Bilateral osteoporotic bone marrow defects of the mandible: a case report

In adult life the presence of hematopoietic marrow in the jaws is usually restricted to the angle of the mandible, the maxillary tuberosity and the condylar process [1,2]. Osteoporotic bone marrow defect is a radiolucent area that corresponds to the uncommon presence of hematopoietic tissue found in others regions of the jaws [2]. The defect is generally asymptomatic and is discovered incidentally during radiographic analysis. Radiographically, it is a localized radiolucency that varies in size, shape, trabeculae and border definition [2-4].Since the osteoporotic bone marrow defect is rarely included in the differential diagnosis of radiolucent lesions of the jaws, the knowledge of the clinical, radiographic and histopathological characteristics in association with an accurate examination, are mandatory, in order to distinguish it from other most common intrabony lesions as odontogenic tumors or cysts, pseudocysts or primary or metastatic malignancies.This paper describes an unusual case of bilateral bone marrow defects and discusses the characteristics and etiopathogeny of this condition.A 32-year-old white woman was referred to private dental clinic for routine prosthodontic treatment. Intraoral examination revealed healthy mucosa and there was not any sign of infection. Her past medical history was unremarkable. Panoramic radiography of the jaws showed 4？cm x 3？cm radiolucencies with quite ill-defined and irregular borders located bilaterally in molar edentulous regions (Figure 1). Two small sclerotic flecks were associated with left radiolucent area. The lesions were asymptomatic and no expansion of the cortical jawbone was detected. A provisional diagnosis of odontogenic cyst or tumor was made and focal osteoporotic bone marrow defect was considered as a differential diagnosis based on age, site, clinical and radiographic findings. Under local anesthesia, a biopsy specimen was performed from the both edentulous molar regions and the tissues submitted to the Bau