JOURNAL OF MEDICAL AND SURGICAL RESEARCH - Vol. IV, n 3, February 2018

Pages: 490-498
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Osteonecrosis of the Jaw Induced by Biphosphonates: About 2 Clinical Cases

Author: Oussama Nabih, Ihsane Benyahya

Category: JMSR Dentistry

Abstract:

Biphospohonates are a class of drugs used to treat multiple disorders of calcium metabolism. Since 2003, patients receiving therapies concomitants with biphosphonates have suffered new complications associated with osteonecrosis of the jaw. Bone necrosis of the maxilla is rare but potentially dramatic. It manifests by a wound of the gum, lesion exposing necrotic bone and episode of clinical infections. These complications may be caused by trauma or dental surgery, but it can be also spontaneous.

We report two cases of osteonecrosis of the jaw. The first case is a mandibular osteonecrosis occurring after tooth extraction in a patient receiving intravenous bisphosphonate. Medical and surgical management has been undertaken with a regular clinical follow up. The second case is a sequestered maxillary osteonecrosis induced by bisphosphonate, that fall down after medical treatment, leading to an oro-antral communication.

The management of this complication remains problematic and the surgical treatment is difficult as for the result is uncertain. Emphasis should therefore be placed on preventive and conservative measures for all patients treated with bisphosphonates, as their therapeutic efficacy seems indisputable. The best attitude remains preventive management of these patients prior to initiation of biphosphonate therapy.

Keywords: Biphosphonates, Jaw, Osteonecrosis

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