Idiopathic Exposed Bone Lesions of the Jaw

Abstract

Introduction: Osteonecrosis of the jaw is defined as exposed bone in the oral cavity that does not heal longer than eight weeks after identification. The two most common predisposing factors for osteonecrosis of the jaw are medication-related and radiotherapy. Rarely, exposed bone in the maxillofacial region can occur due to other causes and represents a clinical and therapeutic challenge for the dentist because there is no universally accepted treatment protocol. Case presentation: We report a case of a patient with two idiopathic lesions of exposed bone which have healed after systemic antibiotic therapy, seven weeks after the first examination. Conclusion: Exposed bone lesions of the jaw are a rare entity and are poorly documented in the literature. It is necessary to exclude possible local or systemic contributing factors. Surgical and conservative therapy (antibiotics) are the treatment of choice.

Clinical Performance of Implant-Supported Prostheses in the Rehabilitation of Patients Previously Treated for Medication-Related Osteonecrosis of the Jaws (MRONJ): A Systematic Review

“…(6) For the analyses in this paper, were the exposure(s) of interest measured prior to the outcome(s) being measured? (7) Was the timeframe sufficient so that one could reasonably expect to see an association between exposure and outcome if it existed? (8) For exposures that can vary in amount or level, did the study examine different levels of the exposure as related to the outcome (e.g., categories of exposure, or exposure measured as a continuous variable)?…”

“…The presence of bone exposure or oral fistulae to comply with this case definition of MRONJ fails to include the so-called "stage 0" or non-exposed bone cases [5,6] No history of radiation therapy to the jaws or metastatic disease to the jaws is, in any case, required to fulfill MRONJ case definition [1]. MRONJ should be distinguished from other forms of oral and systemic osteonecrosis (ONJ) conditions [7][8][9] and identified by history and clinical examination [1].…”

Osteonecrosis of the Jaw

“…Traumatic osteonecrosis is caused by thermal, mechanical, or chemical damage, while non-traumatic osteonecrosis is caused by neoplasms, infection, acquired and congenital diseases, and the use of narcotics [4]. Rare cases of idiopathic osteonecrosis have also been described [4,5].…”

“…It is a rare entity, and the literature data are scarce. Some described cases suspect lingual exostoses or prominent bone structures are potential predisposing factors [5,101,102]. Treatment options include conservative or surgical approaches [100].…”

“…Non-traumatic osteonecrosis is associated with infections, neoplasms, use of narcotics, and vascular causes such as ischemia, occlusion, coagulopathy, hemoglobinopathy, and some autoimmune diseases. However, some cases of idiopathic osteonecrosis that developed without an obvious etiological cause have also been described [4,5].…”