A case report of a rare course of secondary chronic odontogenic osteomyelitis of the upper jaw in a young patient

Background: Chronic jaw osteomyelitis is an inflammatory disease of the entire bone which results in jaw destruction and sequestrum formation, usually it`s more common in the lower jaw. Only a few clinical cases have documented the development of chronic odontogenic osteomyelitis on the upper jaw that is why the clinical course of the disease is variable and not typical in different patients. A quite rare variant of chronic maxilla osteomyelitis manifestation in a healthy young individual that was undiagnosed for a long time is presented in this case report.

Case Description: This clinical case report demonstrates a secondary chronic odontogenic osteomyelitis of the upper jaw in a young male individual. A patient has complains of the presence of the hard formation in the vestibular alveolar bone of the right upper jaw, enlargement of the cervical lymph nodes on the right side, high body temperature. On examination the face asymmetry was observed, swelling of the soft tissues on the right side, cervical lymphadenitis on the right side and poor oral hygiene. A mucosal defect and exposed bone with a diameter of 1.5 cm was detected on the vestibular surface of alveolar bone, the oral mucosae around the defect was hyperaemic and swollen. Tooth 1.6 was dark in color with a large filling on the occlusal surface, painful percussion, class 1 mobility. Cone beam computed tomography was performed to diagnose changes in the bone and maxillary sinus. The treatment of a patient was significantly complicated because of financial factor. After 10 days of postoperative treatment complete wound healing was observed, with the occurrence of alveolar bone deformation.

Conclusions: A not typical clinical course for young age healthy individual of the upper jaw osteomyelitis is presented. Therefore, a disease was undiagnosed for a long time during the regular check-ups by general dentists. Taking in account a difficult financial status, young age, good health of a patient, an optimal treatment method of the upper jaw chronic osteomyelitis was provided, using minimal invasive and defect-oriented approaches of surgical treatment.