Nonexposed bisphosphonate-related osteonecrosis of the jaws: another clinical variant?

A selection of abstracts of clinically relevant papers from other journals. The abstracts on this page have been chosen and edited by John R. Radford.

Abstract

Does bone have to be exposed in bisphosphate necrosis of the jaws?

Main

Junquera L, Gallego L. J Oral Maxillofac Surg 2008; 66: 1516–1517

Based on two case-histories, the authors ask if they have identified a variant of bisphosphonate-related osteonecrosis of the jaws (BRONJ). In the first case, they describe a patient who received bisphosphonate therapy for multiple myeloma in 2004. The remaining premolar teeth had been extracted in early 2006, with the authors claiming that no bone had been exposed. Pain and swelling occurred 4 months later. As medical therapy with antimicrobials and antiseptic mouthwashes did not bring about healing, 'minimal sequestrectomy' was undertaken and that brought about successful resolution. In the second case, a patient presented with pain and swelling of her upper anterior sextant following monthly intravenous bisphosphonate therapy for metastatic disease for about one year. No exposed bone was observed.