PDF(Pubmed)
Abstract：
Chronic diffuse sclerosing osteomyelitis is a very rare condition, described as a non-suppurative, inflammatory disease of the bone and characterized by a proliferative endosteal reaction, which clinically reveals itself with cyclic pain of the jaw and swelling. We reported two clinical cases, where patients suffered recurrent swelling and pain at the mandible irradiating to the preauricular area, denying any previous trauma or significant medical history. Odontogenic causes were excluded. An initial treatment with antibiotics and NSAIDs temporarily relieved the symptoms without complete resolution, prompting further investigations. After a comprehensive array of diagnostic tools (X-rays, CT scans, scintigraphy, bone biopsy, serum markers), both patients were diagnosed with chronic diffuse sclerosing osteomyelitis of the mandible. Bisphosphonates (clodronate and zolendronate) with different treatment schemes were used to treat the condition, until a full recovery from symptoms was reported. Bisphosphonates could therefore represent an effective option in managing this rare but impactful condition. Further research is warranted to better understand the underlying mechanisms of the disease and to optimize treatment strategies.
摘要：
慢性弥漫性硬化性骨髓炎是一种非常罕见的疾病，被描述为非化脓性的，骨的炎症性疾病，其特征是增生性内膜反应，它在临床上表现为颌骨的周期性疼痛和肿胀。我们报道了两例临床病例,患者在下颌骨照射耳前区域时反复肿胀和疼痛，否认任何以前的创伤或重大病史。牙源性原因被排除。抗生素和NSAIDs的初始治疗暂时缓解了症状，但没有完全缓解。促使进一步调查。经过一系列全面的诊断工具（X射线，CT扫描,闪烁显像,骨活检,血清标志物)，两名患者均被诊断为下颌骨慢性弥漫性硬化性骨髓炎。使用不同治疗方案的双膦酸盐（氯膦酸盐和唑仑膦酸盐）治疗该病症，直到报告症状完全康复。因此，双膦酸盐可能是管理这种罕见但有影响的疾病的有效选择。需要进一步的研究以更好地了解该疾病的潜在机制并优化治疗策略。
