Periostitis Ossificans: Report of Two Cases Resolved with Endodontic Treatment

Periostitis ossificans is a chronic disease characterized by an ossifying periostitis, occurring in children and young adults, commonly as a reaction to a mild infection or irritation. It is also characterized by the presence of lamellae of newly formed periosteal bone outside the cortex, giving the...

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Main Authors: Hana Bougatef, Eya Moussaoui, Ines Kallel, Mahmoud Smaoui, Lamia Oualha, Nabiha Douki
Format: Article
Language:English
Published: Wiley 2020-01-01
Series:Case Reports in Dentistry
Online Access:http://dx.doi.org/10.1155/2020/8876268
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author Hana Bougatef
Eya Moussaoui
Ines Kallel
Mahmoud Smaoui
Lamia Oualha
Nabiha Douki
author_facet Hana Bougatef
Eya Moussaoui
Ines Kallel
Mahmoud Smaoui
Lamia Oualha
Nabiha Douki
author_sort Hana Bougatef
collection DOAJ
description Periostitis ossificans is a chronic disease characterized by an ossifying periostitis, occurring in children and young adults, commonly as a reaction to a mild infection or irritation. It is also characterized by the presence of lamellae of newly formed periosteal bone outside the cortex, giving the characteristic radiographic appearance of “onion skin.” Aim. The aim of this paper was to present the clinical and radiographic findings, as well as the postoperative follow-up of two cases diagnosed with periostitis ossificans of dental origin, and to discuss the differential diagnosis and treatment modalities. Case Reports. In the first case, a 16-year-old adolescent was referred for a persistent mandibular swelling. Intraoral examination showed two sinus tracts in relation to the carious necrotic left mandibular first molar. The periapical radiograph showed a periapical lesion in relation to the two root canals of the left mandibular first molar. Occlusal radiographs revealed the “onion skin” bone formation aspect. In the second case, a 10-year-old girl presented to our department with a slightly painful mandibular swelling. The periapical radiograph showed a periapical lesion in relation to both the mesial and distal roots of the carious necrotic right mandibular first molar. Cone beam computed tomography (CBCT) showed a subperiosteal bone formation with an “onion skin” aspect. Diagnosis of periostitis ossificans in the two cases was confirmed and the lesion was resolved by simply an endodontic treatment. Conclusion. Specific attention should be given to clinical and radiographic exploration in case of children with mandibular swelling. As osteosarcoma can be misdiagnosed, additional examinations, such as computed tomography, can be useful in differential diagnosis and in searching malignancy signs.
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spelling doaj-art-324f3e62e51e4c17a8ebf596e1b95a762025-08-20T03:55:03ZengWileyCase Reports in Dentistry2090-64472090-64552020-01-01202010.1155/2020/88762688876268Periostitis Ossificans: Report of Two Cases Resolved with Endodontic TreatmentHana Bougatef0Eya Moussaoui1Ines Kallel2Mahmoud Smaoui3Lamia Oualha4Nabiha Douki5Department of Dental Medicine, EPS Sahloul, Sousse, TunisiaDepartment of Dental Medicine, EPS Sahloul, Sousse, TunisiaDepartment of Dental Medicine, EPS Sahloul, Sousse, TunisiaDepartment of Dental Medicine, EPS Sahloul, Sousse, TunisiaDepartment of Dental Medicine, EPS Sahloul, Sousse, TunisiaDepartment of Dental Medicine, EPS Sahloul, Sousse, TunisiaPeriostitis ossificans is a chronic disease characterized by an ossifying periostitis, occurring in children and young adults, commonly as a reaction to a mild infection or irritation. It is also characterized by the presence of lamellae of newly formed periosteal bone outside the cortex, giving the characteristic radiographic appearance of “onion skin.” Aim. The aim of this paper was to present the clinical and radiographic findings, as well as the postoperative follow-up of two cases diagnosed with periostitis ossificans of dental origin, and to discuss the differential diagnosis and treatment modalities. Case Reports. In the first case, a 16-year-old adolescent was referred for a persistent mandibular swelling. Intraoral examination showed two sinus tracts in relation to the carious necrotic left mandibular first molar. The periapical radiograph showed a periapical lesion in relation to the two root canals of the left mandibular first molar. Occlusal radiographs revealed the “onion skin” bone formation aspect. In the second case, a 10-year-old girl presented to our department with a slightly painful mandibular swelling. The periapical radiograph showed a periapical lesion in relation to both the mesial and distal roots of the carious necrotic right mandibular first molar. Cone beam computed tomography (CBCT) showed a subperiosteal bone formation with an “onion skin” aspect. Diagnosis of periostitis ossificans in the two cases was confirmed and the lesion was resolved by simply an endodontic treatment. Conclusion. Specific attention should be given to clinical and radiographic exploration in case of children with mandibular swelling. As osteosarcoma can be misdiagnosed, additional examinations, such as computed tomography, can be useful in differential diagnosis and in searching malignancy signs.http://dx.doi.org/10.1155/2020/8876268
spellingShingle Hana Bougatef
Eya Moussaoui
Ines Kallel
Mahmoud Smaoui
Lamia Oualha
Nabiha Douki
Periostitis Ossificans: Report of Two Cases Resolved with Endodontic Treatment
Case Reports in Dentistry
title Periostitis Ossificans: Report of Two Cases Resolved with Endodontic Treatment
title_full Periostitis Ossificans: Report of Two Cases Resolved with Endodontic Treatment
title_fullStr Periostitis Ossificans: Report of Two Cases Resolved with Endodontic Treatment
title_full_unstemmed Periostitis Ossificans: Report of Two Cases Resolved with Endodontic Treatment
title_short Periostitis Ossificans: Report of Two Cases Resolved with Endodontic Treatment
title_sort periostitis ossificans report of two cases resolved with endodontic treatment
url http://dx.doi.org/10.1155/2020/8876268
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