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Garre Osteomyelitis — MFDS Part 1 MCQ

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ModerateOral PathologyGarre OsteomyelitisMFDS Part 1

A 12-year-old presents with a slowly developing hard swelling along the buccal aspect of the mandibular body adjacent to a heavily carious first permanent molar. Which radiographic finding is most characteristic of osteomyelitis with proliferative periostitis (Garré osteomyelitis)?

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Correct answer: D — Laminated subperiosteal new bone producing an onion-skin appearance

Explanation lettering: C = shown as A · E = shown as B · B = shown as C · A = shown as D · D = shown as E

A is correct. Garré osteomyelitis is osteomyelitis with proliferative periostitis, seen mainly in children and young adults and most commonly affecting the mandible. Chronic low-grade odontogenic irritation stimulates successive layers of reactive subperiosteal bone along the buccal or outer cortex, producing the laminated onion-skin appearance. The patient's age, mandibular molar infection and hard swelling support this diagnosis. A multilocular radiolucency suggests an intramedullary lesion rather than a periosteal reaction. A periapical radiolucency may represent the source of infection but is not the defining osseous response. Cotton-wool and ground-glass appearances are associated with other sclerotic or fibro-osseous processes and do not describe laminated periosteal new bone.

Reference: Kim H, Kwon J, Kim H-J, et al. Garre's osteomyelitis of the mandible managed by nonsurgical re-endodontic treatment. Restorative Dentistry & Endodontics. 2024;49(2):e13. https://pubmed.ncbi.nlm.nih.gov/38841385/