Medication-related osteonecrosis of the mandible: an unusual presentation and treatment.

R Rothweiler, P J Voss, R Schmelzeisen, M C Metzger

International journal of oral and maxillofacial surgery 2021 Apr

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A 71-year-old woman was referred to the clinic with extensive medication-related osteonecrosis of the jaw (MRONJ) involving the mandible. She had received 7 years of zoledronate therapy. On cone beam computed tomography, the MRONJ presented as a large sequestrum spanning from the left to the right condylar process, surrounded by thick sub-periosteal bone. The sequestrum was excised via an intraoral approach, leaving the newly formed sub-periosteal bone as a neo-mandible. The patient recovered well from the operation and was discharged 5 days after surgery. She healed completely without complications. This case report presents an alternative surgical treatment that may be considered if there is clinically stable sub-periosteal bone surrounding extensive MRONJ. Copyright © 2020 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Citation

R Rothweiler, P J Voss, R Schmelzeisen, M C Metzger. Medication-related osteonecrosis of the mandible: an unusual presentation and treatment. International journal of oral and maxillofacial surgery. 2021 Apr;50(4):511-515