Youichi Nakagawa

Central and periapical actinomycosis of the jaw bones: Report of three cases

Actinomycosis is an infectious disease caused by organisms of t h e order Actinomycetales. Microorganisms classified as Actinomyces are common inhabitants of the human oral cavity and the pharyngeal region and can be isolated from such sites as the tonsillar crypt, dental plaque, carious dentin, gingival sulci and periodontal pockets. 1,2~ The microorganisms reveal their pathogenity when they enter the mandible or the surrounding soft tissue. Some cases of actinomycotic infections have been associated with trauma such as tooth extraction, Jaw fracture or periodontal surgery. Deep periodontal pockets may also provide a point of entry for the microorganism. Classically, cervicofacial actinomycosis has been described as a granulomatous lesion of a chronic or subacute nature, which develops through local invasion and produces hard swelling and multiple fistulous tracts that rupture through reddish-purple discoloured skin. Recently an increasing number of nontypical actinomycosis cases have been reported. Some non typical types include 1) oral actinomycosis, 2) periapical actinomycosis, 3) actinomycosis of the lymph nodes, and 4) actinomycosis of the salivary gland. In this paper, the authors report on three cases of atypical central and periapical acthnomycosis.