Surgical management of primary chronic osteomyelitis of the jaws in children: a prospective analysis of five cases and review of the literature.
BACKGROUND
Primary chronic osteomyelitis (PCO) of the jaws is an uncommon non-suppurative inflammatory disease of unknown origin. Although the disease is not age-specific, only sparse cases with onset during childhood or adolescence have been reported in the literature.


OBJECTIVE
This study seeks to present five cases of maxillofacial PCO in children and to evaluate the effectiveness of the applied therapeutic protocol. A review of the literature concerning diagnosis and treatment of PCO with special emphasis on surgical therapy is also performed.


METHODS
Demographic data, clinical, radiographic and histopathologic findings, blood tests results, and the treatment protocol applied to five young patients suffering from PCO and referred to the Department of Oral and Maxillofacial Surgery at "A. & P. Kyriakou Children's Hospital" over the past 5 years are presented. Decortication and contouring of the affected bone were performed; antibiotics were administered for a short period of time and the patients remained under follow-up evaluation.


RESULTS
The posterior mandible was affected in four cases and the maxilla-zygomatic bone in one case. All patients showed remission of signs and symptoms after surgical treatment. The postsurgical clinical course was uneventful in all cases. However, recurrences have been noted, as reported in the literature.


CONCLUSIONS
PCO of the jaws is a complex clinical entity, presenting both a diagnostic and therapeutic challenge, especially in young patients. Surgical treatment in conjunction with antibiotics and non-steroid anti-inflammatory drugs proved to be beneficial and to improve considerably the patients' quality of life. Nevertheless, exacerbation of the disease may appear and regular follow-up of the patients is required.
Theologie-Lygidakis
Nadia
N
University Department of Oral and Maxillofacial Surgery, A. & P. Kyriakou Children's Hospital, Dental School, University of Athens, Athens, Greece. lygidakis-nadia@ath.forthnet.gr
Schoinohoriti
Ourania
O
Iatrou
Ioannis
I
D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D003131:Combined Modality Therapy; D003646:Debridement; D005260:Female; D006801:Humans; D008297:Male; D008334:Mandible / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D008336:Mandibular Diseases / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008437:Maxilla / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D008439:Maxillary Diseases / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D010019:Osteomyelitis / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D011862:Radiography, Panoramic; D014057:Tomography, X-Ray Computed; D015050:Zygoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*
D000900:Anti-Bacterial Agents