Radiological and histological study of osteomyelitis of the jaws - Correlation between radiographic and histological patterns

Fifty-six patients with maxillary and mandibular osteomyelitis were investigated radiologically and histopathologically. The radiographic changes were classified into 5 patterns: osteolytic, mixed, sclerosing, sequestrum and irregular trabeculation patterns. Osteomyelitis was classified into 3 histological types, based on the amount of bony trabeculae present. Type I bone consisted of severely sclerotic bone, type II bone had coarse trabeculae with fibrotic marrow spaces. In contrast, type III bone had thin trabeculae with occasional osteoblastemata. The correlations between the radiographic and histological patterns and differences between acute and chronic cases were examined. Acute cases were often of the osteolytic or sequestrum patterns, and had type I or II bone. Type II bone was the most common, and was found in all radiographic types. Type III bone was frequently seen in cases with an osteolytic or mixed radiographic pattern. It seemed that severely sclerotic bone with narrowed or occluded Haversian canals (type I bone) tended to develop following acute infection. A possible explanation of the relationship of 5 radiographic types is also discussed.