BISPHOSPHONATE RELATED OSTEONECROSIS OF THE JAW AND IT'S MANAGEMENT

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Karabıyık Z., Çoban E., Hakiki H.

Uluslararası Ağız Kanserleri Kongresi, Eskişehir, Turkey, 4 - 06 March 2020, pp.301

  • Publication Type: Conference Paper / Full Text
  • City: Eskişehir
  • Country: Turkey
  • Page Numbers: pp.301
  • Kütahya Health Sciences University Affiliated: Yes

Abstract

BISPHOSPHONATE RELATED OSTEONECROSIS OF THE JAW AND ITS MANAGEMENT

Objective: Bisphosphonates are commonly used to treat osteoporosis and prevent bone metastasis of cancer. One of the most recognized complications of bisphosphonates therapy is bone necrosis of the jaws. Dentoalveolar surgery is accepted as a predisposing factor for developing bone necrosis of the jaws. Treatment of bone necrosis of jaws includes reducing signs and symptoms of disease.


Case descriptions: Seventy-eight years old male patient was consulted to our department for the treatment of his halitosis. His medical history revealed prostate cancer which was diagnosed four years ago. He received chemotherapy along with bisphosphonates (Zoledronic acid ) for four years. İntraoral examination showed asymptomatic necrotic bone mass at the upper right posterior region. Tooth has been extracted two years ago at the affected area.


Materials and methods: Oral hygiene encouragement was provided and necrotic bone was removed. As a result of this, oro-antral communication was closed by using his upper denture that was modified by using viscogel and used as a obturator. The aim of the obturator was to help patient keep to clean oro-antral communication area and prevent food impaction. Saline mixed with povidone iyodine was prescribed for patient and and instructed to rinse the area three times a day.


Result: After two weeks following, oro-anrtral communication and bone was fully covered with soft tissue. By preferring conservatice approach, ıt was aimed to not further interference with necrotic bone and prevent worsening of exposed bone area. Conclusion: Patient who were bone necrosis associated with using bisphosphonates at jaws should be treated with minimaly invasive procedures because any surgical procedure involving bone cause the worsening of necrotic bone area.