Concomitant Factors Leading to an Atypical Osteonecrosis of the Jaw in a Patient with Multiple Myeloma
Osteonecrosis of the jaw (ONJ) is a site specific osseous pathology, characterized by chronic exposed bone in the mouth, which needs to be reinforced periodically within the medical literature. ONJ is a clinical entity with many possible aetiologies and its pathogenesis is not well understood. The r...
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| Format: | Article |
| Language: | English |
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Wiley
2014-01-01
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| Series: | Case Reports in Medicine |
| Online Access: | http://dx.doi.org/10.1155/2014/281313 |
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| author | Jaume Miranda-Rius Lluís Brunet-Llobet Eduard Lahor-Soler Josep Anton Giménez-Rubio |
| author_facet | Jaume Miranda-Rius Lluís Brunet-Llobet Eduard Lahor-Soler Josep Anton Giménez-Rubio |
| author_sort | Jaume Miranda-Rius |
| collection | DOAJ |
| description | Osteonecrosis of the jaw (ONJ) is a site specific osseous pathology, characterized by chronic exposed bone in the mouth, which needs to be reinforced periodically within the medical literature. ONJ is a clinical entity with many possible aetiologies and its pathogenesis is not well understood. The risk factors for ONJ include bisphosphonates treatments, head and neck radiotherapy, dental procedures involving bone surgery, and trauma. Management of ONJ has centred on efforts to eliminate or reduce severity of symptoms, to slow or prevent the progression of disease, and to eradicate diseased bone. This case describes a rare case of ONJ in a 64-year-old Caucasian male diagnosed with multiple myeloma stage III. The lesion was related to a traumatic injury during mastication. Eighteen months ago in the same area the molar 37 was extracted, achieving a complete satisfactory healing, when only 2 doses of zoledronic acid had been administered. Actinomyces bacterial aggregates were also identified in the microscopic analysis. The management of this osteonecrotic lesion included antibiotic treatment and chlorhexidine topical gel administration. The evolution was monitored every two weeks until patient’s death. The authors provide a discussion of the etiology, pathogenesis, diagnosis, and management. This case report may shed light on the controversies about concomitant factors and mechanisms inducing ONJ. |
| format | Article |
| id | doaj-art-e427f7404de44de9b4765da87a57cf9a |
| institution | Kabale University |
| issn | 1687-9627 1687-9635 |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Medicine |
| spelling | doaj-art-e427f7404de44de9b4765da87a57cf9a2025-08-20T03:26:25ZengWileyCase Reports in Medicine1687-96271687-96352014-01-01201410.1155/2014/281313281313Concomitant Factors Leading to an Atypical Osteonecrosis of the Jaw in a Patient with Multiple MyelomaJaume Miranda-Rius0Lluís Brunet-Llobet1Eduard Lahor-Soler2Josep Anton Giménez-Rubio3Departament d’Odontostomatologia, Facultat d’Odontologia, Universitat de Barcelona, L’Hospitalet de Llobregat, 08907 Barcelona, SpainServei d’Odontologia, Hospital Universitari Sant Joan de Déu, Universitat de Barcelona, Esplugues de Llobregat, 08950 Barcelona, SpainDepartament d’Odontostomatologia, Facultat d’Odontologia, Universitat de Barcelona, L’Hospitalet de Llobregat, 08907 Barcelona, SpainServei de Cirurgia Oral i Maxil·lofacial, Hospital Universitari Mútua de Terrassa, Universitat de Barcelona, Terrassa, 08221 Barcelona, SpainOsteonecrosis of the jaw (ONJ) is a site specific osseous pathology, characterized by chronic exposed bone in the mouth, which needs to be reinforced periodically within the medical literature. ONJ is a clinical entity with many possible aetiologies and its pathogenesis is not well understood. The risk factors for ONJ include bisphosphonates treatments, head and neck radiotherapy, dental procedures involving bone surgery, and trauma. Management of ONJ has centred on efforts to eliminate or reduce severity of symptoms, to slow or prevent the progression of disease, and to eradicate diseased bone. This case describes a rare case of ONJ in a 64-year-old Caucasian male diagnosed with multiple myeloma stage III. The lesion was related to a traumatic injury during mastication. Eighteen months ago in the same area the molar 37 was extracted, achieving a complete satisfactory healing, when only 2 doses of zoledronic acid had been administered. Actinomyces bacterial aggregates were also identified in the microscopic analysis. The management of this osteonecrotic lesion included antibiotic treatment and chlorhexidine topical gel administration. The evolution was monitored every two weeks until patient’s death. The authors provide a discussion of the etiology, pathogenesis, diagnosis, and management. This case report may shed light on the controversies about concomitant factors and mechanisms inducing ONJ.http://dx.doi.org/10.1155/2014/281313 |
| spellingShingle | Jaume Miranda-Rius Lluís Brunet-Llobet Eduard Lahor-Soler Josep Anton Giménez-Rubio Concomitant Factors Leading to an Atypical Osteonecrosis of the Jaw in a Patient with Multiple Myeloma Case Reports in Medicine |
| title | Concomitant Factors Leading to an Atypical Osteonecrosis of the Jaw in a Patient with Multiple Myeloma |
| title_full | Concomitant Factors Leading to an Atypical Osteonecrosis of the Jaw in a Patient with Multiple Myeloma |
| title_fullStr | Concomitant Factors Leading to an Atypical Osteonecrosis of the Jaw in a Patient with Multiple Myeloma |
| title_full_unstemmed | Concomitant Factors Leading to an Atypical Osteonecrosis of the Jaw in a Patient with Multiple Myeloma |
| title_short | Concomitant Factors Leading to an Atypical Osteonecrosis of the Jaw in a Patient with Multiple Myeloma |
| title_sort | concomitant factors leading to an atypical osteonecrosis of the jaw in a patient with multiple myeloma |
| url | http://dx.doi.org/10.1155/2014/281313 |
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