Fig. 9.

Osteomyelitis after tooth extraction. a OPT. b Contrast-enhanced, axial CT image with bone window settings. c Three-dimensional reconstruction. Ill-defined osteolytic area (asterisks) extending into the ascending ramus of the mandible, with cortical destruction (arrows in b and c). d Axial T1-weighted image before (d) and after (e) injection of gadolinium chelates. Hypointense signal of the mandible (arrows in d) due to marrow oedema and strong enhancement (arrows in e) due to hyperaemia. Myositis of the masseter muscle (thick dashed arrow) and streaky enhancement of the subcutaneous fat and platysma muscle (thin dashed arrow) suggesting a phlegmon. f Histology (haematoxylin-eosin stain, original magnification 20×): non-viable trabeculae (large asterisks) with bone resorption and destroyed osteoblasts. Inflammatory infiltrate (small asterisks) with neutrophils and lymphocytes as well as increased vascularisation within the fatty marrow