Osteomyelitis is an inflammatory condition of the bone with a multifactorial etiology, including trauma and odontogenic infections. Despite being a common condition in clinical practice, limited research exists on the clinical and pathological profile of Osteomyelitis of the Jaws (OJ). This 51-year retrospective study aimed to describe the clinical, radiographic, and histopathological features of OJ diagnosed at a single oral pathology referral center.

Clinical, radiographic, and histopathological data of cases diagnosed as OJ were collected and categorized using Zurich Classification System.

Among 17,991 cases diagnosed at the service, 75 (0.004 %) were identified as OJ. Patients were predominantly female (n = 67; 89.3 %), with a mean age of 42.68 years (±21.10) at diagnosis. OJ commonly presented as slow-growing, symptomatic lesions (n = 69; 92.0 %) with a predilection for the mandible. Secondary chronic osteomyelitis (SCO) was the most common subtype (n = 44; 84.0 %). Odontogenic infections were identified as the most common etiological factor associated with OJ (n = 41; 54.7 %). Radiographic analysis frequently revealed generalized, moderate bone loss, while histopathological examination often showed a discrete mononuclear inflammatory infiltrate (n = 29; 38.7 %). Bacterial colonies were observed in 26 cases (34.7 %) and were significantly associated with SCO (p = 0.04).

The findings indicate that OJ is a rare condition in oral pathology centers, predominantly affecting white females in their fifth decade at life, with a predilection for the mandible. Dental infections were the primary causative factor. SCO is the most common OJ subtype in cases requiring surgical management.