Etiology • An acute or chronic inflammatory process within the
medullary space or along the cortical surface of bone • Usually due to extension of a periapical abscess • Other common causes include physical trauma (fracture) or
bacteremia. • Most common organisms include staphylococci and streptococci
Clinical Presentation • Pain, swelling, fever, lymphadenitis • Sequestrum formation • Lower lip paresthesia, occasionally with acute disease in
medullary space or along the cortical surface of bone • Usually due to extension of a periapical abscess • Other common causes include physical trauma (fracture) or
bacteremia. • Most common organisms include staphylococci and streptococci
Clinical Presentation • Pain, swelling, fever, lymphadenitis • Sequestrum formation • Lower lip paresthesia, occasionally with acute disease in
mandible • Associated soft tissue swelling
Radiographic Findings • Acute phase may be unremarkable • Ill-defined, patchy radiolucency (“moth eaten”)
Diagnosis • Presentation and radiographic findings • Microscopic evidence of intrabony inflammation, marrow
fibrosis, osteoclastic resorption, reduced osteoblastic activity, nonviable bone
Differential Diagnosis • Osteosarcoma • Local extension of malignant tumor • Metastatic tumor • Osteoradionecrosis
Treatment • Drainage and antibiotics for acute disease • Débridement, sequestrectomy, antibiotics for chronic disease • Reconstruction if necessary after disease is resolved
Prognosis • Good