title: [Avascular jaw osteonecrosis in a hemodialysis patient treated with bisphosphonates].
abstract: Bisphosphonates are molecules derived from pyrophosphates,but, unlike pyrophosphates, they are resistant to enzymatic hydrolysis. Bisphosphonates are used in the treatment of Paget's disease, cancer-related osteolysis, myeloma, primary hyperparathyroidism, and osteoporosis. In dialysis patients bisphosphonates may be used to reduce bone pain due to renal osteodystrophy. We describe the case of a 60-year-old woman with a history of breast cancer who had been on dialysis for 8 years. She had been receiving clodronic acid at 100 mg per week intravenously for the last 2 years. A year ago, the patient underwent surgical extraction of the lower right second molar. Her jaw pain increased in the following days. An orthopanthograph and a CT scan of the head showed osteolysis, and a surgical osteotomy was performed. Histological examination led to a diagnosis of avascular osteonecrosis of the jaw. Avascular osteonecrosis is typically described in the jaw. In this case, prolonged bisphosphonate treatment may have worsened the osteonecrosis.
authors.affiliation: Centro Dialitico CBH, Bisceglie (BA) - Italy.
authors.forename: S
authors.initials: S
authors.lastname: Papagni
authors.forename: N
authors.initials: N
authors.lastname: Mongelli
authors.forename: M
authors.initials: M
authors.lastname: Cozzolino
authors.forename: D
authors.initials: D
authors.lastname: Brancaccio
authors.forename: F
authors.initials: F
authors.lastname: Ciccolella
authors.forename: G
authors.initials: G
authors.lastname: Favia
mesh_terms: D059266:Bisphosphonate-Associated Osteonecrosis of the Jaw / Q000175:diagnosis / Q000601:surgery; D005260:Female; D006801:Humans; D008875:Middle Aged; D006435:Renal Dialysis