P.066 Treatment of bisphosphonate-related osteonecrosis of the jaw

Ariyoshi, Yasunori; Shimahara, Masashi; Okutomi, Tadashi; Kono, Kazuhiko; Dote, Tomotaro; Usuda, H.; Shimizu, Hajime

doi:10.1016/s1010-5182(08)71854-7

Cited by 1 publication

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“…For BRONJ treatment, we perform conservative management in principle at our department in accordance with those reports. We also provide instruction for mouth cleaning and perform frequent local irrigation, administration of antibacterial agents, debridement of exposed bone, and removal of mobile segments of bony sequestrum 3) . Meanwhile, for treatment of acute inflammation secondary to BRONJ, such as in the present case, it is considered necessary to take the effects of BP into consideration, in addition to diagnosis and treatment for odontogenic infection in general.…”

Section: Association Of Oral and Maxillofacial Surgeons (Aaoms) And Tmentioning

confidence: 99%

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Cellulitis Extending from Submandibular to Temporal Region Originating from Bisphosphonate-related Osteonecrosis of the Mandible

Ariyoshi

Ueno

Ito

et al. 2013

J. Hard Tissue Biology.

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We report a case of bisphosphonate-related osteonecrosis of the jaw (BRONJ) that caused cellulitis extending from the submandibular to temporal region. An 81 year-old man was referred to our department because of trismus and painful swelling of the left mandible, for which extraction of the wisdom tooth had been performed 3 months prior. He suffered from bone metastasis of prostate cancer, and was being administered anticancer drugs and zoledronate. A physical examination revealed an exposed jaw bone, and our clinical diagnosis was BRONJ with secondary infection. Five days after his first visit, the patient suffered from rapidly increased painful swelling extending from the submandibular to temporal region. Following admission, incision of the submandibular abscess was performed and acute phase inflammation was tentatively relieved. However, painful swelling in the temporal region recurred and an incision of the temporal skin for drainage was performed, which caused persistent purulent discharge. We performed a computed tomography examination, which excluded temporal bone necrosis. Thereafter, irrigation of the abscess cavity and systemic antibiotic chemotherapy were maintained. Although the exposed jaw bone persisted, there was no further pus discharge from the incision wound and the patient was discharged 45 days after admission.

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Section: Association Of Oral and Maxillofacial Surgeons (Aaoms) And Tmentioning

confidence: 99%

“…In principle, we perform conservative therapy including minimum-invasive surgery as the first choice of treatment 3) . However, difficulties are sometimes faced when treating patients who do not respond to conservative treatment as well as those with widespread cellulitis 4,5) .…”

Section: Introductionmentioning

confidence: 99%