Journal article Open Access

The Challenge Treatment of Medication Related Osteonecrosis of the Jaw: A Case Report

M Rodríguez Sánchez; Bassi AP; Carvalho PS


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        <foaf:name>M Rodríguez Sánchez</foaf:name>
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            <foaf:name>Postgraduate Student, Department of Surgery and Integrated Clinics, Aracatuba Dental School, Sao Paulo State University, Brazil</foaf:name>
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        <foaf:name>Bassi AP</foaf:name>
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            <foaf:name>Professor at Aracatuba Dental School, Department of Surgery and Integrated Clinics, Sao Paulo State University, Aracatuba SP, Brazil</foaf:name>
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        <foaf:name>Carvalho PS</foaf:name>
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            <foaf:name>Professor at Bauru Dental School, Department of Stomatology, Sao Paulo State University, Bauru SP, Brazil.</foaf:name>
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    <dct:title>The Challenge Treatment of Medication Related Osteonecrosis of the Jaw: A Case Report</dct:title>
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    <dct:issued rdf:datatype="http://www.w3.org/2001/XMLSchema#gYear">2015</dct:issued>
    <dcat:keyword>Osteonecrosis of the Jaw</dcat:keyword>
    <dcat:keyword>Oral Surgery</dcat:keyword>
    <dcat:keyword>Tooth Extraction</dcat:keyword>
    <dcat:keyword>Bisphosphonates</dcat:keyword>
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    <dct:description>&lt;p&gt;Bisphosphonates toxicological effect on alveolar bone could be associated to medication related osteonecrosis of the jaw.&amp;nbsp;(MRONJ) Oral surgical procedures as; tooth extractions, implants placements or trauma are suggested risk factors. The aim&amp;nbsp;of this paper is to describe a case of MRONJ and recurrence after the first right mandibular molar extraction. A 54 years&amp;nbsp;old man was referred to the Department of Surgery and Integrated Clinic of Aracatuba Dental School, Univ. Estadual&amp;nbsp;Paulista - UNESP with a medical history of myeloma multiple and treated with zoledronic acid during 3 years. Her dental&amp;nbsp;history consisted of a mandibular molar extraction 3 years after having finished zoledronic acid intake. After the dental&amp;nbsp;extraction the patient developed a clinical features of MRONJ that was treated with antibiotics, sequestrectomy, hyperbaric&amp;nbsp;oxygen, with apparently total resolution for about five month. The post-operative 6th month the patient complained of&amp;nbsp;recurrent pain, exudates and swelling. Antibiotic were prescribed in addition to surgical debridement. Even though mucosal&lt;br /&gt; coverage was achieved during the second surgical procedures, healing occurred without signs of infection but without&amp;nbsp;complete gingival coverage until the second year postoperative. MRONJ is a challenge complication and there is not a gold&lt;br /&gt; standard treatment.&lt;/p&gt;</dct:description>
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