Florid osseous dysplasia with chronic suppurative osteomyelitis in Asian female: an incidental finding on Panoramic and CBCT examination
Abstract
Objectives: In a previous case study, we reported an incidental finding of florid osseous dysplasia with osteomyelitis, which was identified on panoramic and CBCT imaging.Case Report: A 53-year-old female patient came to the Radiology Department of Dental Hospital Padjadjaran Bandung with the chief complaint of recurrent pain one year ago; there was swelling from the cheek to the left mandible; the swelling reappeared one week ago with clinical pus mixed with blood in the swelling area. The patient had previously seen an oral surgeon and was referred for panoramic and CBCT radiographs. The results of the panoramic radiographs were that there was an irregular radiopaque lesion with ill-defined borders in the posterior region affecting 4 quadrants; in the sinister mandibular region, there was cortical destruction, root resorption, and the lesion appeared to extend to the canalis mandibular area. The CBCT examination showed multiple globular radiopaque lesions affecting 4 quadrants in the posterior area. There were sequestra with lytic lesions on the sinistra mandible resulting in buccal and lingual cortical bone discontinuity and buccal-lingual expansion. Expansion of the lesion area resulted in discontinuity of the canals mandibular sinistra and decreased bone density of the trabeculae up to the mandibular ramus; there was apical resorption trabecula bone density. From the Panoramic examination and CBCT results, the suspect radiodiagnosis was Florid osseous dysplasia associated with osteomyelitis.
Conclusion: An examination of panoramic and CBCT images revealed FOD that had been secondarily infected with chronic diffuse osteomyelitis.
References
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Suei Y, Taguchi A, Tanimoto K. Diagnosis and classification of mandibular osteomyelitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005;100(2):207–14.
Goel S, Singh A, Ghosh S, Gupta S, Gupta S, Garg A. Florid osseous dysplasia with Klebsiella associated osteomyelitis and periapical osseous dysplasia in Asian females: A report of two cases. J Oral Maxillofac Radiol. 2015;3(1):19–22.
Singh R, Gupta D, Aggarwal A, Sheikh S, Bansal N, Mago J, et al. Florid cemento-osseous dysplasia with chronic osteomyelitis: A case report. J Adv Med Dent Scie Res. 2014;2(3):146–50.
Sanjaya AN, Pramanik F, Rizki RF. Gambaran radiografis panoramik pada evaluasi kasus osteomielitis pasca sequestrectomy disertai temuan florid osseous dysplasia. J Ked Gi Univ Padjadjaran. 2021;32(3):92–7.
Mehra H, Gupta S, Gupta H, Sinha V, Singh J. Chronic suppurative osteomyelitis of mandible: A case report. Craniomaxillofac Trauma Reconstr. 2013;6(3):197–200.
Akkas I, Tozoglu S, Caglayan F, Ozan F. The importance of CBCT imaging to determine the characteristics of a bone sequestrum in a case of chronic osteomyelitis. Cumhuriyet Dent J. 2013;16(2):138–43.
Manekar V, Gadve V, Dhote V, Radke S. Evaluation of secondary chronic suppurative osteomyelitis of jaw in 15 cases: A retrospective analysis. J Clin Diagn Res. 2021;15(8):27–30.
Schulze D, Blessmann M, Pohlenz P, Wagner KW, Heiland M. Diagnostic criteria for the detection of mandibular osteomyelitis using cone-beam computed tomography. Dentomaxillofac Radiol. 2006;35(4):232–5.
Eskandarloo A, Yousefi F. CBCT findings of periapical cemento-osseous dysplasia: A case report. Imaging Sci Dent. 2013;43(3):215–8.
Gumru B, Akkitap MP, Deveci S, Idman E. A retrospective cone beam computed tomography analysis of cemento-osseous dysplasia. J Dent Sci. 2021;16(4):1154–1161.
Mahalingam G, Manoharan GV. Florid osseous dysplasia: Report of two cases and review of literature. J Clin Diagn Res. 2017;11(1):ZD21–ZD24.
Saikia J, Pachipulusu B, Govindaraju P. Florid cemento-osseous dysplasia associated with chronic suppurative osteomyelitis and multiple impacted teeth: An incidental finding – A rare case report. J Family Med Prim Care. 2020;9(3):1757–60.
Melka AC, Barthélémy I, Cousson PY, Devoize L, Dang NP. Florid osseous dysplasia causing sensory disturbances in the area supplied by the inferior alveolar nerve. Med Buccale Chir Buccale. 2017;23(3):196–9.
Daviet-Noual V, Ejeil AL, Gossiome C, Moreau N, Salmon B. Differentiating early stage florid osseous dysplasia from periapical endodontic lesions: A radiological-based diagnostic algorithm. BMC Oral Health. 2017;17(1):161.
Barajas-Pérez VH, Recendez-Santillan NJ, Vega-Memíje ME, García-Calderón GG, Cuevas-González CJ. Chronic suppurative osteomyelitis of the mandible treated with antibiotics complemented with surgical treatment: A case report. Int J Odontostomat. 2017;11(3):261–5.
Apurba P, Saberi A, Sultana G, Kumari A, Kumari M, Raj S, et al. Osteomyelitis of maxilla: A rare case presentation with detailed radiological assessment. Int Clin Med Case Rep J. 2023;2(16):1–8.
Shin HS, Kim BC, Lim HJ, Jo SY, Lee J. Chronic osteomyelitis induced by the placement of dental implants on cemento-osseous dysplasia. Br J Oral Maxillofac Surg. 2019;57(3):268–70.
Mallya SM, Lam EW. White and Pharoah's Oral Radiology: Principles and Interpretation. 8th ed. Canada: Elsevier; 2018. p. 1608.
Suei Y, Taguchi A, Tanimoto K. Diagnosis and classification of mandibular osteomyelitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005;100(2):207–14.
Published
2025-05-31
How to Cite
SUKMADEWI, Putri Marina; PRAMANIK, Farina.
Florid osseous dysplasia with chronic suppurative osteomyelitis in Asian female: an incidental finding on Panoramic and CBCT examination.
Jurnal Radiologi Dentomaksilofasial Indonesia (JRDI), [S.l.], v. 9, n. 1, p. 23-28, may 2025.
ISSN 2686-1321.
Available at: <http://jurnal.pdgi.or.id/index.php/jrdi/article/view/1226>. Date accessed: 07 june 2025.
doi: https://doi.org/10.32793/jrdi.v9i1.1226.
Section
Case Report

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