JAPANESE JOURNAL OF ORAL & MAXILLOFACIAL SURGERY

Vol. 54 No. 3       2008

ISSN: 0021-5163      UBIC: 151-J

ABSTRACT

Recently, osteonecrosis of the jaw (ONJ) has been reported in some patients who receive bisphosphonates. We report a case of ONJ associated with the use of bisphosphonates in a patient with multiple myeloma (MM). A 70-year-old man with MM was referred to our department because of a non-healing socket after extraction of the lower left second molar. We performed curettage of the dental socket. Two weeks later, oral examination showed exposed necrotic bone at the lower left first molar region. A panoramic radiograph showed osteonecrosis of the lower left first molar region. A biopsy showed only necrotic bone, with no histologic evidence of MM disease. Because the patient had received intravenous bisphosphonates 27 times, we suspected that the ONJ was caused by bisphosphonate therapy. We repeatedly performed local irrigation and minimal sequestrectomy. The socket at the lower left first molar region underwent good epithelization with residual necrotic bone. There is no consensus on the management of ONJ associated with the use of bisphosphonates. Further investigations are needed to establish a satisfactory therapy for ONJ. Key words: bisphosphonate, osteonecrosis of the jaw, multiple myeloma

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