Arch Craniofac Surg.  2025 Apr;26(2):70-75. 10.7181/acfs.2024.0091.

Multidisciplinary approach for medication-related osteonecrosis of the jaws: a case report and literature review

• Annamalai S
• Kamalakaran A
• Jayaraman B
• Selvakumar A
• Kulkarni HS

• KMID: 2567356
• DOI: http://doi.org/10.7181/acfs.2024.0091

Abstract

Medication-related osteonecrosis of the jaw (MRONJ) is a relatively rare but well-documented complication of bisphosphonate therapy. Bisphosphonates are prescribed to millions of patients for the treatment of osteoporosis, Paget’s disease, multiple myeloma, bone metastases, and other bone-related conditions. These drugs inhibit bone resorption by binding to hydroxyapatite, particularly in areas of active resorption, thereby preventing osteoclasts from attaching to the bone. Long-term bisphosphonate therapy is considered a primary risk factor for MRONJ. Bisphosphonate-induced osteonecrosis typically manifests as exposed alveolar bone, which may occur spontaneously or following invasive dental procedures such as extractions, apicectomies, or implant placement. This case report describes a female who developed osteonecrosis in the maxilla and mandible after undergoing bisphosphonate therapy for multiple myeloma and subsequent tooth extractions.

Keyword

Bone diseases / Case reports / Dry socket / Multiple myeloma / Osteonecrosis / Tooth extraction