A 10 year old male greyhound presented with a hard swelling of the right ventral mandible. Please review this radiograph.

The skull radiograph of this dog demonstrates a smooth periosteo reaction ventral to the right mandibular for three molar and first molar. Skull really wraps in veterinary medicine for dental disease carrying little diagnostic value in general.

See the two additional veterinary dental radiographs below.
What is the most likely diagnosis?

There is significant bone loss associated with the distal aspect of the mesial root of the right mandibular first molar (tooth 409) extending roster has the mesial weight of the right mandibular fourth premolar (tooth 408). Radiographically, osteomyelitis in veterinary dental patients often presents as irregular, punctate areas of radiolucency within the cortical bone. Partial bone necrosis can’t be ruled out.

The radiographic diagnoses is osteomyelitis secondary to periodontal disease.

Surgical exposure revealed areas of necrosis in the dorsal bone throughout the length of the diseased bone and tissue. Extraction of the adjacent teeth and a conservative rim mandibulectomy was utilized to eliminate visible necrotic bone. A diamond bur was then used to contour the marginal bone. The inflamed gingiva and mucosa were excised. The right mandibular third premolar (tooth 407) was extracted to facilitate a tension free closure. Due to the radiographic presence of osteomyelitis deeper ventrally, Clindamycin was prescribed for a total of 6 weeks.

Veterinary Dental Rim Mandibulectomy Post-op Image Series

Soft tissue and bone removed from the defect were sent for histopathological evaluation.

Radiographic and gross view of the patient 30 day post surgery. Extraction sites that filled with healthy alveolar bone with evidence of resolving osteomyelitis.