Abstract
Treating chronic diffuse sclerosing osteomyelitis (DSO) is challenging and many treatments
have been reported. However, we know of no standard protocol or guidelines. In this
systematic review of relevant publications we provide an overview of the different
treatments used. We made an electronic search of PubMed, Medline, Embase, Web of Science,
and the Cochrane Library databases, for papers that described the treatment of DSO
of the mandible. The search yielded 48 papers that applied to all inclusion criteria,
resulting in 16 case reports, 13 case series, 18 retrospective clinical cohort studies,
and one randomised controlled trial. Reported treatment options included different
operations; the use of antibiotics, anti-inflammatories, and antiresorptive medication;
conservative treatment; and hyperbaric oxygen. Surgical treatment resulted in a low
success rate and was associated with higher morbidity than other treatments. Conservative
treatment, and that of bisphosphonates, yielded more promising results, so conservative
treatment and bisphosphonates seem to be the most promising therapeutic options. However,
because of the high risk of bias, no firm conclusions can be drawn, and larger studies
with clear inclusion criteria and specified endpoints are needed.
Keywords
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Article info
Publication history
Published online: February 05, 2020
Accepted:
January 13,
2020
Received:
August 16,
2019
Identification
Copyright
© 2020 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
