Dental and Medical Problems

Dent Med Probl
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ISSN 1644-387X (print)
ISSN 2300-9020 (online)
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Dental and Medical Problems

2017, vol. 54, nr 3, July-September, p. 297–302

doi: 10.17219/dmp/74884

Publication type: clinical case

Language: English

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Creative Commons BY-NC-ND 3.0 Open Access

Bone necrosis associated with the use of bisphosphonates: Case report

Martwica kości żuchwy po zastosowaniu bifosfonianu – opis przypadku

Tomasz Krzysztof Jachewicz1,A,B,C,D,E, Joanna Jakiel1,A,B,D

1 Chair and Department of Oral Surgery, Medical University of Lublin, Lublin, Poland

Abstract

The aim of this study was to present the case of a 68-year-old female patient with jaw bone necrosis associated with the use of bisphosphonates. The case was qualified for the second degree of severity (BRONJ). The study demonstrates a multi-month observation of the patient and describes the sequestrectomy procedure performed, which was supplemented by covering the bone tissue with a collagen sponge. The treatment applied was slightly different from the accepted algorithms of proceedings. The difference was connected with the use of a collagen sponge containing gentamicin (used to cover the bone’s surface) after the sequestrectomy. The collagen material, in contrast to the exposed dead bone, is a surface which may be susceptible to epithelization. This gives a possibility to the secondary closing of the wound as a result of granulation and epithelization without the bone’s re-exposure. Moreover, the study characterizes indications for the use of bisphosphonates, their chemical structure and mechanism of action. It shows the definition of BRONJ (bisphosphonate-related osteonecrosis of the jaw) and risk factors for its occurrence, as well as prevention and treatment methods.

Key words

osteonecrosis, diphosphonates, bisphosphonate related osteonecrosis of the jaw

Słowa kluczowe

martwica kości, difosfoniany, martwica kości żuchwy spowodowana zastosowaniem bisfosfonianu

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