Findings:
An osteolysis area is seen in the left hemimandible, centred in the premolar region, with erosion, cortical breach and fragmentation of the mandibular body. It is open on the vestibular surface with smooth periosteal reaction and some flecks of gas. It is associated soft tissue swelling and left submental and submandibular lymphadenopathy.
The inferior alveolar canal shows some bony dehiscence at the site of osteolysis.
Mild elongation of the mandibular coronoid process is noted bilaterally.
Buccoangular impacted and unerupted left upper third molar.
The paranasal sinuses, mastoid air cells and the middle ear cavities are clear.
Conclusion:
Osteolytic process involving the body of the left hemimandible with bony erosion and fragmentation as well as associated soft tissue swelling, likely in keeping with mandibular osteomyelitis.
Histological evaluation to rule out underlying malignancy is advised.