Kugushev A.YU., Lopatin A.V., Yasonov S.A., Rogozhin D.V. Productive periostitis of the mandible in children. Head and neck. Russian Journal. 2020;8(3):16–24 (in Russian).
The authors are responsible for the originality of the data presented and the possibility of publishing illustrative material – tables, figures, and photographs of patients.
Aim of the study. Productive periostitis is a rare form of chronic osteomyelitis in which a new periosteal bone tissue over the cortical bone is formed. This disease is not accompanied by pain, but is always associated with inflammatory changes in the molars and premolars area. Differential diagnosis should be considered with fibrous bone lesions and sarcomas due to the similar clinical, radiological and histopathological picture, as well as the rarity of occurrence.
Material and methods. In 2014–2019, 8 patients were admitted to the Department of Maxillofacial Surgery of the Russian Childrens’ Clinical Hospital with a painless asymmetry of the face in the lower jaw region. Based on the local examination and computed tomography findings, a diagnosis of productive periostitis was made in these children. Surgical treatment included the removal of fibrous bone growth on the lower jaw and extraction of carious-destroyed premolars or molars above the lesion area.
Results. Radiological diagnostics revealed characteristic signs allowing differential diagnosis with other forms of chronic osteomyelitis. Complete recovery with a complete restoration of the bone structure was achieved in all cases within 6 months of observation. One of the cases required to detect the MDM2 mutation to exclude low-grade sarcoma after immunohistological assessment, despite the specific clinical and radiological picture.
Conclusion. The formation of a new bone may occur in many pathological conditions, which requires differential diagnosis with the obligatory immunohistological examination.
Key words: periostitis, Garre, osteomyelitis, lower jaw, fibrous bone lesions, dental caries
Conflicts of interest. The authors have no conflicts of interest to declare.
Funding. There was no funding for this study.