Condensing osteitis is a

periapical Dental anatomy is a field of anatomy dedicated to the study of human tooth structures. The development, appearance, and classification of teeth fall within its purview. (The function of teeth as they contact one another falls elsewhere, under den ...

inflammatory disease Inflammation (from la, inflammatio) is part of the complex biological response of body tissues to harmful stimuli, such as pathogens, damaged cells, or irritants, and is a protective response involving immune cells, blood vessels, and molecu ...

that results from a reaction to a dental related infection. This causes more bone production rather than bone destruction in the area (most common site is near the root apices of

premolars The premolars, also called premolar teeth, or bicuspids, are transitional teeth located between the canine and molar teeth. In humans, there are two premolars per quadrant in the permanent set of teeth, making eight premolars total in the mouth ...

and

molars The molars or molar teeth are large, flat teeth at the back of the mouth. They are more developed in mammals. They are used primarily to grind food during chewing. The name ''molar'' derives from Latin, ''molaris dens'', meaning "millstone to ...

). The lesion appears as a radiopacity in the periapical area hence the sclerotic reaction. The sclerotic reaction results from good patient

immunity Immunity may refer to: Medicine * Immunity (medical), resistance of an organism to infection or disease * ''Immunity'' (journal), a scientific journal published by Cell Press Biology * Immune system Engineering * Radiofrequence immunity desc ...

and a low degree of

virulence Virulence is a pathogen's or microorganism's ability to cause damage to a host. In most, especially in animal systems, virulence refers to the degree of damage caused by a microbe to its host. The pathogenicity of an organism—its ability to ca ...

of the offending

bacteria Bacteria (; singular: bacterium) are ubiquitous, mostly free-living organisms often consisting of one biological cell. They constitute a large domain of prokaryotic microorganisms. Typically a few micrometres in length, bacteria were among ...

. The associated tooth may be carious or contains a large restoration, and is usually associated with a non-vital tooth. It was described by Dr.

Carl Garré Carl Alois Philipp Garrè (12 December 1857, Ragaz – 6 March 1928) was a Swiss surgeon. He proved that Staphylococcus aureus causes carbuncles and boils by experimenting on himself and had one condition named after himself, Garre's sclerosi ...

in 1893.

Cause

Infection of periapical tissues of a high immunity host by organisms of low virulence which leads to a localized bony reaction to a low grade inflammatory stimulus.

Diagnosis

*1-

TENDERNESS ON VERTICAL PERCUSSION Tenderness may refer to: Films * ''Tenderness'' (2009 film), a 2009 American crime film * ''Tenderness'' (2017 film), a 2017 Italian film also known as ''La tenerezza'' Medicine * Rebound tenderness, a clinical sign that a doctor may detect i ...

Differential diagnosis

*1-

Idiopathic osteosclerosis Idiopathic osteosclerosis, also known as enostosis or dense bone island, is a condition which may be found around the roots of a tooth, usually a premolar or molar. It is usually painless and found during routine radiographs as an amorphous radi ...

. *2-

cementoblastoma Cementoblastoma, or benign cementoblastoma, is a relatively rare benign neoplasm of the cementum of the teeth. It is derived from ectomesenchyme of odontogenic origin. Cementoblastomas represent less than 0.69–8% of all odontogemic tumors. Signs ...

. *NOTE: An abnormal result with

pulp Pulp may refer to: * Pulp (fruit), the inner flesh of fruit Engineering * Dissolving pulp, highly purified cellulose used in fibre and film manufacture * Pulp (paper), the fibrous material used to make paper * Molded pulp, a packaging material ...

testing strongly suggests condensing

osteitis Osteitis is inflammation of bone. More specifically, it can refer to one of the following conditions: * Osteomyelitis, or ''infectious osteitis'', mainly ''bacterial osteitis'' * Alveolar osteitis or "dry socket" * Condensing osteitis (or Osteitis ...

and tends to rule out

osteosclerosis Osteosclerosis is a disorder that is characterized by abnormal hardening of bone and an elevation in bone density. It may predominantly affect the medullary portion and/or cortex of bone. Plain radiographs are a valuable tool for detecting and ...

and

Treatment

The process is usually

asymptomatic In medicine, any disease is classified asymptomatic if a patient tests as carrier for a disease or infection but experiences no symptoms. Whenever a medical condition fails to show noticeable symptoms after a diagnosis it might be considered asy ...

and

benign Malignancy () is the tendency of a medical condition to become progressively worse. Malignancy is most familiar as a characterization of cancer. A ''malignant'' tumor contrasts with a non-cancerous benign tumor, ''benign'' tumor in that a malign ...

, in most cases the tooth will require root canal treatment.

endodontic treatment Root canal treatment (also known as endodontic therapy, endodontic treatment, or root canal therapy) is a treatment sequence for the infected pulp of a tooth which is intended to result in the elimination of infection and the protection o ...

. The offending tooth should be tested for vitality of the pulp, if inflamed or necrotic, then endodontic treatment is required as soon as possible, while hopeless teeth should be extracted.

Prognosis

The prognosis is excellent, once root canal treatment is completed. If the offending tooth is extracted, the area of condensing osteitis may remain in the jaws indefinitely, which is termed osteosclerosis or bone scar.

References

External links

{{Medical resources , DiseasesDB = 33858 , ICD10 = , ICD9 = , ICDO = , OMIM = , MedlinePlus = , eMedicineSubj = , eMedicineTopic = , MeshID = Inflammations Osteitis Pathology of the maxilla and mandible