Imaging Science in Dentistry  2015;45(3):199-203

doi:10.5624/isd.2015.45.3.199

Bisphosphonate-related osteonecrosis of the jaw in a multiple myeloma patient: A case report with characteristic radiographic features.

Byung Do LEE 1 ; Moo Rim PARK ; Kyung Hwan KWON

Affiliations

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Keywords

Multiple Myeloma; Bisphosphonate-Associated Osteonecrosis of the Jaw; Tooth Extraction

Country

Republic of Korea

Language

English

Abstract

A 59-year-old male who had suffered from multiple myeloma for nine years and had been administered bisphosphonates for seven years visited a dental hospital for pain relief due to extensive caries in his left maxillary molars. The molars were extracted, leaving an exposed wound for three months. The radiograph showed sequestra formation and irregular bone destruction in the left maxilla. Sudden pain and gingival swelling in the right mandibular molar area occurred six months later. The interseptum of the right lower second molar was observed to be necrotic during surgery. These findings coincided with the features of bisphosphonate-related osteonecrosis of the jaw (BRONJ). In this case, the long intravenous administration of bisphosphonates and tooth extraction were likely the etiologic factors of BRONJ in a patient with multiple myeloma; moreover, the bilateral occurrence of BRONJ is a characteristic feature.