Osteomyelitis with Fracture Risk Following Third Molar Extraction

A 43-year-old female was referred for TMJ evaluation approximately 1.5 months after third molar extractions. The patient had been experiencing persistent symptoms in the left mandible and had consulted multiple specialists, including an ENT, an oral and maxillofacial surgeon, and a TMJ specialist, in an effort to identify the source of the problem. Upon review of the CBCT scan, the radiologist identified radiographic signs of osteomyelitis at the site of tooth #17. Of particular concern, the radiologist noted that the left mandible in the #17 area presented a very high risk for fracture. The radiologist immediately contacted the referring practice after completing the report, recommending that the patient be informed of the radiographic findings and the elevated fracture risk, placed on a soft food diet to minimize stress on the weakened bone, and referred to an oral and maxillofacial surgeon for further management.