# Anterior Mandibular Osteomyelitis: A Narrative Review of Clinical Presentation, Diagnosis, and Management Strategies

## TL;DR

This review discusses the diagnosis and treatment of a rare but serious infection in the front part of the lower jaw, emphasizing the need for early detection and tailored management.

## Contribution

The paper provides a focused narrative review on the unique aspects of anterior mandibular osteomyelitis, including its management and diagnostic challenges.

## Key findings

- Anterior mandibular osteomyelitis is often linked to dental implants, trauma, and systemic conditions like diabetes.
- Advanced imaging techniques are essential for diagnosing chronic or atypical cases of the condition.
- Multidisciplinary treatment combining antibiotics and surgery is effective, with emerging techniques improving reconstruction outcomes.

## Abstract

Osteomyelitis of the anterior mandible is a relatively uncommon but clinically significant condition that presents unique diagnostic and therapeutic challenges. Although mandibular osteomyelitis more frequently affects the posterior region, anterior involvement is increasingly recognized owing to rising incidences associated with dental implants, trauma, and systemic conditions such as diabetes and immunosuppression. This narrative review provides a comprehensive overview of anterior mandibular osteomyelitis, highlighting its pathogenesis, epidemiological trends, clinical features, diagnostic approaches, and current treatment modalities. The anatomical and functional significance of the anterior mandible necessitates early recognition and precise management to prevent long-term morbidities. The clinical manifestations vary from acute infections with swelling and pain to chronic presentations involving bone necrosis, sinus tract formation, or features mimicking neoplastic processes. Advanced imaging techniques, including cone-beam computed tomography and magnetic resonance imaging, are crucial for the early detection and assessment of disease extent, particularly in chronic or atypical cases. Management typically involves a multidisciplinary strategy that combines prolonged antibiotic therapy with surgical debridement or resection, particularly in chronic or refractory cases. Emerging techniques such as distraction osteogenesis and computer-assisted surgical planning have improved outcomes in cases requiring reconstruction. Conservative approaches may be considered for early or non-suppurative forms of the disease, while hyperbaric oxygen therapy has shown promise in select patients. This review highlights the importance of clinician awareness regarding the various presentations of anterior mandibular osteomyelitis. Emphasis should be placed on comprehensive evaluation, prompt intervention, and addressing predisposing factors to reduce recurrence and enhance prognosis. Further studies are warranted to better define the anterior-specific epidemiological data, microbial profiles, and long-term outcomes, ultimately supporting the development of targeted management protocols.