An Unusual Finding of Proliferative Periostitis in a Child: a Case Report

Proliferative periostitis is a pathologic lesion that displays an osteo-productive and proliferative inflammatory response of the periosteum to infection or other irritation. This lesion is a form of chronic osteomyelitis that is often asymptomatic, occurring primarily in children, and found only in the mandible. The lesion can be odontogenic or non-odontogenic in nature. A 12 year-old boy presented with an unusual odontogenic proliferative periostitis that originated from the lower left first molar, however, the radiographic radiolucent area and proliferative response were discovered at the apices of the lower left second molar. The periostitis was treated by single-visit non-surgical endodontic treatment of lower left first molar without antibiotic therapy. The patient has been recalled regularly; the lesion had significantly reduced in size 3-months postoperatively. Extraoral symmetry occurred at approximately one year recall. At the last visit, 2 years after initial treatment, no problems or signs of complications have occurred; the radiographic examination revealed complete resolution of the apical lesion and apical closure of the lower left second molar. Odontogenic proliferative periostitis can be observed at the adjacent normal tooth. Besides, this case demonstrates that non-surgical endodontics is a viable treatment option for management of odontogenic proliferative periostitis.