Paget's disease of bone and osteonecrosis.
Paget's disease of bone, although common in the long bones and pelvis, is less common in the head and neck. A 20-year follow-up is reported of a patient who was diagnosed with Paget's disease following the investigation of her initial oral complaint. Following surgical extraction of two teeth in her maxilla, the sockets have failed to heal, despite numerous attempted interventions. This case highlights both the cranio-maxillofacial and oral manifestations of Paget's disease of bone, its effects on surgical exodontia and the possible effects of bisphosphonate therapy.


CONCLUSIONS
Paget's disease of bone does not manifest in the head and neck commonly but, when it does, there are significant implications for the dentist. Prevention and conservation of the patient's remaining teeth are paramount as the complications of extraction are significant.
Seehra
Jadbinder
J
Kent and Canterbury NHS Trust and GKT Dental Institute, UK.
Sloan
Philip
P
Oliver
Richard J
RJ
D000368:Aged; D050071:Bone Density Conservation Agents / Q000008:administration & dosage / Q000009:adverse effects; D004164:Diphosphonates / Q000008:administration & dosage / Q000009:adverse effects; D004368:Dry Socket / Q000209:etiology; D005260:Female; D006801:Humans; D006936:Hypercementosis / Q000209:etiology; D007093:Imidazoles / Q000008:administration & dosage / Q000009:adverse effects; D007275:Injections, Intravenous; D008439:Maxillary Diseases / Q000139:chemically induced* / Q000150:complications; D010001:Osteitis Deformans / Q000150:complications* / Q000188:drug therapy / Q000473:pathology*; D010020:Osteonecrosis / Q000139:chemically induced* / Q000150:complications / Q000209:etiology; D000077268:Pamidronate; D012886:Skull / Q000473:pathology; D014081:Tooth Extraction / Q000009:adverse effects; D020390:Tooth Socket / Q000503:physiopathology; D000077211:Zoledronic Acid
D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D007093:Imidazoles; D000077211:Zoledronic Acid; D000077268:Pamidronate