JAPANESE JOURNAL OF ORAL & MAXILLOFACIAL SURGERY

Vol. 54 No. 3       2008

ISSN: 0021-5163      UBIC: 151-J

ABSTRACT

Bisphosphonates, nonmetabolized analogues of pyrophosphate, have been widely used to treat patients with hypercalcemia caused by malignancy, bone metastasis, multiple myeloma, and osteoporosis. Recent studies have documented that bisphosphonates can cause osteonecrosis of the jaws. We report a case of bisphosphonateassociated osteonecrosis of the maxilla. A 72-years-old woman was referred to our clinic for further examination of the upper left premolar region. Intraoral examination revealed necrotic alveolar bone in the upper left premolar region, with swelling of the surrounding soft tissue and exposed necrotic bone at the right side of the upper jaw. The patinet had a past medical history of breast cancer with bone metastases to the ribs and received intravenous pamidronate at a dose of 30 mg every 2 weeks. We suspected bisphosphonate-associated osteonecrosis and performed sequestrectomy after antibiotic therapy and local irrigation. Because the number of patients who receive bisphosphonates is increasing in Japan, dentists, especially oral surgeons, should be careful about bisphosphonate-associated osteonecrosis of the jaw bones. Key words: bisphosphonate, osteonecrosis, jaw

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