Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Dr Bhanu K Bhakhri

"The Journal of Clinical and Diagnostic Research (JCDR) has been in operation since almost a decade. It has contributed a huge number of peer reviewed articles, across a spectrum of medical disciplines, to the medical literature.
Its wide based indexing and open access publications attracts many authors as well as readers
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Dr Bhanu K Bhakhri
Faculty, Pediatric Medicine
Super Speciality Paediatric Hospital and Post Graduate Teaching Institute, Noida
On Sep 2018

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Believers Church Medical College,
Thiruvalla, Kerala
On Sep 2018

Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."

Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018

Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."

Dr Kalyani R
Professor and Head
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Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
On Sep 2018

Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
‘Knowledge is treasure of a wise man.’ The free access of this journal provides an immense scope of learning for the both the old and the young in field of medicine and dentistry as well. The multidisciplinary nature of the journal makes it a better platform to absorb all that is being researched and developed. The publication process is systematic and professional. Online submission, publication and peer reviewing makes it a user-friendly journal.
As an experienced dentist and an academician, I proudly recommend this journal to the dental fraternity as a good quality open access platform for rapid communication of their cutting-edge research progress and discovery.
I wish JCDR a great success and I hope that journal will soar higher with the passing time."

Dr Saumya Navit
Professor and Head
Department of Pediatric Dentistry
Saraswati Dental College
On Sep 2018

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Dr. Arunava Biswas
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Calcutta National Medical College & Hospital , Kolkata

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" Journal of Clinical and Diagnostic Research (JCDR) is a multi-specialty medical and dental journal publishing high quality research articles in almost all branches of medicine. The quality of printing of figures and tables is excellent and comparable to any International journal. An added advantage is nominal publication charges and monthly issue of the journal and more chances of an article being accepted for publication. Moreover being a multi-specialty journal an article concerning a particular specialty has a wider reach of readers of other related specialties also. As an author and reviewer for several years I find this Journal most suitable and highly recommend this Journal."
Best regards,
C.S. Ramesh Babu,
Associate Professor of Anatomy,
Muzaffarnagar Medical College,
On Aug 2018

Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".

Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
On Aug 2018

Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".

Dr. Mamta Gupta
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018

Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.

Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."

Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
On May 11,2011

Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."

Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
On April 2011

Important Notice

Year : 2010 | Month : October | Volume : 4 | Issue : 5 | Page : 3261 - 3265

Maxillary Osteomyelitis Secondary To Osteopetrosis – A Rare Case Report


*M D S, Assistant Professor,**MDS, Assistant Professor, ***MDS, Assistant Professor, ****MDS, Professor, Department of Oral and Maxillofacial Surgery, Government Dental College, Pandit BD Sharma UHS, Rohtak, Haryana, India.

Correspondence Address :
Dr. Ambika Gupta
Assistant Professor,
Department of Oral Medicine and Radiology,
Government Dental College, Pandit B.D.Sharma U.H.S, Rohtak, Haryana, India.
E mail id-
Phone no: +91- 9315903300, +91-1262- 212614
Fax no: +91- 1262- 212648


Osteomyelitis of the mandible at a young age may occur as a complication of immunocompromised status or bone disorders. Osteomyelitis rarely occurs in the maxilla due to thin bone and collateral blood supply of the maxillary bone. We report here, a rare case of maxillary osteomyelitis that led to the diagnosis of the underlying condition of osteopetrosis. The clinical and radiographical features are being discussed here, along with the relevant review of literature.


Osteopetrosis, maxilla, osteomyelitis

Osteopetrosis, also known as Albers- Schonberg’s disease or Marble bone disease, is a group of rare hereditary skeletal disorders which are characterized by a marked increase in bone density, resulting from a defect in remodeling, caused by the failure of normal osteoclast function. (1) There is overgrowth and sclerosis of the bone, causing thickening of the cortices and narrowing of the marrow spaces. The prevalence of this disorder is estimated to be 1 in 100,000 to 1 in 500,000. The disease may present clinically in a variety of subtypes. However, the two major clinical presentations are the infantile form (autosomal recessive, malignant form) and the adult form (autosomal dominant, benign form). Both forms are characterized by a decreased vascularity of the involved bones that predisposes the patient to the development of osteomyelitis. Osteomyelitis may occur as a complication to odontogenic infections in almost 10% of the cases. (2) Osteomyelitis secondary to Osteopetrosis is more common in the mandible than in the maxilla due to thin cortical bone and a rich collateral blood supply to the maxilla. (3)

We report here, a rare case of osteomyelitis of the maxilla in a young male with osteopetrosis, that occurred secondary to the extraction of teeth.

Case Report

A 28 year old male reported to the department with a seven month history of a non healing wound in the maxilla. There was a history of trauma nine months ago, following which the patient had pain in the maxillary right teeth. The pain was accompanied by a swelling in the right cheek region. He went to a private dentist who extracted his maxillary right molars. The patient reported that the site of extraction did not heal even after taking repeated courses of antibiotics. Pus discharge was present extraorally from the right infraorbital and the zygomatic regions and intraorally from the right maxillary posterior region since three months.

(Table/Fig 1): Extra oral view of the patient showing extent of swelling and extraoral sinuses.

The patient was a chronic tobacco chewer since five years. The medical history of the patient was non contributory and the vital signs were stable. Inspection revealed a diffuse irregular swelling on the right side of the maxilla and the zygoma, approximately 5 x 4 cm in size, with multiple discharging sinuses and erythema on the right cheek and the infraorbital region. The swelling was bony hard in consistency, with signs of inflammation. The right lower eyelid was stretched due to a puckered appearance around the infraorbital sinuses.[ Table/ Fig. 1]

(Table/Fig 2): Intraoral view showing the necrosed bone at the site of extraction.

Intra oral examination revealed a mucosal defect in the right maxillary molar region, with exposed necrotic bone extending upto the maxillary tuberosity. The right maxillary molars were missing. [Table/Fig.2] The radiographical examination of the jaws was done.

(Table/Fig 3): Pantomograph revealing increased density of maxilla and mandible with extensive osteosclerosis in right maxilla.
The trabecular architecture was fine and it was increased in number and density in both the maxilla and the mandible on pantomography. Distinct cortical outlines of the inferior and the posterior border of the mandible, the inferior alveolar canal, the maxillary antrum, the nasal cavity and the lamina dura around the teeth were not traceable. There was a generalized narrowing of the periodontal ligament spaces and the inferior alveolar canal. An increased sclerosis of bone was evident in the right maxilla with irregular ragged margins. 18, 28 and 38 were impacted. [Table/ Fig. 3]

(Table/Fig 4): Thickened soft tissue in right maxillary alveolar region, right masticator space involving the right masseter and medial and lateral pterygoid muscles, with loss of fat planes.
The paranasal sinus view showed extensive osteosclerosis. [Table/Fig. 5] CT scan revealed a generalized increased density of the visualized skull and facial bones.

(Table/Fig 5): Coronal CT section showing osteosclerosis of bones and obliteration of maxillary sinus.

Irregularity of bone was seen in the right maxilla with the erosion of the buccal cortex of the right maxilla, the adjacent zygomatic bone, the lateral wall of the right orbit, the antero lateral wall of the right maxillary sinus and the maxillary alveolus, causing a breach in the continuity of the maxillary alveolus in the midline. Soft tissue thickening was present in the right maxillary antrum and along the right side of the hard palate with periosteal reaction. [Table/Fig 4,5] Axial CT revealed a heterogenous enhancement of the thickened soft tissue in the right maxillary alveolar region, the right masticator space involving the right masseter and the medial and the lateral pterygoid muscles, with loss of the fat planes. (Table/Fig 4) The frontal sinus was underpneumatized for his age. On the basis of the radiographical evaluation, a diagnosis of Osteopetrosis with infective osteomyelitis of the right maxilla was given. The patient was referred for further work up.
Ultrasonography of the abdomen revealed massive enlargement of the spleen (25 cm), with mild hepatomegaly (14 cm). The routine blood tests showed alteration of haemoglobin levels (Hb-6.7gm/dl) and haematocrit was 25%. The red blood cells were microcytic and hypochromic. Other parameters were within normal limits (leukocytes: 6,800/cumm with 2% atypical cells and normal differential count; platelets: 2,34,000/cubic mm). His liver and renal function tests were normal. Bone marrow aspiration was pancellular and diluted, leading to no further conclusion. The serum calcium, phosphorus, alkaline phosphatase and acid phosphatase levels were normal. Chest radiograph and long bone revealed a generalized increased density of the visualized bones.

A biopsy from the oral lesion revealed necrotic material with bacterial and fungal colonies, with acute and chronic inflammatory granulation tissue, with tiny strips of stratified squamous epithelium. Based on the culture sensitivity report, the patient was given oral ciprofloxacin 500 mg, twice daily for 15 days. This was followed by local debridement and sequestrectomy. Partial maxillectomy was subsequently planned for the patient. But, the patient refused any further treatment. He was asymptomatic for the next 3 months, after which he did not follow up.


Adult osteopetrosis is usually discovered later in life than the infantile form and exhibits less severe manifestations. (1) It is usually inherited as an autosomal dominant trait. Mostly, the axial skeleton is involved. Adult osteopetrosis may exist clinically in two major variants. In Type I, cranial nerve compression is a predominant feature and in Type II, skeletal fractures occur more frequently than nerve compression. In the present case, the patient had no signs of osteopetrosis at birth or in early infancy. There was no history of recurrent bone fractures, visual or auditory disturbances, or facial palsy. The examination revealed no facial deformity or delayed tooth eruption. Therefore, a diagnosis of adult osteopetrosis was made. The clinical presentation of osteomyelitis at the site of extraction was the first manifestation of his disease.
Radiographical examination plays a vital role in the diagnosis of Osteopetrosis. There is an increased radiopacity of the entire skeleton, resulting in diffuse, homogenous and sclerotic bones. The normal trabecular pattern may not be visualized due to the excessive density of the bones. The normal landmarks of the skull are lost. There is narrowing of the foramina of the skull, leading to the compression of the cranial nerves and blood vessels. On dental radiographs, the morphology of the roots is obscured due to the presence of dense bones. Lamina dura around the teeth is not traceable. Other dental findings include the delayed eruption of teeth, early tooth loss, impacted teeth, malformed teeth, partial anodontia, enamel hypoplasia, abnormal pulp chambers and a tendency for the early decay of teeth.(4) In the present case, there was extensive osteosclerosis of the entire skeleton. The inferior alveolar canal was narrowed. However, the patient had no signs of paraesthesia or anaesthesia. The lamina dura was not traceable around the teeth. Thickening of the adjacent soft tissue and loss of the muscle planes and the periosteal reaction were suggestive of an infective aetiology. Osteopetrosis may be differentiated from other bone diseases like polyostotic fibrous dysplasia, Paget’s disease, infantile cortical hyperostosis, pyknodysostosis and florid cemento- osseous dysplasia by the fact that osteopetrosis usually involves the entire skeleton. Skeletal fluorosis and secondary hyperparathyroidism may also result in a similar radiographical appearance. The presence of osteosclerosis and pathological fractures on radiographshave been reported to be sufficiently characteristic of of Osteopetrosis. (5) The structural weakness associated with poorly organized bone and the persistent accumulation of immature bone and calcified cartilage have been postulated as the possible reason behind the pathological fractures. (6) The compromised vascularity of the bones and the decreased amount of intraosseous haematopoietic marrow that causes anaemia and neutropaenia may predispose the patient to osteomyelitis. (7) Both these findings were positive in our case, which could have predisposed to the development of osteomyelitis after the extraction. The incidence of osteomyelitis in the jaws increases with the presence of odontogenic infections and surgical intervention.
The serum levels of calcium, phosphorus and alkaline phosphatase are usually within the normal limits. The serum acid phosphatase levels are commonly elevated in the infantile, intermediate and the adult type II forms of the disease. In the present case, the serum levels of calcium, phosphorus, alkaline phosphatase and acid phosphatase were normal.

Although the diagnosis of Osteopetrosis is easy to make, the real challenge lies in the treatment of this disease. Bone marrow transplantation is the only hope for the permanent cure of Osteopetrosis. Other treatment modalities like interferon gamma -1b and calcitriol have shown some benefits in reducing the bone mass, thereby preventing other complications like osteomyelitis and nerve compression. Other therapeutic avenues like corticosteroids, parathormone, macrophage colony stimulating factor, erythropoietin and dietary calcium restriction have also been suggested to play some roles. [8-11]

Osteomyelitis is a well recognized complication of Osteopetrosis. In some cases, osteomyelitis may be the first presentation of this disease, as was present in our case. (12) Osteomyelitis secondary to Osteopetrosis is mostly refractory to various treatment modalities like incision and drainage, antibiotic therapy and surgical procedures such as sequestrectomy, saucerization and decortication. High dose and prolonged systemic antibiotic therapy with fluoroquinolones and lincomycin are considered to be helpful. [13,14] The only methods that have proved to be helpful are the resection of the jaws and hyperbaric oxygen. The surgical defect is filled by the fabrication of the obturators.(5) Bone grafts and myo-osseous flaps are not feasible in such cases because of the compromised vascular supply and the lack of suitable donor sites.(15) Surgical intervention is limited to necessary extraction with antibiotic coverage, incision and drainage and possible palliative debridement. (7) The Pubmed search of English literature revealed different therapeutic modalities for the management of Osteopetrosis induced osteomyelitis, with variable outcomes. (Table/Fig 6)

With the availability of newer and better antibiotics, the incidence of osteomyelitis has been reduced dramatically, even in the elderly. The presence of osteomyelitis in a young healthy patient should prompt the clinician to look for some underlying bony pathosis or predisposing immunocompromised status.


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