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Concomitant Factors Leading to an Atypical Osteonecrosis of the Jaw in a Patient with Multiple Myeloma

Concomitant Factors Leading to an Atypical Osteonecrosis of the Jaw in a Patient with Multiple Myeloma

Authors :
Jaume Miranda-Rius
Lluís Brunet-Llobet
Eduard Lahor-Soler
Josep Anton Giménez-Rubio
Source :
Case Reports in Medicine, Vol 2014 (2014)
Publication Year :
2014
Publisher :
Hindawi Limited, 2014.

Abstract

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.

Subjects

Subjects :
Medicine

Details

Language :
English
ISSN :
16879627 and 16879635
Volume :
2014
Database :
Directory of Open Access Journals
Journal :
Case Reports in Medicine
Publication Type :
Academic Journal
Accession number :
edsdoj.427f7404de44de9b4765da87a57cf9a
Document Type :
article
Full Text :
https://doi.org/10.1155/2014/281313