case_images: PMC11724726_01
case_images: (a) Preoperative intraoral periapical radiograph of the region of missing mandibular right molars and (b) a reconstructed panoramic CBCT image (cropped) through the same region, revealing a bony sequestrum, slight soft tissue swelling, and sclerotic area in the underlying bone.
case_images: CRID2025-6211159.001.jpg
case_images: PMC11724726_01_CRID2025-6211159.001.jpg
case_images: fig1
case_images: A segmental radiograph of the affected area showed ill-defined bony changes with osteolytic and osteosclerotic areas (Figures 1(a) and 1(b)).
case_images: (a, b) Histological features of Splendore-Hoeppli phenomenon appearing as radiating eosinophilic material around bacterial colonies due to deposition of antigen-antibody complexes and debris from the inflammatory cells. Basophilic bacterial aggregates with filamentous periphery surrounded by neutrophils and chronic granulomatous inflammation (H&E stain, x40). (c) Large basophilic bacterial aggregates (sulfur granules) surrounded by neutrophils (H&E stain, x5). (d) Fragments of necrotic bone (H&E stain, x5).
case_images: CRID2025-6211159.002.jpg
case_images: PMC11724726_01_CRID2025-6211159.002.jpg
case_images: fig2
case_images: Within the granulation, tissue granules were surrounded by polymorphonuclear cells (Figures 2(a), 2(b), and 2(c)). Actinomycosis is an indolent pyogranulomatous disease that can cause destruction of the underlying bone (Figures 2(b) and 2(d)). The exact pathologic diagnosis requires the constellation of dense filamentous bacterial aggregates and associated infiltrate of neutrophils and granulation tissue (Figures 2(b), 2(c), and 2(d)).
case_images: Intraoral periapical radiograph of the region 5 months postoperatively.
case_images: CRID2025-6211159.003.jpg
case_images: PMC11724726_01_CRID2025-6211159.003.jpg
case_images: fig3