Case Report DOI: 10.18231/2395-499X.2017.0049 International Journal of Oral Health Dentistry; October-December 2017;3(4):223-224 223 Localized Osteomyelitis of the mandible: A case report Soundarya Singh 1,* , Puneet Kalra 2 1 Lecturer, 2 Professor, 1 Dental Dept, LLRM Medical College, Meerut, 2 Dept. of Oral Surgery Teerthanker University, Meerut, Uttar Pradesh *Corresponding Author: Email: Singhsoundarya@gmail.com Abstract Osteomyelitis of the jaws is a rare condition which usually occurs in medically -compromised patients both locally and generally. A case is presented with the alveolar bone necrosis.The treatment procedures and the outcomes are discussed in this article. Keywords: Localized osteomyelitis, Osteomyelitis of mandible. Introduction Osteomyelitis (OM) of the jaws is now defined by the presence of exposed bone in the mouth, which fails to heal after appropriate intervention. (1) Osteomyelitis can be defined as an inflammatory condition of the bone, which begins as an infection of the medullary cavity, rapidly involves the Haversian systems, and extends to involve the periosteum of the affected area. (2) It is a well-known entity in the historical literature where in the absence of antibiotics, compound fractures of long bones frequently failed to heal. Such cases are no longer part of modern medical experiences. In the twenty-first century osteomyelitis presents as a sub-chronic condition and is more commonly associated with debilitated, immunosuppressed or medically compromised patients and the pattern of events does not pose a diagnostic dilemma. (3) The incidence of osteomyelitis has dramatically decreased since the introduction of antibiotics. Moreover, OM of the head and neck skeleton is rare, particularly in the jaws. (4) Osteomyelitis is diagnosed on the basis of patient history, clinical examinations, and the surgical and radiographic findings. The most commonly used definitions of OM are an inflammatory reaction within the bone caused by bacterial invasion or merely an inflammatory process of the bone, both cortical and cancellous. In the mandible, the most common sites are the body, followed by the symphysis, angle, ascending ramus and condyle. (5) OM is very rarely seen in the maxilla. (6) This article reports a case of a healthy patient who developed osteomyelitis of the lower jaw following root canal therapy. Case Report A 45 year old male patient came with the chief complain of pain in left lower back tooth region since fifteen days. The medical history of patient was a contributing factor. The medical history revealed that the patient was medically compromised, and had undergone chemotherapy and was on medication since many years. A detailed medical and dental history was recorded. On clinical examination, a bony growth was visible on the left lingual side of the mandible in lower back tooth region(Fig.1).There was spontaneous mandibular pain and tenderness. Three months before,the tooth had undergoneroot canal treatment. The bone surrounding the tooth had a moth-eaten appearance and there was evidence of sequestrum formation on conventional x- rays. (Fig.2) With the clinical diagnosis of osteomyelitis, the patient was instructed to rinse with 0.2% chlorhexidine digluconate for 30 s. The local anaesthesia was injected, the exposed bone was removed and complementary curettage and irrigation was performed. (Fig. 3). The postoperative period was uneventful and the patient was discharged.The patient was symptom- free in the first postoperative follow-up one month after the surgery. The patient refused to undergo postoperative control x-rays. Fig. 1 Fig. 2