J Korean Assoc Oral Maxillofac Surg.  2010 Dec;36(6):508-514.

Clinical feature and treatment of bisphosphonate-related osteonecrosis of jaw about oral bisphosphonate administrated patients: case reports

• Choi WS
• Yoon HJ
• Lee SH

Abstract

Bisphosphonates are used effectively for many medical conditions, such as multiple myeloma, Paget's disease, osteoporosis, etc. However, recently, osteonecrosis of the jaw was observed in patients receiving long-term bisphosphonate therapy, including oral administration. This osteonecrosis is refractory, and complete recovery is not guaranteed despite a standard treatment protocol being established by many associations related to oral and maxillofacial surgery. The treatment outcome of oral bisphosphonate-related osteonecrosis of jaw (BRONJ) is reported with a review of the relevant literature.

Keyword

Bisphosphonate; Osteonecrosis; Osteoporosis

MeSH Terms

Administration, Oral
Clinical Protocols
Diphosphonates
Humans
Jaw
Multiple Myeloma
Osteonecrosis
Osteoporosis
Surgery, Oral
Treatment Outcome
Diphosphonates

Figure

• 

  Fig. 1. A. Case 1: Initial intraoral view. It was observed gingival swelling, pus discharged.(blue arrow) B. Case 1: Initial CT scan, transverse view. Focal osteolytic lesion at the right upper alveolar process with marked soft tissue swelling. (red arrow) C. Case 1: Thirteen months later intraoral view. Bone exposure was detected.(blue arrow) The other symptom was subside. (CT: computed tomography)

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  Fig. 2. A. Case 2: Initial intraoral view. Pus was discharged.(blue arrow) B. Case 2: Initial CT scan, transverse view. Osteolytic lesion at the left maxillary alveolar process.(red arrows) C. Case 2: Intraoperative view. Primary closure and tisseel application was done.(blue arrow) D. Case 2: Postoperation 5 months later CT scan, transverse view. Sequestrae are still observered E. Case 2: Postoperation 5 months later intraoral view. Bone exposure was persisted, but the other symptom was subside.(blue arrow) (CT: computed tomography)

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  Fig. 3. A. Case 3: Initial intraoral view. Bone was detected.(blue arrow) Patient had painful sensation. B. Case 3: Bone fragment was extracted during wound irrigation. C. Case 3: Six months later intraoral view. Pain was subside, but bone exposure was remained.(blue arrow)

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