Conservative treatment of children with chronic diffuse sclerosing osteomyelitis/tendoperiostitis of the mandible

Marieke M. van de Meent, Hamid Meshkini, Marta Fiocco, Miranda J.M. Wetselaar-Glas, Natasha M. Appelman-Dijkstra, J. P.Richard van Merkesteyn

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12 Citations (Scopus)


Chronic diffuse sclerosing osteomyelitis (DSO) of the mandible is a rare disease of unknown aetiology. It has been suggested that overuse of the masticatory muscles, tendoperiostitis (TP), is a contributing factor for DSO. Therefore, we tested this hypothesis by treating consecutive children with conservative therapy. All patients were treated with conservative therapy, comprising occlusal splint therapy, physiotherapy, and/or disease counselling. Pain intensity on a visual analogue scale (VAS) and pain frequency in number of days per 3 months were recorded before the start of treatment, and at 3, 6, and 12 months after treatment initiation. Eleven children (seven girls, four boys, mean age: 11.55 ± 1.97 years) were included in this study. Six patients showed a decrease in pain intensity and pain frequency over time and they continued with conservative therapy. For the remaining five patients, bisphosphonate administration was initiated because of persistent severe pain – one after 3 months of conservative therapy, and the other four after 1 year of conservative therapy. The pain complaints of patients with DSO/TP decreased with conservative therapy, and 55% did not require additional therapy. This suggests that DSO/TP of the mandible is precipitated by muscle overuse.

Original languageEnglish
Pages (from-to)1938-1943
Number of pages6
JournalJournal of Cranio-Maxillofacial Surgery
Issue number12
Publication statusPublished - Dec 2017
Externally publishedYes


  • Bisphosphonates
  • Chronic tendoperiostitis
  • Conservative therapy
  • Diffuse sclerosing osteomyelitis
  • Pain


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