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CT findings as a significant predictive factor for the curability of mandibular osteomyelitis: multivariate analysis

Oral and Maxillofacial Radiology, Department of Oral Restitution, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan

^* Correspondence to: Mizue Ida, Department of Oral and Maxillofacial Radiology, Graduate School, Tokyo Medical and Dental University, 5-45, Yushima 1-chome, Tokyo 1138549, Japan; E-mail: ida.orad{at}tmd.ac.jp

Received 13 October 2004; revised 5 January 2005; accepted 6 January 2005

Objectives: To re-evaluate computed tomographic (CT) imaging as a diagnostic tool for mandibular osteomyelitis and to assess the clinical significance of CT findings.

Methods: CT images of 78 patients with mandibular osteomyelitis were reviewed. All patients were classified as cured or non-cured. Each CT finding was investigated for frequency, correlation with duration and disease cure.

Results: Of the 78 patients, 49 (63%) were classified as "cured" and 29 (37%) as "non-cured". Non-cured had experienced a significantly longer duration of symptoms. The most frequent CT finding was sclerosis and defect in the trabecular bone. Changes of bone width and thickening of the cortical plate were accompanied with longer disease duration. The extent of the diseased area was linearly correlated with the duration of symptoms. The significant factors to discriminate non-cured from cured were the extent of the disease, the number of findings, changes in the bone width, osteosclerosis and thickening of the cortex. Multivariate logistic regression analysis indicated that the extent of the disease and presence of changes in bone width were significant variables correlating with the cure of osteomyelitis.

Conclusions: The extent of disease and the presence of change in bone width shown on CT were significantly correlated with the curability of osteomyelitis. These results indicated the usefulness and importance of CT examination for the diagnosis of mandibular osteomyelitis.

Keywords: osteomyelitis; mandible; tomography, X-ray computed

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