MANDIBULAR MANIFESTATIONS OF SAPHO SYNDROME. A SYSTEMATIC REVIEW
DOI:
https://doi.org/10.31435/ijitss.2(50).2026.5842Keywords:
SAPHO Syndrome; Mandible; Temporomandibular Joint; Osteitis; Hyperostosis; Misdiagnosis; Targeted TherapyAbstract
Background: SAPHO syndrome is a rare, long-lasting inflammatory disease. While it usually affects the chest wall and spine, it attacks the lower jaw in about 10% of patients. Because its symptoms closely mimic regular tooth infections, it frequently leads to wrong diagnoses and delayed care.
Aim: This study aims to provide a clear, detailed review of SAPHO syndrome in the jaw based on 22 scientific reports. The goal is to describe clinical signs, imaging results, and treatment options, and to compare modern medicines with major surgeries.
Results: The most common signs are recurrent severe jaw pain, facial swelling, and severe trismus. Without treatment, the jaw joint can completely fuse or melt away. Early diagnosis requires advanced scans: MRI with a STIR setting is the best tool to find early bone fluid (edema), while CT scans show a characteristic "onion-skin" bone pattern. Traditional treatments like antibiotics offer only short-term relief. Today, modern targeted drugs—such as biologic agents, bisphosphonates, and Yunke (99Tc-MDP)—are used to successfully stop bone damage and calm the immune system.
Conclusion: The treatment of SAPHO syndrome in the jaw has shifted from major bone surgery to smart, targeted medicines. Early diagnosis using MRI is critical to avoid pulling healthy teeth. Surgery should only be used to rebuild the face or free a stuck joint after the medicine has stopped the active disease.
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Copyright (c) 2026 Paulina Szczepańska, Sylwia Olizarowicz, Michał Mierzejewski, Alia Echtay Yarbou, Rami Mallah, Jacek Kowalski, Dominika Julia Kozdroń, Michalina Weronika Nieścioruk, Dominika Dutkiewicz, Adrian Mikołajuk
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