Garre's osteomyelitis is a unique form of osteomyelitis characterized rediographically by localized thickening of the periosteum and deposition of laminated subperiosteal bone. The most common inciting factor is a mandibular infection in
permanent
first
molar with necrotic pulp. This disease occurs primarily in children and to date in all instances it has occured only in mandible. It usually results in hard swelling over the jaws, producing facial asymmetry withlittle or no pain. The overlying
skin is
normal but can occasionally be inflammed mostly when pain is present. Palpation reveals a usually smooth, bone-hard lesion which feel like an inherent part of the mandible. Unlike other forms of osteomyelitis, there is no marked increase in
fever,
white
bloods cell count, sedimentation rate or alkaline phosphatase value. The treament of Garre's osteomyelitis usually consist of elimination of the sourses of infection, i.e., either extration of anoffending infected teeth or root canal therapy.
This
treatment almost always results in resolution of the Garre's osteomyelitis.
Resistant cases have involved secondary surgery, i.e., decortication and sequestrectomy.
This report presents three cases of Garre's osteomyelitis resolved by endodontic treat ment. Clinical examination revealed swelling on the face with no tenderness. Periapical rediograph showed deep caries lesion extending intop pulp chamber and
periapical radiolucency. Occlusal radiograph showed an enlargement of bone and stretching the periosteum. A clinical iagnosis of the Garre's osteomyelitis was made. Endodontic treatment was accomplished with conventional method and restored
facial
symmetry. Long-term check-ups are necessary to evaluate the results of endodontic treatment.
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