Proliferative periostitis of Garré: Report of a case

Garré's osteomyelitis: case report with a 6-month follow-up

“…Some hypothesis postulate that the high periosteum activity in young individuals can react strongly against low virulence infections or that an imbalance between the osteoblastic and osteoclastic activities may enable the predominance of osteoblastic activity. [1][2][3][4][5][6]14 In most cases, Garrè's osteomyelitis originates from lesions of mandibular permanent molars, as reported in the present study. The extent of the lesion as well as its clinical symptoms depend on microbiological factors such as the degree of virulence of the microorganism, and on the immunological state of the host.…”

“…This condition is also referred to as osteomyelitis with proliferative periostitis, ossificating periostitis, non-suppurative ossifying periostitis, Garrè's periostitis, and perimandibular ossification; its etiology or pathophysiology are still under speculation. [1][2][3] Garrè's osteomyelitis presents as an infection with periosteal reaction that induces new bone formation. It affects children and young adults, with an average onset age of 13 years.…”

Garrè's osteomyelitis managed by root canal treatment of a mandibular second molar: incorporation of computed tomography with 3D reconstruction in the diagnosis and monitoring of the disease

“…In some cases, however, endodontic treatment has been reported as a successful means of treating odontogenic causes of proliferative periostitis (Mattison et al. 1981, McWalter & Schaberg 1984, Jacobson et al. 2002).…”

“…However, as the patient was involved in breast‐feeding during treatment, minimal use of antibiotics was requested. Jacobson et al. (2002) reported endodontic treatment of proliferative periostitis of Garrè without antibiotic therapy during the whole course of treatment.…”

Systemic complications due to endodontic manipulations

“…Inoculation of bacteria by instruments into a previously uninfected site, followed by an acute exacerbation may result in localized bone infection. Proliferative periostitis of Garre, a productive and proliferative inflammatory response of periosteum to infection or other irritation may result from periapical inflammation of endodontic origin (28). Elimination of pulpal/periapical infection through root canal treatment was shown to be sufficient management in such a case (29).…”