Unusual treatment of symptomatic condensing osteitis related to mandibular premolar teeth: a case report

Abstract

Objectives: Condensing osteitis is defined as pathologic sclerosis of maxillo-mandibular bones characterized bymild clinical symptoms. This case report presented a different approach to a patient with symptomaticcondensing osteitis. Materials and Methods: A twenty one years old male patient was referred to our department because of pain inhis left mandibular region during chewing. Intraoral examination revealed pain in the lower left first premolartooth during percussion and it was seen that this tooth was associated with an apical sclerotic lesionapproximately 1cm wide in radiographic examination. Root canal treatment was performed to the tooth. Ascomplaints of pain during chewing exceeded, both biopsy and apical root resection were performed. Results: The lesion was diagnosed as symptomatic condensing osteitis after clinical, radiological andpathological examinations. A month after the operation, the patient s symptoms completely disappeared. In 6,and 12 months radiographic controls, beginning of new bone formation in region of resection and also regressionof lesion were observed. Conclusions: The conventional treatment of condensing osteitis is extraction of related tooth and curetting ofthat region or root treatment of related the tooth. In this type of lesion, in condition of failed root canal treatment,instead of the tooth extraction, as a different treatment option, apical root resection can cut the relationshipbetween the root and the lesion.