J Korean Assoc Oral Maxillofac Surg 2019; 45(2): 68~75
Chronic non-bacterial osteomyelitis in the jaw
Soung Min Kim1,2, Suk Keun Lee3
1Oral and Maxillofacial Microvascular Reconstruction LAB, Brong Ahafo Regional Hospital, Sunyani, Ghana, 2Department of Oral and Maxillofacial Surgery, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, 3Department of Oral Pathology, College of Dentistry and Institute of Oral Science, Gangneung-Wonju National University, Gangneung, Korea
Suk Keun Lee
Department of Oral Pathology, College of Dentistry, Gangneung-Wonju National University, 7 Jukheon-gil, Gangneung 25457, Korea, TEL: +82-33-640-2228 FAX: +82-33-642-6410, E-mail: sukkeunlee@hanmail.net
ORCID: https://orcid.org/0000-0001-6255-4197
Received July 17, 2018; Revised August 13, 2018; Accepted August 21, 2018.; Published online April 30, 2019.
© The Korean Association of Oral and Maxillofacial Surgeons.. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Chronic recurrent multifocal osteomyelitis (CRMO) is one of the most severe form of chronic non-bacterial osteomyelitis (CNO), which could result in bone and related tissue damage. This autoinflammatory bone disorder (ABD) is very difficult for its clinical diagnosis because of no diagnostic criteria or biomarkers. CRMO in the jaw must be suspected in the differential diagnosis of chronic and recurrent bone pain in the jaw, and a bone biopsy should be considered in chronic and relapsing bone pain with swelling that is unresponsive to treatment. The early diagnosis of CRMO in the jaw will prevent unnecessary and prolonged antibiotic usage or unnecessary surgical intervention. The updated researches for the identification of genetic and molecular alterations in CNO/CRMO should be studied more for its correct pathophysiological causes and proper treatment guidelines. Although our trial consisted of reporting items from Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), there are very few articles of randomized controlled trials. This article was summarized based on the author’s diverse clinical experiences. This paper reviews the clinical presentation of CNO/CRMO with its own pathogenesis, epidemiology, recent research studies, and general medications. Treatment and monitoring of the jaw are essential for the clear diagnosis and management of CNO/CRMO patients in the field of dentistry and maxillofacial surgery.
Keywords: Autoinflammatory bone disorder, Chronic non-bacterial osteomyelitis, Chronic recurrent multifocal osteomyelitis, Chronic recurrent multifocal osteomyelitis in the jaw
Fig. 1. Schematic diagrams for the generalized medication protocols of CNO/CRMO in the jaw. (CNO: chronic non-bacterial osteomyelitis, CRMO: chronic recurrent multifocal osteomyelitis, NSAIDs: nonsteroidal anti-inflammatory drugs, TNF-α: tumor necrosis factor alpha)
Soung Min Kim et al: Chronic non-bacterial osteomyelitis in the jaw.

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