{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T23:40:32Z","timestamp":1792453232593,"version":"4.5.0"},"reference-count":22,"publisher":"Springer Science and Business Media LLC","issue":"10","license":[{"start":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T00:00:00Z","timestamp":1790899200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T00:00:00Z","timestamp":1790899200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Oral Invest"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Diffuse sclerosing osteomyelitis (DSO) of the mandible is a rare chronic inflammatory disease characterized by recurrent painful swelling and trismus. While advanced stages are known to show radiographically evident bone sclerosis, objective quantitative imaging criteria remain poorly defined. This study aimed to characterize modality-specific radiological features of DSO using intra-individual side-to-side comparison of bone density and cortical thickness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>This single-center retrospective study included 22 patients treated for DSO between 2010 and 2021. Pre-treatment panoramic radiographs were available for all patients, CT datasets for 6 patients, and CBCT for 3 patients. Bone density was quantified using relative grayscale values in panoramic radiography, Hounsfield units (HU) in CT, and gray values in CBCT. Cortical thickness was measured on CT using standardized regions of interest, with contralateral-side comparison. Two blinded observers performed all measurements.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Quantitative analysis demonstrated significantly higher bone density on the affected side in panoramic radiography and CT (panoramic: 46.0 \u00b1 4.0% vs. 39.0 \u00b1 3.6%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001; CT: 1220.9 \u00b1 215.8 HU vs. 1108.0 \u00b1 163.9 HU,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01). In the three available CBCT datasets, descriptively higher gray values were observed on the affected side. CT analysis revealed significantly increased cortical thickness (5.63 \u00b1 0.96\u00a0mm vs. 3.86 \u00b1 0.75\u00a0mm,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.04). A blurred inferior alveolar nerve canal was consistently observed on panoramic radiographs.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Quantitative side-to-side assessment provides an objective radiological description of DSO and may support imaging assessment when interpreted together with clinical and histopathological findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical relevance<\/jats:title>\n                    <jats:p>In this selected cohort, DSO-affected regions showed relative densification, cortical thickening in the available CT examinations, and blurring of the inferior alveolar nerve canal on panoramic radiographs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00784-026-07160-8","type":"journal-article","created":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T07:14:23Z","timestamp":1790925263000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Modality-specific quantitative radiologic characterization of diffuse sclerosing osteomyelitis of the mandible: a pilot study"],"prefix":"10.1007","volume":"30","author":[{"given":"Katharina Theresa","family":"Obermeier","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenko","family":"Smolka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sven","family":"Otto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anusha","family":"Abdullah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele","family":"Kaeppler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Hesse","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ina","family":"Dewenter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoana","family":"Malenova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,2]]},"reference":[{"issue":"5","key":"7160_CR1","doi-asserted-by":"publisher","first-page":"631","DOI":"10.1093\/jac\/47.5.631","volume":"47","author":"T Yoshii","year":"2001","unstructured":"Yoshii T, Nishimura H, Yoshikawa T, Furudoi S, Yoshioka A, Takenono I, Ohtsuka Y, Komori T (2001) Therapeutic possibilities of long-term roxithromycin treatment for chronic diffuse sclerosing osteomyelitis of the mandible. J Antimicrob Chemother 47(5):631\u2013637. https:\/\/doi.org\/10.1093\/jac\/47.5.631","journal-title":"J Antimicrob Chemother"},{"issue":"5","key":"7160_CR2","doi-asserted-by":"publisher","first-page":"363","DOI":"10.1016\/S0300-9785(84)80062-9","volume":"13","author":"S Jacobsson","year":"1984","unstructured":"Jacobsson S (1984) Diffuse sclerosing osteomyelitis of the mandible. Int J Oral Surg 13(5):363\u2013385","journal-title":"Int J Oral Surg"},{"issue":"10","key":"7160_CR3","doi-asserted-by":"publisher","first-page":"825","DOI":"10.1016\/0278-2391(88)90042-0","volume":"46","author":"JP Van Merkesteyn","year":"1988","unstructured":"Van Merkesteyn JP et al (1988) Diffuse sclerosing osteomyelitis of the mandible: clinical radiographic and histologic findings in twenty-seven patients. J Oral Maxillofac Surg 46(10):825\u2013829","journal-title":"J Oral Maxillofac Surg"},{"issue":"9","key":"7160_CR4","doi-asserted-by":"publisher","first-page":"1837","DOI":"10.1016\/j.jcms.2015.08.028","volume":"43","author":"S Otto","year":"2015","unstructured":"Otto S, Troeltzsch M, Burian E, Mahaini S, Probst F, Pautke C, Ehrenfeld M, Smolka W (2015) Ibandronate treatment of diffuse sclerosing osteomyelitis of the mandible: Pain relief and insight into pathogenesis. J Craniomaxillofac Surg 43(9):1837\u20131842. https:\/\/doi.org\/10.1016\/j.jcms.2015.08.028","journal-title":"J Craniomaxillofac Surg"},{"issue":"1","key":"7160_CR5","doi-asserted-by":"publisher","first-page":"188","DOI":"10.4103\/ams.ams_257_18","volume":"9","author":"CJ Antao","year":"2019","unstructured":"Antao CJ, Dinkar AD, Khorate MM, Raut Dessai SS (2019) Chronic diffuse sclerosing osteomyelitis of the mandible. Ann Maxillofac Surg 9(1):188\u2013191. https:\/\/doi.org\/10.4103\/ams.ams_257_18","journal-title":"Ann Maxillofac Surg"},{"issue":"5","key":"7160_CR6","doi-asserted-by":"publisher","first-page":"386","DOI":"10.1016\/S0300-9785(84)80063-0","volume":"13","author":"JP Van Merkesteyn","year":"1984","unstructured":"Van Merkesteyn JP, Bakker DJ, Van der Waal I, Kusen GJ, Egyedi P, Van den Akker HP et al (1984) Hyperbaric oxygen treatment of chronic osteomyelitis of the jaws. Int J Oral Surg 13(5):386\u2013395. https:\/\/doi.org\/10.1016\/S0300-9785(84)80063-0","journal-title":"Int J Oral Surg"},{"issue":"5","key":"7160_CR7","doi-asserted-by":"publisher","first-page":"437","DOI":"10.1016\/j.oooo.2019.11.010","volume":"129","author":"J Matharu","year":"2020","unstructured":"Matharu J, Taylor H, Sproat C, Kwok J, Brown J, Patel V (2020) Diffuse sclerosing osteomyelitis: a case series and literature review. Oral Surg Oral Med Oral Pathol Oral Radiol 129(5):437\u2013446. https:\/\/doi.org\/10.1016\/j.oooo.2019.11.010","journal-title":"Oral Surg Oral Med Oral Pathol Oral Radiol"},{"issue":"9","key":"7160_CR8","doi-asserted-by":"publisher","first-page":"727","DOI":"10.1038\/sj.bdj.2017.412","volume":"222","author":"NP Shah","year":"2017","unstructured":"Shah NP, Nayee S, Pazianas M (2017) Beyond ONJ \u2013 A review of the potential uses of bisphosphonates in dentistry. Br Dent J May; 222(9):727\u2013730","journal-title":"Br Dent J"},{"issue":"4","key":"7160_CR9","doi-asserted-by":"publisher","first-page":"534","DOI":"10.1016\/j.jcms.2017.10.011","volume":"46","author":"S Otto","year":"2018","unstructured":"Otto S, Burian E, Troeltzsch M, Kaeppler G, Ehrenfeld M (2018) Denosumab as a potential treatment alternative for patients suffering from diffuse sclerosing osteomyelitis of the mandible-A rapid communication. J Craniomaxillofac Surg 46(4):534\u2013537. https:\/\/doi.org\/10.1016\/j.jcms.2017.10.011","journal-title":"J Craniomaxillofac Surg"},{"issue":"9","key":"7160_CR10","doi-asserted-by":"publisher","first-page":"1631","DOI":"10.1016\/j.jcms.2018.06.015","volume":"46","author":"MM van de Meent","year":"2018","unstructured":"van de Meent MM, Pichardo SEC, Rodrigues MF, Verbist BM, van Merkesteyn JPR (2018) Radiographic characteristics of chronic diffuse sclerosing osteomyelitis\/tendoperiostitis of the mandible: A comparison with chronic suppurative osteomyelitis and osteoradionecrosis. J Craniomaxillofac Surg 46(9):1631\u20131636. https:\/\/doi.org\/10.1016\/j.jcms.2018.06.015","journal-title":"J Craniomaxillofac Surg"},{"issue":"1","key":"7160_CR11","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1111\/jop.13384","volume":"52","author":"K Jia","year":"2023","unstructured":"Jia K, Zhang J, Li T, Zhang Y, An J (2023) Comparison of the histopathological characteristics of diffuse sclerosing osteomyelitis of the mandible, chronic suppurative osteomyelitis, and craniofacial fibrous dysplasia. J Oral Pathol Med 52(1):91\u201398. https:\/\/doi.org\/10.1111\/jop.13384","journal-title":"J Oral Pathol Med"},{"issue":"5","key":"7160_CR12","doi-asserted-by":"publisher","first-page":"634","DOI":"10.1016\/s1079-2104(05)80107-6","volume":"79","author":"T Kaneda","year":"1995","unstructured":"Kaneda T, Minami M, Ozawa K, Akimoto Y, Utsunomiya T, Yamamoto H, Suzuki H, Sasaki Y (1995) Magnetic resonance imaging of osteomyelitis in the mandible. Comparative study with other radiologic modalities. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 79(5):634\u2013640. https:\/\/doi.org\/10.1016\/s1079-2104(05)80107-6","journal-title":"Oral Surg Oral Med Oral Pathol Oral Radiol Endod"},{"issue":"1","key":"7160_CR13","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1016\/j.rcl.2017.08.003","volume":"56","author":"S Mardini","year":"2018","unstructured":"Mardini S, Gohel A (2018) Imaging of Odontogenic Infections. Radiol Clin North Am 56(1):31\u201344. https:\/\/doi.org\/10.1016\/j.rcl.2017.08.003","journal-title":"Radiol Clin North Am"},{"key":"7160_CR14","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1016\/j.jcms.2010.03.014","volume":"39","author":"SCC Kuijpers","year":"2011","unstructured":"Kuijpers SCC, De Jong E, Hamdy NAT, Van Merkesteyn JPR (2011) Initial results of the treatment of diffuse sclerosing osteomyelitis of the mandible with bisphosphonates. J. Cranio-Maxillo-fac. Surg. Off. Publ. Eur. Assoc. Cranio-Maxillo-fac. Surg 39:65\u201368. https:\/\/doi.org\/10.1016\/j.jcms.2010.03.014","journal-title":"Surg"},{"issue":"10","key":"7160_CR15","doi-asserted-by":"publisher","first-page":"1334","DOI":"10.1038\/s41379-022-01103-w","volume":"35","author":"J Xue","year":"2022","unstructured":"Xue J, Jia K, Li T, Zhang J, An J (2022) GNAS mutation analysis assists in differentiating chronic diffuse sclerosing osteomyelitis from fibrous dysplasia in the jaw. Mod Pathol 35(10):1334\u20131340. https:\/\/doi.org\/10.1038\/s41379-022-01103-w","journal-title":"Mod Pathol"},{"key":"7160_CR16","unstructured":"DenOtter TD, J. Schubert J Hounsfield Unit, in StatPearls. 2023, StatPearls Publishing"},{"issue":"1","key":"7160_CR17","first-page":"1","volume":"10","author":"P Trisi","year":"1999","unstructured":"Trisi P, Rao W (1999) Bone classification: clinical-histomorphometric comparison. Clin Oral Implants Res 10(1):1\u20137","journal-title":"Clin Oral Implants Res"},{"issue":"6","key":"7160_CR18","first-page":"1438","volume":"27","author":"A Parsa","year":"2012","unstructured":"Parsa A, Ibrahim N, Hassan B, Motroni A, van der Stelt P, Wismeijer D (2012) Reliability of voxel gray values in cone beam computed tomography for preoperative implant planning assessment. Int J Oral Maxillofac Implants 27(6):1438\u20131442","journal-title":"Int J Oral Maxillofac Implants"},{"issue":"12","key":"7160_CR19","doi-asserted-by":"publisher","first-page":"1922","DOI":"10.1016\/j.jcms.2019.11.020","volume":"47","author":"MM van de Meent","year":"2019","unstructured":"van de Meent MM, Wetselaar-Glas MJM, Fiocco M, Appelman-Dijkstra NM, van Merkesteyn JPR (2019) Non-surgical treatment of adults with chronic diffuse sclerosing osteomyelitis\/tendoperiostitis of the mandible. J Craniomaxillofac Surg 47(12):1922\u20131928. https:\/\/doi.org\/10.1016\/j.jcms.2019.11.020","journal-title":"J Craniomaxillofac Surg"},{"issue":"3","key":"7160_CR20","doi-asserted-by":"publisher","first-page":"e38","DOI":"10.1016\/j.tripleo.2010.10.027","volume":"111","author":"N Kadom","year":"2011","unstructured":"Kadom N, Egloff A, Obeid G, Bandarkar A, Vezina G (2011) Juvenile mandibular chronic osteomyelitis: multimodality imaging findings. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 111(3):e38\u201343. https:\/\/doi.org\/10.1016\/j.tripleo.2010.10.027","journal-title":"Oral Surg Oral Med Oral Pathol Oral Radiol Endod"},{"key":"7160_CR21","doi-asserted-by":"publisher","DOI":"10.2463\/mrms.mp.2021-0153","author":"H Muraoka","year":"2022","unstructured":"Muraoka H, Kaneda T, Hirahara N, Ito K, Okada S, Kondo T (2022) Diagnostic efficacy of diffusion-weighted imaging in distinguishing chronic diffuse sclerosing osteomyelitis from suppurative osteomyelitis of the mandible. Magn Reson Med Sci. https:\/\/doi.org\/10.2463\/mrms.mp.2021-0153","journal-title":"Magn Reson Med Sci"},{"issue":"7","key":"7160_CR22","doi-asserted-by":"publisher","first-page":"599","DOI":"10.1016\/j.jcms.2022.05.011","volume":"50","author":"MM van de Meent","year":"2022","unstructured":"van de Meent MM, Appelman-Dijkstra NM, Wetselaar-Glas MJM, Pichardo SEC, van Merkesteyn JPR (2022) Bisphosphonate therapy in chronic diffuse sclerosing osteomyelitis\/tendoperiostitis of the mandible: Retrospective case series. J Craniomaxillofac Surg 50(7):599\u2013604. https:\/\/doi.org\/10.1016\/j.jcms.2022.05.011","journal-title":"J Craniomaxillofac Surg"}],"container-title":["Clinical Oral Investigations"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00784-026-07160-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00784-026-07160-8","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00784-026-07160-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T23:04:46Z","timestamp":1792451086000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00784-026-07160-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,2]]},"references-count":22,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2026,10]]}},"alternative-id":["7160"],"URL":"https:\/\/doi.org\/10.1007\/s00784-026-07160-8","relation":{},"ISSN":["1436-3771"],"issn-type":[{"value":"1436-3771","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,2]]},"assertion":[{"value":"14 May 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 September 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 October 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The institutional review board authorized the retrospective study, and informed consent was waived (Ethics Committee, Ludwig-Maximilians-University, Munich, Germany, UE Nr 22\u20130445). No other ethical approval or consent to participate was necessary.","order":1,"name":"Ethics","label":"Ethics approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"497"}}