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Jaw osteonecrosis management around a dental implant inserted 2 years before starting treatment with zoledronic acid.

Marín-Fernández AB, García Medina B, Aguilar-Salvatierra A, Jiménez-Burkhardt A, Gómez-Moreno G - J Clin Exp Dent (2015)

Bottom Line: BPs are widely used, with many patients receiving continuous treatment for years.Zoledronic acid (ZA) is an intravenous BP used in the treatment and prophylaxis of bone disease in patients with malignant tumors with bone implication.ZA is the most potent BP in clinical development.

View Article: PubMed Central - PubMed

Affiliation: Oral and Maxillofacial Surgery Service, Virgen de las Nieves University Hospital, Granada, Spain.

ABSTRACT
Bisphosphonates (BP) are a type of drug known to inhibit bone resorption through complex interventions. Their primary mechanism of action is aimed at the cellular level, inhibiting osteoclast activity and so bone resorption. BPs are widely used, with many patients receiving continuous treatment for years. But it is well known that these drugs can produce osteonecrosis of the jaw (ONJ). Zoledronic acid (ZA) is an intravenous BP used in the treatment and prophylaxis of bone disease in patients with malignant tumors with bone implication. ZA is the most potent BP in clinical development. This report describes the case of a 62-year-old woman with breast cancer antecedents which relapsed, who had received a maxillary dental implant two years before the start of therapy with zoledronic acid. She later developed osteonecrosis of the jaw (ONJ), which began in the peri-implant area, and was treated for stage 3 ONJ by sub-total maxillectomy. Key words:Bisphosphonates, zoledronic acid, osteonecrosis of the jaw, peri-implantitis, maxillectomy.

No MeSH data available.


Related in: MedlinePlus

CT shows left side maxillary osteonecrosis.
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Figure 1: CT shows left side maxillary osteonecrosis.

Mentions: Clinical exploration identified an extensive ulcer in the left maxilla with bone exposure (necrotic bone exposure of the alveolar bone at the implant site at 24), but computerized tomography (CT) revealed that necrosis extended from 21 to 25 (although bone exposure had only occurred in the area of 24). The suspected diagnosis was of a lesion compatible with bisphosphonate-related osteonecrosis. Associated with this lesion, the patient also presented an intraoral fistula with purulent drainage. An orthopantomograph and facial CT were made (Fig.1), which confirmed the diagnosis of stage 3 bisphosphonate-related ONJ (3).


Jaw osteonecrosis management around a dental implant inserted 2 years before starting treatment with zoledronic acid.

Marín-Fernández AB, García Medina B, Aguilar-Salvatierra A, Jiménez-Burkhardt A, Gómez-Moreno G - J Clin Exp Dent (2015)

CT shows left side maxillary osteonecrosis.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4554249&req=5

Figure 1: CT shows left side maxillary osteonecrosis.
Mentions: Clinical exploration identified an extensive ulcer in the left maxilla with bone exposure (necrotic bone exposure of the alveolar bone at the implant site at 24), but computerized tomography (CT) revealed that necrosis extended from 21 to 25 (although bone exposure had only occurred in the area of 24). The suspected diagnosis was of a lesion compatible with bisphosphonate-related osteonecrosis. Associated with this lesion, the patient also presented an intraoral fistula with purulent drainage. An orthopantomograph and facial CT were made (Fig.1), which confirmed the diagnosis of stage 3 bisphosphonate-related ONJ (3).

Bottom Line: BPs are widely used, with many patients receiving continuous treatment for years.Zoledronic acid (ZA) is an intravenous BP used in the treatment and prophylaxis of bone disease in patients with malignant tumors with bone implication.ZA is the most potent BP in clinical development.

View Article: PubMed Central - PubMed

Affiliation: Oral and Maxillofacial Surgery Service, Virgen de las Nieves University Hospital, Granada, Spain.

ABSTRACT
Bisphosphonates (BP) are a type of drug known to inhibit bone resorption through complex interventions. Their primary mechanism of action is aimed at the cellular level, inhibiting osteoclast activity and so bone resorption. BPs are widely used, with many patients receiving continuous treatment for years. But it is well known that these drugs can produce osteonecrosis of the jaw (ONJ). Zoledronic acid (ZA) is an intravenous BP used in the treatment and prophylaxis of bone disease in patients with malignant tumors with bone implication. ZA is the most potent BP in clinical development. This report describes the case of a 62-year-old woman with breast cancer antecedents which relapsed, who had received a maxillary dental implant two years before the start of therapy with zoledronic acid. She later developed osteonecrosis of the jaw (ONJ), which began in the peri-implant area, and was treated for stage 3 ONJ by sub-total maxillectomy. Key words:Bisphosphonates, zoledronic acid, osteonecrosis of the jaw, peri-implantitis, maxillectomy.

No MeSH data available.


Related in: MedlinePlus