Case Report

Chronic osteomyelitis

•A 67-year-old female patient

• Complains of swelling in the lower teeth region

•Duration-13 years

Chief Complaint

History of Presenting Illness

•She consulted a hospital 11 years back. Biopsy was done and was diagnosed as osteoma.

•Noticed pus from the front teeth region on pressing 4 months back.

Clinical Examination

Extraoral

No abnormality detected.

Intraoral

Swelling of size 2 x 3 cms present on lingual aspect of 31, 32, 41, and 42 covered by normal mucosa.

On palpation it is firm, non mobile and non-tender.

Pus discharge from swelling

Provisional diagnosis:

•Osteoma• Florid cemento-osseous dysplasia• Late stage fibrous dysplasia•Osteoblastoma• Chronic osteomyelitis

Investigations OPG

Reveals multiple RCT done and missing teeth and bridges.Mixed radiolucent and radioopacity at apex irt 31, 32, 41, and

42.

Occlusal radiograph

Shows mixed radiolucency which is well circumscribed by radiolucency overlapping irt 31 and 32.

Histopathology

Ulcerated epithelium(10x)

Superficial stratified squamous epithelium

(10x)

Histopathology

Sheets of plasmacytoid cells in the connective tissue

10X 40X

Histopathology

Cellular and nuclear pleomorphism

HISTOPATHOLOGY

Vesiculated and hyperchromatic nuclei

peripheral chromatin condensation

HISTOPATHOLOGY

Binucleate plasma cells

Chronic diffuse sclerosing osteomyelitis