Bevacizumab-related osteneocrosis of the jaw.
We describe a case of jaw bone necrosis after a lung adenocarcinoma bone metastasis, treated the first time in 2004 by means of pneumonectomy and lymph node ablation. One week after a dental extraction, the patient experienced pain in the mandibular region, in conjunction with alveolar bone exposure. Treatment with amoxicillin and clavulanate every 12 hours for 15 days and 0.2% chlorhexidine rinses was administered and there was a remission of infective complications, but not the closure of the exposed alveolar bone. Only at this time did the patient refer that he was treated with bevacizumab therapy immediately after the extraction. A preventive dental assessment of patients scheduled for bevacizumab therapy should be useful as for the zoledronic acid therapy. Dental surgery procedures for patients during bevacizumab therapy should be carefully evaluated and considered as the last choice, to reduce all possible risks and prevent complications.
Serra
E
E
Paolantonio
M
M
Spoto
G
G
Mastrangelo
F
F
Tetè
S
S
Dolci
M
M
D000230:Adenocarcinoma / Q000188:drug therapy / Q000556:secondary; D016301:Alveolar Bone Loss / Q000139:chemically induced; D019980:Amoxicillin-Potassium Clavulanate Combination / Q000627:therapeutic use; D020533:Angiogenesis Inhibitors / Q000009:adverse effects*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D001859:Bone Neoplasms / Q000188:drug therapy / Q000556:secondary; D002710:Chlorhexidine / Q000008:administration & dosage; D006801:Humans; D007571:Jaw Diseases / Q000139:chemically induced*; D008175:Lung Neoplasms / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009067:Mouthwashes / Q000008:administration & dosage; D010020:Osteonecrosis / Q000139:chemically induced*; D010146:Pain / Q000139:chemically induced; D014081:Tooth Extraction / Q000009:adverse effects*; D016896:Treatment Outcome
D020533:Angiogenesis Inhibitors; D000900:Anti-Bacterial Agents; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D009067:Mouthwashes; D000068258:Bevacizumab; D019980:Amoxicillin-Potassium Clavulanate Combination; D002710:Chlorhexidine