CASE REPORT
Bisphosphonate-related osteonecrosis of the jaw in a 66-year-old female – Case report
 
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Department of Maxillofacial Surgery. Medical University of Lublin
 
J Pre Clin Clin Res. 2017;11(2):162–166
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ABSTRACT:
Introduction:
Bisphosphonate-related osteonecrosis of the jaws is an increasingly common side-effect of bisphosphonate treatment of malignant cancer of the osseous tissue. Necrotic foci of the bone with secondary inflammation are typical of the condition. The treatment is symptomatic and depends on the severity of the disease. The case is presented of BRONJ in a 66-year-old, occupationally-active female patient who had undergone implant-prosthetic treatment, and whose quality of life deteriorated significantly due to the symptoms of the disease. Bisphosphonate-related osteonecrosis of the jaw is treated conservatively at the initial stages of the disease, and surgical treatment should be avoided. Thorough oral hygiene and irrigations with chlorhexidine solution, supported by guided antibiotic therapy, are recommended. In severe cases, surgical sequestrotomy of the inflammatory foci, aimed at inhibiting or decelerating the course of the disease, is necessary.

CORRESPONDING AUTHOR:
Anna Gaweda   
Department of Maxillofacial Surgery, Department of Maxillofacial Surgery. Medical University of Lublin, The Medical University of Lublin, Staszica 11, 20-081 Lublin, Poland, 20-081 Lublin, Poland
 
REFERENCES (15):
1. Ogata K, Katagiri W, Osugi M et al. Evaluation of the therapeutic effects of conditioned media from mesenchymel stem cells in a rat bisphosphonate-related osteoneccrosis of the jaw-like model. Bone 74(2015)95-105.
2. Williams WB, O'Ryan F. Management of Medication-related Osteonecrosis of the Jaw Oral and Maxillofacial Surgery Clinics of North America, Volume 27, 4, 2015, 517–525.
3. Kim KM, Rhee Y, Kwon T-D, Lee JK, Kim D-Y. Medication Related Osteonecrosis of the jaws: 2015 Position Statement of the Korean Society for bone and mineral research and the Korean As-sociation of oral and maxillofacial surgeons. J.Bone Metab. 2015 Nov 22(4):151-165.
4. Ruggiero LS.Guidelines for the diagnosis of bisphosphonate-related osteoneccrosis of the jaw (BRONJ). Clin.Cases in Mineral and Bone Metabolism 2007,4(1), 37-41.
5. Yuxing Guo, Wang D, Wang Y, Peng X and Guo Ch. Imaging features of medicine-related oste-onecrosis of the jaws: comparison between panoramic radiography and computed tomography. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 122, 2, 2016, 69–76.
6. Pautke C, Bauer F, Tischer T, Kreutze K, Weit J. Fluorescence-Guided Bone Resection in Bisphosphonate-Associated Osteonecrosis of the Jaws: First clinical results of a prospective pilot study. Journal of Oral and Maxillofacial Surgery, 2011, 69, 84-91.
7. AAOMS Updates BRONJ Position Paper: 2014.
8. AAOMS Position Paper on Bisphosphonate-Related Osteonecrosis of the Jaws 2009 Update.
9. Guo Y, Wang D, Wang Y, Peng X at al. Imaging features of medicine-related osteonecrosis of the jaws: comparison between panoramic radiography and computed tomography. Oral Sur, Oral Med, Oral Path and Oral Radiol, Vol 122, Jan. 2017, e69-e76.
10. Li Y, Xu J , Mao L, Liu Y, Gao R, Zheng Z, Chen W, Le A, Shi S, Wang S. Allogeneic mesenchymal stem cell therapy for bisphosphonate-related jaw osteonecrosis in Swine. Stem Cells Dev. 2013 Jul 15;22(14):2047-56. doi: 10.1089/scd.2012.0615. Epub 2013 Apr.
11. Lin JH. Biphosphonates: A review of their pharmacokinetic properties. Bone 1996, 18, 75-86.
12. Moreira MS, Katayama E, Bombana AC, Marques MM. Cytotoxity analyses of alendronate on cultured endotelial and subcutaneous tissue. A pilot study. Dent.Traumatol.2005, 21, 329-335.
13. Berg B-J, Mueller AA, Augello M. et al. Imaging in patients with Bisphosphonate-associated os-teonecrosis of the jaws (MRONJ). Dent.J. 2016,4,3,29; doi:10.3390/dj4030029 (http://dx.doi.org/103390/dj403...).
14. Norholt SE, Hartlev J. Surgical treatment of osteonecrosis of the jaw with the use of platelet-rich fibrin: a prospective study of 15 patients. International Journal of Oral and Maxillofacial Surgery, 45, 10, 2016.
15. Burcip Z, Canay G, Asan Y. Treatment of bisphosphonate-related osteonecrosis of the jaw using platelet-rich fibrin CRANIO, The Journal of Craniomandibular and Sleep Practice, 2016.
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