Peri-implant medication-related osteonecrosis of the jaw mimicking endodontic disease in a cancer patient: A case report.

IF 1.3 4区医学 Q3 DENTISTRY, ORAL SURGERY & MEDICINE

Australian Endodontic Journal Pub Date : 2024-10-12 DOI:10.1111/aej.12893

André Caroli Rocha, Maria Emília Mota, Ricardo Costa Lima, Nayara Fernanda Pereira, Fabio Abreu Alves, Maria Stella Moreira

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引用次数: 0

Abstract

Medication-related osteonecrosis of the jaw (MRONJ) is a progressive condition that can cause significant bone loss and its diagnosis can be challenging. A 68-year-old man with a diagnosis of hepatocellular carcinoma, undergoing treatment with atezolizumab, bevacizumab and zoledronic acid, complained of spontaneous pain in the right lower second premolar. Oral examination revealed no dental changes and implants in the right jaw. A patient history and thorough clinical and radiographic examinations mimic endodontic disease. The implant crowns were removed, bleeding on probing, and peri-implant pockets were observed. The main hypothesis was MRONJ Stage 2, and the surgical treatment was performed. The pain ceased and signs of MRONJ were not observed within 3 months. MRONJ should be considered as a hypothesis in the case of odontalgia and a patient's history of antiresorptive and antiangiogenic therapies. Furthermore, monitoring patients with dental implants in the mandible through detailed clinical and imaging evaluation is required.

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一名癌症患者因种植体周围药物相关性骨坏死而诱发牙髓病：病例报告。

药物相关性颌骨坏死（MRONJ）是一种可导致大量骨质流失的进展性疾病，其诊断可能具有挑战性。一名68岁的男性被诊断为肝细胞癌，正在接受阿替佐珠单抗、贝伐单抗和唑来膦酸治疗，主诉右下第二前磨牙自发疼痛。口腔检查显示牙齿无变化，右下颌有种植体。根据病史以及全面的临床和放射检查，该患者患有牙髓病。种植体牙冠已被拔除，探诊时发现有出血现象，种植体周围有牙周袋。主要假设是 MRONJ 2 期，并进行了手术治疗。3 个月内疼痛消失，也未观察到 MRONJ 的迹象。在牙痛和患者有抗骨质吸收和抗血管生成治疗史的情况下，应将 MRONJ 视为一种假说。此外，还需要通过详细的临床和影像学评估对下颌骨种植牙患者进行监测。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Australian Endodontic Journal DENTISTRY, ORAL SURGERY & MEDICINE-

CiteScore

3.50

自引率

6.20%

发文量

审稿时长

>12 weeks

期刊介绍： The Australian Endodontic Journal provides a forum for communication in the different fields that encompass endodontics for all specialists and dentists with an interest in the morphology, physiology, and pathology of the human tooth, in particular the dental pulp, root and peri-radicular tissues. The Journal features regular clinical updates, research reports and case reports from authors worldwide, and also publishes meeting abstracts, society news and historical endodontic glimpses. The Australian Endodontic Journal is a publication for dentists in general and specialist practice devoted solely to endodontics. It aims to promote communication in the different fields that encompass endodontics for those dentists who have a special interest in endodontics.