IADR Abstract Archives
Conservative Management of two Different Stages Bisphosphonate-Related Osteonecrosis of the jaw in a Patient With Multiple Myeloma.
Objectives: Illustrate through a clinical case the diagnosis and treatment of stage1 and 2 of biphosphonate_related osteonecrosis of the jaw(BRONJ).
Methods: A 63_year_old man patient attended the dental medicine department of Fattouma Bourguiba University Hospital Monastir with a complaint of right mandibular swelling evolving for two days.
the interrogation revealed that he is followed for multiple myeloma and that he received 3 injections of Zoledronic acid (Zometa).
the clinical examination revealed right mandibular osteonecrosis complicated by serous stage cellulitis and an asymptomatic exposed bone in the left maxillary site.
panoramic radiograph showed a persisting root of the right mandibular tooth surrounding sclerotic changes.
we retained stage 2 and stage 1 of BRONJ for the mandibular and maxillary lesions, respectively.
Results: Systemic antibiotics were prescribed followed by the extraction of the persisting root. superficial debridement was necessary for both stages of BRONJ.
The signs and symptoms of BRONJ were effectively managed using the conservative approach.
stabilization on stage 1 of the maxillary lesion and regression to stage 1 for the mandibular BRONJ.
Conclusions: Decisions on operative versus nonoperative therapy should be patient_specific and tailored to individual needs .
Regardless of the stage of the disease, areas of necrotic bone that are a constant source of soft tissue irritation should be removed or recontoured so that soft tissue healing can be optimized. Clinical and radiographic surveillance is critical in managing patients with stage1,2 and 3 of BRONJ to monitor for signs of disease progression.
Methods: A 63_year_old man patient attended the dental medicine department of Fattouma Bourguiba University Hospital Monastir with a complaint of right mandibular swelling evolving for two days.
the interrogation revealed that he is followed for multiple myeloma and that he received 3 injections of Zoledronic acid (Zometa).
the clinical examination revealed right mandibular osteonecrosis complicated by serous stage cellulitis and an asymptomatic exposed bone in the left maxillary site.
panoramic radiograph showed a persisting root of the right mandibular tooth surrounding sclerotic changes.
we retained stage 2 and stage 1 of BRONJ for the mandibular and maxillary lesions, respectively.
Results: Systemic antibiotics were prescribed followed by the extraction of the persisting root. superficial debridement was necessary for both stages of BRONJ.
The signs and symptoms of BRONJ were effectively managed using the conservative approach.
stabilization on stage 1 of the maxillary lesion and regression to stage 1 for the mandibular BRONJ.
Conclusions: Decisions on operative versus nonoperative therapy should be patient_specific and tailored to individual needs .
Regardless of the stage of the disease, areas of necrotic bone that are a constant source of soft tissue irritation should be removed or recontoured so that soft tissue healing can be optimized. Clinical and radiographic surveillance is critical in managing patients with stage1,2 and 3 of BRONJ to monitor for signs of disease progression.