Primary tuberculosis of the jaws: A systematic review

Introduction: Primary tuberculosis of the jaws is a rare form of extrapulmonary tuberculosis involving the mandible or maxilla without active pulmonary disease. Its presentation often mimics odontogenic infections, osteomyelitis, and malignancies, making diagnosis challenging. Awareness of this rare entity is important for early recognition and management.Objectives: To explore the demographics, clinical presentation, radiographic and histopathological features, diagnosis, treatment, and outcomes in primary tuberculosis of the jaws.Materials and Methods: Case reports and case series published from 2000–2025 were identified through a systematic search of PubMed Central, Google Scholar, and Cochrane Central. Studies meeting inclusion and exclusion criteria were analyzed for demographic, clinical, diagnostic, therapeutic, and outcome data.Results: A total of 21 studies were included in the review. Primary tuberculosis of the jaws was observed predominantly in children and young adults, with the mandible more commonly affected. Frequent clinical findings included pain, swelling, non-healing extraction sockets, sinus formation, and osteolytic destruction. Histopathology commonly showed granulomatous inflammation with epithelioid cells, Langhans giant cells, and caseous necrosis. Most cases showed favorable response to antitubercular therapy.Conclusion: Primary tuberculosis of the jaws is a rare diagnostic consideration in persistent jaw lesions due to its nonspecific presentation and resemblance to inflammatory and neoplastic conditions. Early diagnosis through clinicopathologic correlation and prompt antitubercular therapy are essential for favorable outcomes.