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Medical Science Monitor Basic Research


An Approach for the Prevention, Diagnosis, and Treatment of Jaw Osteonecrosis: Report of a Case Associated with Zoledronic Acid

Unknown etiology, Challenging differential diagnosis, Diagnostic / therapeutic accidents, Management of emergency care, Adverse events of drug therapy

Danila S. de Alexandria Santos, Marco Vinícius de Sales Lima, Alexandre do Prado Scherma, Dárcio Kitakawa, Natália de Castro Magalhães, Felipe da Silva Peralta, Luis Felipe das Chagas e Silva de Carvalho

Brazil Department of Dentistry, University Center of Brás Cubas, Mogi das Cruzes, SP, Brazil

Am J Case Rep 2020; 21:e924377

DOI: 10.12659/AJCR.924377

Available online: 2020-10-05

Published: 2020-11-17


BACKGROUND: Osteonecrosis of the jaw is a condition manifesting as necrotic bone for 8 weeks or more, with no history of radiotherapy. It is linked to the use of antiresorptive drugs, such as bisphosphonates and denosumab. We discuss in this case report the importance of infection control during clinical procedures in patients taking antiresorptives.
CASE REPORT: Our case report describes a 52-year-old woman who had received zoledronic acid injections for 7 years, who presented with osteonecrosis of the jaw in the region of teeth 24, 25, and 26, with no local trauma. The report proceeds to describe the extraction of these teeth. After the dental extractions, she did not have any recurrence of the lesion, and she is currently in follow-up care.
CONCLUSIONS: Osteonecrosis of the jaw can be prevented through infection control and local trauma prevention. Patients who are taking antiresorptive drugs must receive special care from dental surgeons and doctors, and receive the necessary oral treatments before starting drug therapy.

Keywords: Bisphosphonate-Associated Osteonecrosis of the Jaw, Bone Density Conservation Agents, Osteoporosis