Maxillary osteonecrosis induced by antiresorptive medication (bisphosphonate) in a patient with multiple myeloma - Case report

Authors

DOI:

https://doi.org/10.33448/rsd-v9i11.9415

Keywords:

Osteonecrose; Maxila; Biphosphonate- associated osteonecrosis of the jaw.

Abstract

Objective: to describe the clinical case of a patient with multiple myeloma, who developed maxillary osteonecrosis induced by anti-resorptive medication (bisphosphonate) submitted to a conservative and surgical therapeutic approach and subsequent prosthetic rehabilitation. Patients and methods: the case report is presented based on a simple review of the literature and clinical experience for the diagnosis, clinical staging of the lesion, carrying out the excision of the necrotic bone, debridement, lesion control and making a obturator prosthesis. Results: Despite the difficulty offered by the pathological condition and continuous use of medication, the treatment employed was successful, restoring health and providing a better quality of life to the patient, which allowed the obturation prosthesis to be made in the 8-month postoperative period. Conclusion: The result obtained emphasizes the importance of knowledge of the staging of the lesion for the application of the treatment protocol, in addition to recognizing patients at risk for the practice of prevention in dental treatments.

References

Arantes, H. P., Silva, A. G., & Lazaretti-Castro, M. (2010). Bisphosphonates in the treatment of metabolic bone diseases. Arquivos brasileiros de endocrinologia e metabologia, 54(2), 206–212. https://doi.org/10.1590/s0004-27302010000200017

Conte-Neto, N., Bastos, A. S., Spolidorio, L. C., Marcantonio, R. A., & Marcantonio, E., Jr (2011). Oral bisphosphonate-related osteonecrosis of the jaws in rheumatoid arthritis patients: a critical discussion and two case reports. Head & face medicine, 7, 7. https://doi.org/10.1186/1746-160X-7-7

Curi, M. M., Cossolin, G. S., Koga, D. H., Zardetto, C., Christianini, S., Feher, O., Cardoso, C. L., & dos Santos, M. O. (2011). Bisphosphonate-related osteonecrosis of the jaws--an initial case series report of treatment combining partial bone resection and autologous platelet-rich plasma. Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons, 69(9), 2465–2472. https://doi.org/10.1016/j.joms.2011.02.078

Escobedo, M. F., Cobo, J. L., Junquera, S., Milla, J., Olay, S., & Junquera, L. M. (2020). Medication-related osteonecrosis of the jaw. Implant presence-triggered osteonecrosis: Case series and literature review. Journal of stomatology, oral and maxillofacial surgery, 121(1), 40–48. https://doi.org/10.1016/j.jormas.2019.04.012

Fliefel, R., Tröltzsch, M., Kühnisch, J., Ehrenfeld, M., & Otto, S. (2015). Treatment strategies and outcomes of bisphosphonate-related osteonecrosis of the jaw (BRONJ) with characterization of patients: a systematic review. International journal of oral and maxillofacial surgery, 44(5), 568–585. https://doi.org/10.1016/j.ijom.2015.01.026

Griz, L. C. G, Bandeira, C, Assunção, V, & Bandeira, F. (2006). Paget's disease of bone. Arquivos Brasileiros de Endocrinologia & Metabologia, 50(4), 814-822. https://doi.org/10.1590/S0004-27302006000400026

Guazzo, R., Sbricoli, L., Ricci, S., Bressan, E., Piattelli, A., & Iaculli, F. (2017). Medication-Related Osteonecrosis of the Jaw and Dental Implants Failures: A Systematic Review. The Journal of oral implantology, 43(1), 51–57. https://doi.org/10.1563/aaid-joi-16-00057

Kos, M., Kuebler, J. F., Luczak, K., & Engelke, W. (2010). Bisphosphonate-related osteonecrosis of the jaws: a review of 34 cases and evaluation of risk. Journal of cranio-maxillo-facial surgery: official publication of the European Association for Cranio-Maxillo-Facial Surgery, 38(4), 255–259. https://doi.org/10.1016/j.jcms.2009.06.005

Krstevska, S., Stavric, S. G., Cevrevska, L., Georgjievski, B., Karanfilski, O., Sotirova, T., & Balkanov, T. (2015). Osteonecrosis of the Jaw After Bisphosphonates Treatment in Patients with Multiple Myeloma. Medical archives (Sarajevo, Bosnia and Herzegovina), 69(6), 367–370. https://doi.org/10.5455/medarh.2015.69.367-370

Marx, R. E., Sawatari, Y., Fortin, M., & Broumand, V. (2005). Bisphosphonate-induced exposed bone (osteonecrosis/osteopetrosis) of the jaws: risk factors, recognition, prevention, and treatment. Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons, 63(11), 1567–1575. https://doi.org/10.1016/j.joms.2005.07.010

Marx R. E. (2009). Reconstruction of defects caused by bisphosphonate-induced osteonecrosis of the jaws. Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons, 67(5 Suppl), 107–119. https://doi.org/10.1016/j.joms.2008.12.007

Ruggiero, S. L., Mehrotra, B., Rosenberg, T. J., & Engroff, S. L. (2004). Osteonecrosis of the jaws associated with the use of bisphosphonates: a review of 63 cases. Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons, 62(5), 527–534. https://doi.org/10.1016/j.joms.2004.02.004

Ruggiero, S. L., Dodson, T. B., Fantasia, J., Goodday, R., Aghaloo, T., Mehrotra, B., O'Ryan, F., & American Association of Oral and Maxillofacial Surgeons (2014). American Association of Oral and Maxillofacial Surgeons position paper on medication-related osteonecrosis of the jaw--2014 update. Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons, 72(10), 1938–1956. https://doi.org/10.1016/j.joms.2014.04.031

Russell, R. G., Watts, N. B., Ebetino, F. H., Rogers, M. J. Mechanisms of action of bisphosphonates: similarities and differences and their potential influence on clinical efficacy. Osteoporos Int. 2008; 19(6), 733-759. doi:10.1007/s00198-007-0540-8

Wang, J., Goodger, N. M., & Pogrel, M. A. (2003). Osteonecrosis of the jaws associated with cancer chemotherapy. Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons, 61(9), 1104–1107. https://doi.org/10.1016/s0278-2391(03)00328-8

Wang, E. P., Kaban, L. B., Strewler, G. J., Raje, N., & Troulis, M. J. (2007). Incidence of osteonecrosis of the jaw in patients with multiple myeloma and breast or prostate cancer on intravenous bisphosphonate therapy. Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons, 65(7), 1328–1331. https://doi.org/10.1016/j.joms.2007.03.006

Zervas, K., Verrou, E., Teleioudis, Z., Vahtsevanos, K., Banti, A., Mihou, D., Krikelis, D., & Terpos, E. (2006). Incidence, risk factors and management of osteonecrosis of the jaw in patients with multiple myeloma: a single-centre experience in 303 patients. British journal of haematology, 134(6), 620–623. https://doi.org/10.1111/j.1365-2141.2006.06230.x

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Published

06/11/2020

How to Cite

OSBORNE, P. R.; MENDES, B.; FAVERANI, L. P.; ALEXANDRE, C. N. .; JESUS, G. P. de . Maxillary osteonecrosis induced by antiresorptive medication (bisphosphonate) in a patient with multiple myeloma - Case report. Research, Society and Development, [S. l.], v. 9, n. 11, p. e1179119415, 2020. DOI: 10.33448/rsd-v9i11.9415. Disponível em: https://www.rsdjournal.org/index.php/rsd/article/view/9415. Acesso em: 20 apr. 2024.

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Section

Health Sciences