 2000;101:330-335. French. 
  13. Koorbusch GF, Deatherage JR, Cure JK. How can we diagnose and treat osteomyelitis of the jaws as early as possible? Oral Maxillofac Surg Clin North Am 2011;23:557-567, vii.  https://doi.org/10.1016/j.coms.2011.07.011
  14. Kothari NA, Pelchovitz DJ, Meyer JS. Imaging of musculoskeletal infections. Radiol Clin North Am 2001;39:653-671.  https://doi.org/10.1016/S0033-8389(05)70304-3
  15. Reinert S, Widlitzek H, Venderink DJ. The value of magnetic resonance imaging in the diagnosis of mandibular osteomyelitis. Br J Oral Maxillofac Surg 1999;37:459-463.  https://doi.org/10.1054/bjom.1999.0200
  16. Tiwari P, Bera RN, Kanojia S, Chauhan N, Hirani MS. Assessing the optimal imaging modality in the diagnosis of jaw osteomyelitis. A meta-analysis. Br J Oral Maxillofac Surg 2021;59:982-992.  https://doi.org/10.1016/j.bjoms.2020.11.012
  17. Stuart J, Whicher JT. Tests for detecting and monitoring the acute phase response. Arch Dis Child 1988;63:115-117. https://doi.org/10.1136/adc.63.2.115