Treatment of Medication-Related Osteonecrosis of the Jaws without Segmental Resections: A Case Series
Abstract
Case series Patients: Females, 58–85 years Final Diagnosis: Medication-related osteonecrosis of the jaws Symptoms: Alveolar bone exposure • gingival hyperemia • intra and extraoral fistulas • mandibular neuralgia • paresthesia • spontaneous alveolar bone sequestration • suppuration Clinical Procedure: Debridement • dental implant removal • sequestrectomy Specialty: Dentistry • Endocrinology and Metabolic • Public Health Objective: Unusual clinical course Background: Medication-related osteonecrosis of the jaw (MRONJ) is a rare but serious reaction to anti-resorptive drugs (ARDs) in patients treated for osteoporosis and conditions related to cancer. Treatment for MRONJ consists of the use of non-operative therapies according to the evolution of the disease, which consist of the use of antimicrobial mouthwashes, systemic antibiotics, and operative therapies, such as debridement of necrotic bone, marginal or segmental resection, and bone reconstruction of the jaws in more advanced stages of the disease. Case Reports: This is a case series of 11 female patients treated for MRONJ, with a mean age of 76.5 years. Patients with malignant diseases of the jaws or those undergoing head and neck radiotherapy were excluded. Nine patients were medicated for osteoporosis with oral bisphosphonates and denosumab, and 2 patients used zoledronate to treat metastatic breast cancer. MRONJ prevailed in the mandible, most patients were classified as stage 2, and the most frequent triggers were…
How strong is the evidence?
Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health. Reported size: 11 participants or records.
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