Abstract
In 2012, a retrospective case report of 60 cases of extreme osteonecrosis in the maxillofacial region collected over a 3-year period, was published. The cases presented in 2 groups. One group showed grey-like necrotic bone, and the other group which was much more plentiful, had swelling and pus draining fistulae associated with the osteonecrosis.
A further prospective study of 19 patients collected over a 3-month period was analysed and indicated tuberculosis to be the cause. All 19 cases presented with mandibular lesions. Orofacial tuberculosis is known to be rare.
Further studies of the clinical samples with amplified DNA and sequencing, provided direct evidence to support the conclusion that a combination of Mycobacterium tuberculosis, Plasmodium ovale wallikeri and oral bacteria are involved in this particular type of maxillofacial destruction.
Further studies are planned to elucidate the cause of the “greyish” necrotic bone documented in the paper from 2012.