{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T04:17:54Z","timestamp":1778213874105,"version":"3.51.4"},"reference-count":23,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2021,3,18]],"date-time":"2021-03-18T00:00:00Z","timestamp":1616025600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>The nonsuppurative osteomyelitis of the mandible is a rare condition that can occur in children due to low-grade inflammatory processes, dental cavities, periodontal lesions as well as the eruption process of the teeth. We submit a case report involving the orthodontic management of a 9-year-old female patient who presented in our service in the mixed dentition period with diagnosed Garre\u2019s sclerosing osteomyelitis of the entire mandibular body. After a full work-up, the following symptoms and signs were noted: bilateral temporomandibular joint (TMJ) pain, loss of the leeway space, anterior open bite, distalization of the secondary maxillary right canine, nail biting and tongue thrust. Our orthodontic objectives were to relieve the TMJ pain, limit the eruption process of the teeth and to diminish the evolution of the osteomyelitis, reduce the growth of the inferior lower third of the face and to prevent further invasive treatment of the patient. In the first phase of treatment, we established a centric relationship using an orthopedic appliance (occlusal splint) and physiotherapy to deprogram the muscles and the TMJ. Throughout the second phase of treatment, we used orthopedic appliances to inhibit the overeruption of the secondary molars. After another year of treatment, the osteomyelitis lesions were under control with the permanent teeth in final position, good facial esthetic and as a functional result, no root resorption. We can conclude that by using low physiological forces to direct and control the growth pattern, good results could be obtained in stabilizing and controlling the sclerosing osteomyelitis of the mandible.<\/jats:p>","DOI":"10.3390\/ijerph18063159","type":"journal-article","created":{"date-parts":[[2021,3,18]],"date-time":"2021-03-18T11:41:06Z","timestamp":1616067666000},"page":"3159","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["An Orthodontic Approach for Garre\u2019s Sclerosing Osteomyelitis of the Mandible"],"prefix":"10.3390","volume":"18","author":[{"given":"Ioan","family":"Barbur","sequence":"first","affiliation":[{"name":"Department Maxillofacial Surgery and Implantology, Iuliu Hatieganu University of Medicine and Pharmacy, 37 Cardinal Iuliu Hossu Street, 400029 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simion","family":"Bran","sequence":"additional","affiliation":[{"name":"Department Maxillofacial Surgery and Implantology, Iuliu Hatieganu University of Medicine and Pharmacy, 37 Cardinal Iuliu Hossu Street, 400029 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mihaela","family":"Baciut","sequence":"additional","affiliation":[{"name":"Department Maxillofacial Surgery and Implantology, Iuliu Hatieganu University of Medicine and Pharmacy, 37 Cardinal Iuliu Hossu Street, 400029 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1087-8522","authenticated-orcid":false,"given":"Gabriel","family":"Armencea","sequence":"additional","affiliation":[{"name":"Department Maxillofacial Surgery and Implantology, Iuliu Hatieganu University of Medicine and Pharmacy, 37 Cardinal Iuliu Hossu Street, 400029 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7954-0266","authenticated-orcid":false,"given":"Alexandra Iulia","family":"Aghiorghiesei","sequence":"additional","affiliation":[{"name":"Department of Prosthodontics and Dental Materials, Iuliu Ha\u021bieganu University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8819-289X","authenticated-orcid":false,"given":"Tudor-Sergiu","family":"Suciu","sequence":"additional","affiliation":[{"name":"Department Maxillofacial Surgery and Implantology, Iuliu Hatieganu University of Medicine and Pharmacy, 37 Cardinal Iuliu Hossu Street, 400029 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adina Maria","family":"Barbur","sequence":"additional","affiliation":[{"name":"Ortolife Orthodontic Private Practice, 8 Andrei Muresanu Street, 400071 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6123-4538","authenticated-orcid":false,"given":"Horia","family":"Opris","sequence":"additional","affiliation":[{"name":"Department Maxillofacial Surgery and Implantology, Iuliu Hatieganu University of Medicine and Pharmacy, 37 Cardinal Iuliu Hossu Street, 400029 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grigore","family":"Baciut","sequence":"additional","affiliation":[{"name":"Department Maxillofacial Surgery and Implantology, Iuliu Hatieganu University of Medicine and Pharmacy, 37 Cardinal Iuliu Hossu Street, 400029 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristian","family":"Dinu","sequence":"additional","affiliation":[{"name":"Department Maxillofacial Surgery and Implantology, Iuliu Hatieganu University of Medicine and Pharmacy, 37 Cardinal Iuliu Hossu Street, 400029 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,3,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1016\/S0140-6736(04)16727-5","article-title":"Osteomyelitis","volume":"364","author":"Lew","year":"2004","journal-title":"Lancet"},{"key":"ref_2","first-page":"1027","article-title":"Diagnosis and management of osteomyelitis","volume":"84","author":"Hatzenbuehler","year":"2011","journal-title":"Am. Fam. Physician"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1065","DOI":"10.1016\/j.berh.2006.08.014","article-title":"Infection and musculoskeletal conditions: Osteomyelitis","volume":"20","author":"Sia","year":"2006","journal-title":"Best Pract. Res. Clin. Rheumatol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"837","DOI":"10.2106\/JBJS.N.01350","article-title":"Trends in the epidemiology of osteomyelitis: A population-based study, 1969 to 2009","volume":"97","author":"Kremers","year":"2015","journal-title":"J. Bone Joint Surg. Am."},{"key":"ref_5","unstructured":"Walls, R.M., Hockberger, R.S., and Gausche-Hill, M. (2018). Rosen\u2019s Emergency Medicine: Concepts and Clinical Practice, Elsevier. [9th ed.]."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e26","DOI":"10.1093\/cid\/civ482","article-title":"2015 Infectious Diseases Society of America (IDSA) Clinical Practice Guidelines for the Diagnosis and Treatment of Native Vertebral Osteomyelitis in Adultsa","volume":"61","author":"Berbari","year":"2015","journal-title":"Clin. Infect. Dis."},{"key":"ref_7","unstructured":"Adam, A. (2015). Grainger & Allison\u2019s Diagnostic Radiology. A Textbook of Medical Imaging, Elsevier."},{"key":"ref_8","unstructured":"Elsevier (2018). Principles and Practice of Pediatric Infectious Diseases, Elsevier."},{"key":"ref_9","first-page":"725","article-title":"Proliferative periostitis of Garr\u00e9: Its differentiation from other neoperiostoses","volume":"37","author":"Eversole","year":"1979","journal-title":"J. Oral Surg."},{"key":"ref_10","unstructured":"Cherry, J., Demmler-Harrison, G.J., Kaplan, S.L., Steinbach, W.J., and Hotez, P.J. (2019). Feigin and Cherry\u2019s Textbook of Pediatric Infectious Diseases, Elsevier."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1038\/sj.bdj.2018.650","article-title":"Space maintainers in the primary and mixed dentition\u2014A clinical guide","volume":"225","author":"Watt","year":"2018","journal-title":"Br. Dent. J."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1308\/rcsann.2019.0021","article-title":"Chronic osteomyelitis with proliferative periostitis of the mandibular body: Report of a case and review of the literature","volume":"101","author":"Liu","year":"2019","journal-title":"Ann. R. Coll. Surg. Engl."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"828","DOI":"10.1053\/hn.1999.v121.a94999","article-title":"Mandibular sclerosing osteomyelitis of Garr\u00e9","volume":"121","author":"Sastre","year":"1999","journal-title":"Otolaryngol. Head. Neck Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1016\/S0099-2399(81)80215-4","article-title":"Garre\u2019s osteomyelitis of the mandible: The role of endodontic therapy in patient management","volume":"7","author":"Mattison","year":"1981","journal-title":"J. Endod."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"193","DOI":"10.14219\/jada.archive.1984.0455","article-title":"Garre\u2019s osteomyelitis of the mandible resolved by endodontic treatment","volume":"108","author":"McWalter","year":"1984","journal-title":"J. Am. Dent. Assoc."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"311","DOI":"10.17796\/jcpd.26.3.v65535482m037304","article-title":"Garre\u2019s osteomyelitis associated with a fistula: A case report","volume":"26","year":"2002","journal-title":"J. Clin. Pediatr. Dent."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1016\/j.ajoms.2012.03.005","article-title":"Root-end resection for preservation of the causative molar in Garr\u00e8\u2019s osteomyelitis of the mandible: A case report","volume":"25","author":"Akiyama","year":"2013","journal-title":"J. Oral Maxillofac. Surg. Med. Pathol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1016\/0030-4220(92)90398-A","article-title":"Changes in masseter inhibitory reflex responses in patients with diffuse sclerosing osteomyelitis of the mandible","volume":"74","author":"Groot","year":"1992","journal-title":"Oral Surg. Oral Med. Oral Pathol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1922","DOI":"10.1016\/j.jcms.2019.11.020","article-title":"Non-surgical treatment of adults with chronic diffuse sclerosing osteomyelitis\/tendoperiostitis of the mandible","volume":"47","author":"Fiocco","year":"2019","journal-title":"J. Craniomaxillofac. Surg."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1938","DOI":"10.1016\/j.jcms.2017.09.024","article-title":"Conservative treatment of children with chronic diffuse sclerosing osteomyelitis\/tendoperiostitis of the mandible","volume":"45","author":"Meshkini","year":"2017","journal-title":"J. Cranio Maxillofac. Surg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1016\/j.bjoms.2020.01.012","article-title":"Outcome of different treatments for chronic diffuse sclerosing osteomyelitis of the mandible: A systematic review of published papers","volume":"58","author":"Pichardo","year":"2020","journal-title":"Br. J. Oral Maxillofac. Surg."},{"key":"ref_22","first-page":"454","article-title":"Initial intrusion of the molars in the treatment of anterior open bite malocclusions in growing patients","volume":"74","author":"Gurton","year":"2004","journal-title":"Angle Orthod."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1007\/s00056-016-0029-1","article-title":"Etiology of anterior open bite: A review","volume":"77","author":"Rijpstra","year":"2016","journal-title":"J. Orofac. Orthop."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/6\/3159\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T05:37:50Z","timestamp":1760161070000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/6\/3159"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,18]]},"references-count":23,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2021,3]]}},"alternative-id":["ijerph18063159"],"URL":"https:\/\/doi.org\/10.3390\/ijerph18063159","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,18]]}}}