A 67-year-old patient smokes 6 cigarettes/day.
Previously diagnosed breast cancer (T2 N0 M0) treated by surgery associated with chemotherapy and radiotherapy.
Because of the metastatic progression of breast carcinoma, treatment with bisphosphonates (pamidronate 90 mg IV) was initiated.
20 cycles).
After the first 9 cycles of pamidronate it is when the patient is referred to our consultation of Oral and Maxillofacial Surgery by her oncologist presenting with a burning sensation and common gingival pain with a very painful lesion in the right hemigua.
The molar extraction associated with lingual lesion and other four non-viable teeth was indicated, appearing approximately one month after each extraction one month after the removal of the lesion by extra decubitus.
Limited debridement of bone necrosis was performed, supplemented with antibiotic therapy (amoxicillin-clavulanic, clarithromycin) and chlorhexidine gel.
The evolution was favorable in all areas except the mandibular molar, in which the exposure of the bone perpetuated the tongue position, requiring a second more aggressive ostectomy.
Although this exposure did not completely disappear, a correct control of the patient's pain was achieved when the lingual lesion disappeared.
