Periostite proliferativa associada a dens in dente

Proliferative periostitis is a disease characterized for successive deposition of layers of subperiosteal bone as a response reaction to a chronic inflammatory stimulation. The affected periosteum forms several rows of reactive bone that are parallel and expand the surface of the altered bone. Dens in dente is a developmental malformation resulting from invagination of the crown before calcification has occurred. They are usually diagnosed upon routine clinical and radiographic examination. An unusual case report of a mandibular dens in dente causing proliferative periostitis is presented. The source of infection was related to dens in dente in mandibular left second premolar's crown, which had apparently communication with periodontal tissues. It was successfully treated by surgical therapy with antibiotic duringthe treatment. After the extraction of the affected tooth, radiographic follow-up showed the decrease of proliferative periostitis, and remodelation of the cortical bone. A periostite proliferativa e uma doenca caracterizada por sucessivas deposicoes de camadas de osso subperiostica como resposta a um estimulo cronico inflamatorio. O periosteo afetado forma sucessivas camadas de osso reacional paralelas entre si e expandem a superficie ossea nesse local. Dens in dente e uma alteracao do desenvolvimento resultante de invaginacao de esmalte para a dentina antes de sua calcificacao ocorrer. Usualmente sao diagnosticadas em exames clinicos-radiograficos de rotina. Um relato de caso clinico raro e apresentado sobre dens in dente na coroa do segundo pre-molar inferior causando periostite proliferativa. A fonte de infeccao foi o dens in dente que tinha comunicacao do meio bucal com a area do periodonto. Foi realizada a extracao do dente anomalo associado com uso de antibioticos. As radiografias de controle mostraram diminuicao da periostite proliferativa como remodelamento do osso cortical.