Sclerosing Osteomyelitis of Jaw – A Case Series and Literature Review

Abstract

Osteomyelitis, a serious condition marked by inflammation of the medullary cavity, Haversian system, and adjacent bone cortex, requires urgent medical attention, especially when it involves the jaw. This condition is particularly concerning due to its potential to cause significant facial disfigurement and the increased risk of the infection spreading to the skull base or fascial spaces of the head and neck. Among the facial bones, the mandible is more commonly affected by osteomyelitis than the maxilla. This discrepancy is attributed to the anatomical and physiological differences between these bones; the maxilla benefits from a rich collateral blood flow and possesses a thin cortical bone, both of which reduce its vulnerability to infections. In this case series, we present three cases of osteomyelitis in patients who had underlying debilitating conditions such as diabetes mellitus and deleterious habits, which acted as predisposing factors for the development of the disease. These cases highlight the complex interplay between systemic health issues and the susceptibility to localized bone infections. The first two cases involve a patient with poorly controlled diabetes, emphasizing how chronic hyperglycemia can impair immune function and compromise healing, thereby facilitating the onset and progression of osteomyelitis. The third case features a patient with a history of tobacco use, illustrating the detrimental impact of deleterious habits on vascular health and immune response. In addition to detailing these cases, this series provides an overview of the current understanding of the pathogenesis and treatment strategies for osteomyelitis. Treatment typically involves a combination of surgical debridement, antimicrobial therapy, and management of underlying conditions to enhance immune function and promote recovery.