case_images: PMC11263092_01
case_images: Panoramic radiograph. August 8th, 2022 (approximately 6 weeks post extraction). Minimal bone infill of extraction sockets #45, #46. No clear evidence of bone destruction in the region. Consistent with the lack of diagnostic ability of panoramic radiographs until 30%-40% of bone destruction has occurred.
case_images: froh-05-1427060-g001.jpg
case_images: PMC11263092_01_froh-05-1427060-g001.jpg
case_images: F1
case_images: A panorex was taken which failed to reveal a significant bony defect (Figure 1). At this stage of treatment, differentiating between a prolonged post-extraction infection in an immunocompromised patient vs.
case_images: Axial slice CT facial bones and neck infused demonstrating areas of osteolysis with intramedullary gas formation. Appearance is concerning for osteomyelitis with cellulitis and areas of osteonecrosis originating from the site of extracted teeth in the lower right mandible.
case_images: froh-05-1427060-g002.jpg
case_images: PMC11263092_01_froh-05-1427060-g002.jpg
case_images: F2
case_images: A CT facial bones was obtained (Figure 2), showing areas of fragmented bone which contained intramedullary gas.
case_images: December 1st, 2022. Panoramic radiograph showing the extent of segmental mandibulectomy and 2.8 mm reconstruction plate in place. Good adaptation of place with 5 screws in proximal segment and 3 screws in distal segment.
case_images: froh-05-1427060-g003.jpg
case_images: PMC11263092_01_froh-05-1427060-g003.jpg
case_images: F3
case_images: A post-operative panoramic radiograph demonstrated a good adaptation of the reconstruction plate (Figure 3).