J Korean Assoc Maxillofac Plast Reconstr Surg.  2010 Sep;32(5):478-483.

Bisphosphonate Related Osteonecrosis of Jaw on Mandibular Molar Area: a Case Report

• Park JA
• Yoon KH
• Cheong JK
• Bae JH
• You KH
• Jo KH
• Shin JM
• Baik JS

Abstract

Bisphosphonates are synthetic analogue and have high affinity on bone remodeling site. Since they have a long half-reduction time, they accumulate at bone and act for a long time. They are widely used in osteoporosis derived from imflammatory bowel disease or postmenopausal osteoporosis patient for bone mineral density improvement. In addition, they neutralize hypercalcemia owing to bone metastasis of malignancy. However, a jaw bone necrosis was recently reported in some patients who have taken bisphosphonates for a long time. It is called Bisphosphonate Related Osteonecrosis of Jaws (BRONJ). It can come spontaneously, but more often after oral surgery including tooth extraction. In this case, a 80-year-old woman was treated with bisphosphonate (sodium alendronate) for 2 years to improve bone mineral density. She had her left lower second molar tooth extracted at local clinic. After extraction, she had inflammatory symptoms like a pain, a cheek swelling, and a discharge of pus. She was referred to our clinic for treatment. We treated meticulously from dressing to surgery. After following up about 1.5 years, the jaw lesion was successfully healed. So we report this case.

Keyword

Bisphosphonate; Osteonecrosis; Jaw

MeSH Terms

Aged, 80 and over
Bandages
Bone Density
Bone Remodeling
Cheek
Diphosphonates
Female
Humans
Hypercalcemia
Jaw
Molar
Necrosis
Neoplasm Metastasis
Osteonecrosis
Osteoporosis
Osteoporosis, Postmenopausal
Suppuration
Surgery, Oral
Tooth
Tooth Extraction
Diphosphonates