title: Bilateral mandibular osteomyelitis mimicking periapical cysts in a patient with sickle cell anemia.
abstract: Sickle cell anemia (SCA) is a hemoglobin disorder that occurs more commonly among Afro-descendants. The authors report the case of a 28-year-old Afro-descendent male patient with the diagnosis of homozygotic sickle cell disease (SCD) referred for evaluation of mandibular lesions. The patient's main complaints included pain and bilateral teeth mobility. An intraoral examination revealed gingiva recession affecting the lower molars with extensive root exposure. A panoramic x-ray showed two radiolucent symmetrical periapical lesions evolving both the first and the second lower molars, bilaterally. The diagnostic hypotheses comprised odontogenic infection, among others. Besides antimicrobial therapy, the two molars of both sides were extracted and bone was collected for histopathological and microbiological analyses. Osteomyelitis was diagnosed, and Streptococcus viridans was recovered from the culture media. Mandibular osteomyelitis should be considered as a diagnosis in patients with SCD. The present case offers an alert to clinicians about the importance of knowing jaw lesions related to SCA.
authors.affiliation: Stomatology Department - School of Dentistry - Universidade de São Paulo, Sao Paulo/SP - Brazil .
authors.forename: Juliane Pirágine
authors.initials: JP
authors.lastname: Araújo
authors.affiliation: Stomatology Department - School of Dentistry - Universidade de São Paulo, Sao Paulo/SP - Brazil .
authors.forename: Ana Maria Hoyos
authors.initials: AM
authors.lastname: Cadavid
authors.affiliation: Stomatology Department - School of Dentistry - Universidade de São Paulo, Sao Paulo/SP - Brazil .
authors.forename: Celso Augusto
authors.initials: CA
authors.lastname: Lemos
authors.affiliation: Oral Pathology Department - School of Dentistry - Universidade de São Paulo, Sao Paulo/SP - Brazil .
authors.forename: Marilia
authors.initials: M
authors.lastname: Trierveiler
authors.affiliation: Stomatology Department - School of Dentistry - Universidade de São Paulo, Sao Paulo/SP - Brazil .
authors.forename: Fabio Abreu
authors.initials: FA
authors.lastname: Alves
keywords: Anemia, Sickle Cell; Mandible; Osteomyelitis