Chronic secondary orofacial pain as the first symptom of chronic non-bacterial osteomyelitis in the mandible: a case report and literature review

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Published: May 11, 2024
DOI: https://doi.org/10.52600/2763-583X.bjcr.2024.4.4.109-117
Keywords:
Osteomyelitis, Dor orofacial, Inflamação

Main Article Content

Samilla Pontes Braga
Orofacial Pain Ambulatory, Clinics Hospital, School of Medicine, University of São Paulo (HCFMUSP)
https://orcid.org/0000-0003-4582-7653
Raniel Ramon Norte Neves
Oral and Maxillofacial Surgery and Traumatology Ambulatory, Clinics Hospital, School of Medicine, University of São Paulo (HCFMUSP)
https://orcid.org/0000-0002-5098-6432
Sumatra Melo da Costa Pereira Jales
Orofacial Pain Ambulatory, Clinics Hospital, School of Medicine, University of São Paulo (HCFMUSP)
André Caroli Rocha
Oral and Maxillofacial Surgery and Traumatology Ambulatory, Clinics Hospital, School of Medicine, University of São Paulo (HCFMUSP)
Rosa Maria Rodrigues Pereira
Rheumatology Ambulatory, Clinics Hospital, School of Medicine, University of São Paulo (HCFMUSP)
José Tadeu Tesseroli de Siqueira
Orofacial Pain Ambulatory, Clinics Hospital, School of Medicine, University of São Paulo (HCFMUSP)
https://orcid.org/0000-0002-9721-1634

Abstract

Chronic non-bacterial osteomyelitis clinically manifests with pain, swelling and limitation of movement. When it affects the jaws, it can cause pain, similar to other orofacial conditions, requiring a correct differential diagnosis. The objective of this study was to report a clinical case of chronic secondary orofacial pain as the first manifestation of an inflammatory bone disease located in the mandible, in addition to discussing the diagnostic hypotheses, the pathophysiological aspects and the therapy. A 21-year-old male patient came to the service complaining of pain in the mandible, preauricular and temporal regions bilaterally with one year of evolution, associated with anterior open bite and psychological impairment. So, it was chronic orofacial pain secondary to non-bacterial osteomyelitis with a high rate of bone remodeling. Elevation of pro-inflammatory cytokines can lead to an increased power cycle of nociceptive signaling, chronic inflammation, and bone loss. Pro-inflammatory cytokines that originate in neuronal and glial cells can trigger effects such as chronic hyperexcitability, changes in the phenotypic expression of nociceptors and abnormal processing of noxious signals. The patient is still undergoing treatment and without pain. Careful assessment, ordering tests and multidisciplinary investigation are essential in the care of patients with chronic and complex orofacial pain.

Article Details

How to Cite
Braga, S. P., Neves , R. R. N., Jales , S. M. da C. P., Rocha, A. C., Pereira , R. M. R., & Siqueira, J. T. T. de. (2024). Chronic secondary orofacial pain as the first symptom of chronic non-bacterial osteomyelitis in the mandible: a case report and literature review. Brazilian Journal of Case Reports, 4(4), 109–117. https://doi.org/10.52600/2763-583X.bjcr.2024.4.4.109-117
Issue
Vol. 4 No. 4 (2024): October/December - 2024
Section
Clinical Case Reports
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This work is licensed under a Creative Commons Attribution 4.0 International License.

Author Biographies

Samilla Pontes Braga, Orofacial Pain Ambulatory, Clinics Hospital, School of Medicine, University of São Paulo (HCFMUSP)

Orofacial Pain Ambulatory, Clinics Hospital, School of Medicine, University of São Paulo (HCFMUSP), São Paulo, SP, Brazil.

Raniel Ramon Norte Neves , Oral and Maxillofacial Surgery and Traumatology Ambulatory, Clinics Hospital, School of Medicine, University of São Paulo (HCFMUSP)

Oral and Maxillofacial Surgery and Traumatology Ambulatory, Clinics Hospital, School of Medicine, University of São Paulo (HCFMUSP), São Paulo, SP, Brazil.

Sumatra Melo da Costa Pereira Jales , Orofacial Pain Ambulatory, Clinics Hospital, School of Medicine, University of São Paulo (HCFMUSP)

Orofacial Pain Ambulatory, Clinics Hospital, School of Medicine, University of São Paulo (HCFMUSP), São Paulo, SP, Brazil.

 

André Caroli Rocha, Oral and Maxillofacial Surgery and Traumatology Ambulatory, Clinics Hospital, School of Medicine, University of São Paulo (HCFMUSP)

Oral and Maxillofacial Surgery and Traumatology Ambulatory, Clinics Hospital, School of Medicine, University of São Paulo (HCFMUSP), São Paulo, SP, Brazil.

Rosa Maria Rodrigues Pereira , Rheumatology Ambulatory, Clinics Hospital, School of Medicine, University of São Paulo (HCFMUSP)

Rheumatology Ambulatory, Clinics Hospital, School of Medicine, University of São Paulo (HCFMUSP), São Paulo, SP, Brazil.

José Tadeu Tesseroli de Siqueira, Orofacial Pain Ambulatory, Clinics Hospital, School of Medicine, University of São Paulo (HCFMUSP)

Orofacial Pain Ambulatory, Clinics Hospital, School of Medicine, University of São Paulo (HCFMUSP), São Paulo, SP, Brazil.

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