DIFFUSE SCLEROSING OSTEOMYELITIS AND FLORID OSSEOUS DYSPLASIA

The literature on diffuse sclerosing osteomyelitis of the mandible has included at least two groups of lesions: (1) those from which bacteri al infectious agents are rarely isolated (chronic-tendoperiostitis); a nd (2) those from which bacteria are readily isolated (true diffuse sc lerosing osteomyelitis). The latter should be distinguished from secon darily infected florid osseous dysplasia. In this article the features of 16 patients with sclerotic jawbone lesions associated with symptom s of infection are analyzed. Eleven patients showed a large area of sc lerosis of the mandible that was not restricted to the alveolar proces s and was surrounding an infectious focus. The histologic pattern reve aled a deposition of reactive bone. These lesions are considered to re present true diffuse sclerosing osteomyelitis. The remaining five pati ents showed sclerotic lesions restricted to the alveolar process in on e or more quadrants of the jaws. Apart from inflammation and reactive changes, histologic pattern revealed a fibroblastic stroma with bone a nd cementum-like structures that are formed by metaplasia. These lesio ns are considered to represent secondarily infected florid osseous dyp lasia.