Chronic Periapical Inflammation Induced Garré's Sclerosing Osteomyelitis of the Mandible-A Case Report

慢性根尖炎引發下顎骨之蓋銳氏硬化性骨髓炎－病例報告

江天恩(Tien-En Chiang) ； 林佑俊(Yu-Chun Lin) ； 劉釗誌(Chao-Chih Liu) ； 吳契璁(Chi-Tsung Wu) ； 陳元武(Yuan-Wu Chen)

《臺灣口腔顎面外科學會雜誌》 31卷4期 (2020/12) Pp. 298-306

摘要

Garré's sclerosing osteomyelitis is a distinctive type of chronic osteomyelitis that mainly affects young adults and is difficult to differentiate from other bone diseases. Here, we report the case of a 27-year-old woman who presented with facial swelling and pain and was treated at a local dental clinic with a root canal therapy of the lower right second premolar. With no improvement in her condition, she was transferred to our hospital for further treatment. Physical examination, radiographic examination including dental X-rays, computed tomography (CT), and a whole-body bone scan were performed. From our investigation, a differential diagnosis was established, and the pathologic diagnosis confirmed our impression of Garré's sclerosing osteomyelitis. The patient was treated with medication and endodontic treatment; close follow-up revealed that the treatments were successful.

關鍵字

Garré's osteomyelitis ； Proliferative periostitis ； Mandible

並列摘要

蓋銳氏骨炎硬化性骨髓炎為一慢性骨髓炎的獨特類型，主要影響年輕人居多，由於臨床表現常模仿了不同的骨疾病，故難以診斷。本病例報告一位27歲女性，因慢性疼痛以及臉部腫脹於診所接受下顎右側第二小臼齒根尖周圍感染的根管治療，治療後症狀仍然明顯，因此轉診至本院進行後續診斷及治療。臨床檢查包含牙科Ｘ光、電腦斷層及全身骨掃描，進而逐步建立鑑別診斷，手術切片確診此為蓋銳氏硬化性骨髓炎。患者服藥後症狀改善，並轉診至牙髓病科接受進一步的牙髓治療及追蹤。

並列關鍵字

蓋銳氏硬化性骨髓炎 ； 增生性骨膜炎 ； 下顎骨