Juvenile chronic mandibular osteomyelitis: successful non-surgical treatment with five-year follow-up

Abstract

Juvenile Chronic Mandibular Osteomyelitis (JCMO) is a rare, non-infectious inflammatory bone disorder predominantly affecting pediatric patients. This case report presents an 8-year-old girl with persistent unilateral mandibular swelling, pain, and trismus. Diagnostic imaging revealed a mixed radiopaque lesion with cortical perforation and periosteal reaction, while histopathological analysis identified woven bone with osteoblastic rimming and mild chronic inflammation. The diagnosis of JCMO was established based on clinical, radiographic, and histological findings. Initial treatment with NSAIDs provided partial relief but caused gastric symptoms.A revised regimen of naproxen and low-dose prednisone achieved sustained clinical and radiographic remission. This case highlights the diagnostic challenges posed by JCMO and demonstrates the effectiveness of conservative management with NSAIDs and corticosteroids as a non-surgical treatment strategy. Our findings underscore the need for standardized diagnostic criteria and treatment protocols for this rare condition, emphasizing the importance of continued research and case documentation to improve understanding and management.