Accurate Approach in the Treatment of Oral Bisphosphonate-Related Jaw Osteonecrosis

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Data

2011-11-01

Autores

Faloni, Ana Paula de Souza [UNESP]
Queiroz, Thallita Pereira
Comelli Lia, Raphael Carlos
Cerri, Paulo Sérgio [UNESP]
Margonar, Rogerio
Rastelli, Alessandra Nara de Souza [UNESP]
Marcantonio, Elcio

Título da Revista

ISSN da Revista

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Editor

Lippincott Williams & Wilkins

Resumo

Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is not completely understood and difficult to treat. Even though the occurrence of BRONJ is mainly related to the therapy with intravenous bisphosphonates (BPs), this article reports a case of long-term oral BP use and BRONJ occurrence. In addition, a literature review provides some additional information about BPs, BRONJ, and also a guideline for the prevention and treatment of BRONJ stages. A 79-year-old patient presented intense and persistent pain, purulent secretion, and exposed bone at the right side of the lower jaw. Thus, she was submitted to anamnesis, radiologic and tomographic examinations, and bacterial culture and sensitivity tests. These procedures were followed by surgical debridement of the bone and surrounding tissues/cyst and antibiotic prescription and histopathologic analysis of the fragments. Together, the examinations performed showed the occurrence of stage 2 BRONJ. Moreover, the antibiotic prescription, discontinuation of oral BP, and surgical procedures ensure that the patient had no more symptoms. Therefore, considering the presented case, we believe that an accurate approach is promising to diagnose and treat stage 2 BRONJ and other associated pathologic findings.

Descrição

Palavras-chave

Sodium alendronate, osteonecrosis, cyst, lower jaw, treatment

Como citar

Journal of Craniofacial Surgery. Philadelphia: Lippincott Williams & Wilkins, v. 22, n. 6, p. 2185-2190, 2011.