title: Denosumab-related osteonecrosis of the jaw.
abstract: BACKGROUND
  Osteonecrosis of the jaw (ONJ) is a debilitating chronic illness that has become one of the literature's most discussed adverse events in relation to advanced malignancy. In 2010, the first case reports of ONJ linked with denosumab administration were published.
  
  
  METHODS
  The authors describe a case of denosumab-related ONJ in a 73-year-old man with a diagnosis of prostatic adenocarcinoma, the treatment for which included the antiresorptive agent denosumab and who experienced severe pain and delayed healing after a mandibular molar extraction performed six months after the cessation of denosumab therapy. The patient had not received radiotherapy to the head and neck, nor had he received any bisphosphonate treatment.
  
  
  RESULTS
  Clinicians established a diagnosis of denosumab-related ONJ. Follow-up across 12 months revealed that the patient needed long-term courses of antibiotics and that he experienced progressive bone destruction requiring surgical debridement.
  
  
  CONCLUSIONS
  and
  
  
  CONCLUSIONS
  The authors suggest that in patients receiving denosumab therapy, the dosing interval, the cumulative dose or both may be important in terms of the development of denosumab-related ONJ. This allows the hypothesis that preventive dentistry may reduce the prevalence of ONJ in those receiving denosumab as it has in those receiving bisphosphonates.
authors.affiliation: Oral Medical-Surgical Research Group, Department of Stomatology, Faculty of Medicine and Dentistry, Santiago de Compostela University, Calle Entrerríos S/N, 15782 Santiago de Compostela (La Coruña), Spain. pedro.diz@usc.es
authors.forename: Pedro
authors.initials: P
authors.lastname: Diz
authors.forename: José Luis
authors.initials: JL
authors.lastname: López-Cedrún
authors.forename: Jorge
authors.initials: J
authors.lastname: Arenaz
authors.forename: Crispian
authors.initials: C
authors.lastname: Scully
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects*; D050071:Bone Density Conservation Agents / Q000009:adverse effects*; D003475:Curettage; D003646:Debridement; D000069448:Denosumab; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008336:Mandibular Diseases / Q000139:chemically induced* / Q000601:surgery; D010014:Osteolysis / Q000139:chemically induced / Q000601:surgery; D010020:Osteonecrosis / Q000139:chemically induced* / Q000601:surgery; D011471:Prostatic Neoplasms / Q000188:drug therapy; D053245:RANK Ligand / Q000037:antagonists & inhibitors*; D014081:Tooth Extraction; D020390:Tooth Socket / Q000187:drug effects
chemical_list: D000900:Anti-Bacterial Agents; D061067:Antibodies, Monoclonal, Humanized; D050071:Bone Density Conservation Agents; D053245:RANK Ligand; D000069448:Denosumab