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Imaging Sci Dent. 2015 Sep;45(3):199-203. English. Case Report. https://doi.org/10.5624/isd.2015.45.3.199
Lee BD , Park MR , Kwon KH .
Department of Oral and Maxillofacial Radiology and Wonkwang Dental Research Institute, College of Dentistry, Wonkwang University, Iksan, Korea. eebydo@wonkwang.ac.kr
Department of Internal Medicine, School of Medicine, Wonkwang University, Iksan, Korea.
Department of Oral and Maxillofacial Surgery, College of Dentistry, Wonkwang University, Iksan, Korea.
Abstract

A 59-year-old male who had suffered from multiple myeloma for nine years and had been administered bisphosphonates for seven years visited a dental hospital for pain relief due to extensive caries in his left maxillary molars. The molars were extracted, leaving an exposed wound for three months. The radiograph showed sequestra formation and irregular bone destruction in the left maxilla. Sudden pain and gingival swelling in the right mandibular molar area occurred six months later. The interseptum of the right lower second molar was observed to be necrotic during surgery. These findings coincided with the features of bisphosphonate-related osteonecrosis of the jaw (BRONJ). In this case, the long intravenous administration of bisphosphonates and tooth extraction were likely the etiologic factors of BRONJ in a patient with multiple myeloma; moreover, the bilateral occurrence of BRONJ is a characteristic feature.

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