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Abstract:
Purpose of study: Differential diagnosis of chronic osteomyelitis and fibrous dysplasia of the mandible is a difficult task. The similarity of clinical, radiological and morphological manifestations of these diseases leads to errors and incorrect approaches to treatment.
Patients and methods: A retrospective comparative study of clinical and radiological features was conducted in patients with primary chronic osteomyelitis and fibrous dysplasia treated in the Department of Maxillofacial Surgery of the Russian Children’s Clinical Hospital from 2015 to 2023. Clinical characteristics were assessed: pain, swelling and trismus, and radiological characteristics — sclerosis, lysis and formation of subperiosteal regenerate. Statistical methods were used to determine differences.
Results: The analysis of 36 patients with PCO and 12 patients with FD included in the study (average age 8.9 and 8.5 years, respectively); showed that girls and unilateral lesions predominated in both groups (PHO (83.3%) and FD (100%)). Patients with PHO mainly complained of pain (94.4%), swelling of soft tissues (100.0% ), and trismus (100%), while in patients with FD there was no pain and there was an increase in bones (83.3%) without trismus. Computed tomography of patients with PCO showed the formation of subperiosteal bone, lysis of the cortical layer, and expansion of the mandibular canal. on the affected side, whereas patients with FD generally had moderate to severe bone swelling, well-demarcated cortex, and displacement of the teeth and mandibular canal from the node.
Conclusions: These data highlight the importance of clinical and radiological features in various diseases. Pain, swelling, subperiosteal bone formation, unilateral expansion of the mandibular canal, clarity of the cortex- medullary boundary, and continuity of the cortical bone are key points in differentiating these conditions.