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The diagnosis of sclerosing osteomyelitis of Garrè, or periostitis ossificans, is suggested by a history of hard swelling of the mandible accompanied by a carious dentition. Computed tomography, nuclear medicine scanning, and pantomography are used to illustrate the appearance of this condition arising in a 25-year-old woman. The differential diagnosis of mandibular thickening and associated bony sclerosis is discussed.

Fourteen patients with chronic sclerosing osteomyelitis of the mandible were investigated with 99mTc-labeled bone-seeking agents. Scintigraphic findings were compared with radiographic features. High uptake of diphosphonate and polyphosphate was demonstrated in diseased areas. Good agreement was found between radiography and scintigraphy concerning the extent and activity of each process. The use of bone-seeking radiopharmaceuticals in other types of skeletal lesions and differential diagnostic aspects are discussed.

Chronic sclerosing osteomyelitis has been frequently described in the literature but little has been recommended for the management of the resistant cases that fail to respond to conservative treatment. This report describes the long term management of a particularly aggressive case of CSO and indicates maxillary sinus disease as a possible etiologic factor in CSO of the maxillary alveolus. Treatment required in more extensive cases must be as aggressive as dictated by the entire disease process and the total medical evaluation.

Florid osseous dysplasia has been described as a condition that characteristically affects the jaws of middle-aged black women. It usually manifests as multiple radiopaque cementum-like masses distributed throughout the jaws. This condition has also been classified by various authors as sclerosing osteomyelitis, sclerosing osteitis, sclerotic cemental masses, gigantiform cementoma, and various other terms. In this series, we want to document eight cases of florid osseous dysplasia in middle-aged, female ethnic Chinese and one case in an Indian subject on the basis of radiographic and histopathologic findings. On the basis of this series, incidence is estimated to be 0.01 case per year 100,000 population. Florid osseous dysplasia constitutes 11% of cemental lesions in our files.

The histologic features of chronic sclerosing osteomyelitis of the mandible were studied. Four different types of tissue reaction were found to be characteristic of the disease. Histochemical recordings were used in an attempt to facilitate differential diagnosis. Similar types of fibro-osseous lesions and biopsy technique are discussed.

Osteomyelitis sicca, chronic sclerosing osteomyelitis with fine-meshed bone structure, and local and more extensive sclerosing osteomyelitis are primarily chronic inflammations, accompanied by endosteal bone apposition which is reflected on the x-ray picture in a sclerosis. The lesions were discussed mainly from a clinical-roentgenologic standpoint. The differential diagnosis, together with a brief explanation, was given for each type of sclerosing inflammation. However important the clinical-roentgenologic characteristics may be for the diagnosis, the final diagnosis is made mostly in close cooperation between pathologist and clinician.