Medication-related osteonecrosis of the jaw in an older patient with multiple myeloma

IF 2 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Gerodontology Pub Date : 2025-02-28 DOI:10.1111/ger.12758

Larissa Couto de Freitas, Vanessa Silvestre de Aquino Silva, Marta Miyazawa, Carine Ervolino de Oliveira, Felipe Fornias Sperandio, João Adolfo Costa Hanemann

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引用次数: 0

Abstract

Objective

This article reports a case of medication-related osteonecrosis of the jaw (MRONJ) associated with multiple myeloma (MM).

Background

Bisphosphonates (BPs) are constantly used as part of the treatment for MM. The main adverse effects of bisphosphonates are renal insufficiency and medication-related osteonecrosis of the jaw (MRONJ).

Materials and Methods

A 67-year-old female with a previous diagnosis of MM and undergoing current receiving intravenous injections of pamidronate underwent a tooth extraction and subsequently developed MRONJ.

Results

MRONJ was managed with clindamycin, surgical removal of bony sequestrum and curettage. At 3 years of follow-up, the patient was asymptomatic with no clinical changes and panoramic radiography without evidence of recurrence.

Conclusion

Management of patients under antiresorptive drugs who require invasive dental procedures is challenging. Therefore, interprofessional collaboration, especially between the general practitioner and oncologist and/or haematologist, is essential to reach the best clinical approach and reduce the risk of MRONJ.

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老年多发性骨髓瘤患者颌骨药物相关性骨坏死1例

目的报道一例药物相关性颌骨骨坏死（MRONJ）合并多发性骨髓瘤（MM）的病例。双膦酸盐（bp）一直被用作MM治疗的一部分。双膦酸盐的主要副作用是肾功能不全和药物相关性颌骨骨坏死（MRONJ）。材料与方法一名67岁女性，既往诊断为MM，目前正在接受帕米膦酸钠静脉注射，拔牙后出现MRONJ。结果采用克林霉素、骨截骨切除、刮除术治疗MRONJ。在3年的随访中，患者无症状，无临床变化，全景x线片无复发迹象。结论抗吸收药物治疗下需要进行有创牙科手术的患者的管理具有挑战性。因此，跨专业合作，特别是全科医生与肿瘤学家和/或血液学家之间的合作，对于达到最佳临床方法和降低MRONJ的风险至关重要。

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

Gerodontology 医学-老年医学

CiteScore

4.10

自引率

10.00%

发文量

审稿时长

3-6 weeks

期刊介绍： The ultimate aim of Gerodontology is to improve the quality of life and oral health of older people. The boundaries of most conventional dental specialties must be repeatedly crossed to provide optimal dental care for older people. In addition, management of other health problems impacts on dental care and clinicians need knowledge in these numerous overlapping areas. Bringing together these diverse topics within one journal serves clinicians who are seeking to read and to publish papers across a broad spectrum of specialties. This journal provides the juxtaposition of papers from traditional specialties but which share this patient-centred interest, providing a synergy that serves progress in the subject of gerodontology.