title: Root resorption caused by jaw infiltration of multiple myeloma: report of a case and literature review.
abstract: BACKGROUND
  Infiltration of the maxillofacial region by multiple myeloma is common and typically appears as punched out osteolytic lesions of the jaws. Although swelling, bone pain, and tooth mobility are characteristic clinical symptoms, root resorption is rare in conjunction with myeloma nests.
  
  
  METHODS
  A case of a 67-year-old man with multiple myeloma is presented. Root resorption of the second mandibular premolar and the first and second molars on the right side, with consecutive tooth mobility, was the initial manifestation of the disease and was primarily detected on a periapical radiograph. The treating dentist referred the patient to the department for further examination, which revealed multiple myeloma. The patient received tandem high-dose chemotherapy and autologous stem cell transplantation as standard myeloma treatment. Intravenous bisphosphonates were administered to curb the osteolytic lesions.
  
  
  RESULTS
  No signs of bisphosphonate-related osteonecrosis of the jaw were observed until the end of the follow-up period.
  
  
  CONCLUSIONS
  Only 5 reports of myeloma-associated root resorption have been reported in the literature. In all cases, mandibular premolars or molars were involved, and the patients exhibited extensive involvement of the jaw by myeloma. This report highlights the importance of correct interpretation of clinical signs and radiographs by dental specialists in the diagnostic algorithm of systemic diseases. Furthermore, this is an example for the inevitable part of bisphosphonates in the treatment of osteolytic processes.
authors: Department of Oral and Maxillofacial Surgery, Ludwig Maximilians University of Munich, Munich, Germany. Electronic address: matthias_troeltzsch@hotmail.com.
authors: Matthias
authors: M
authors: Troeltzsch
authors: Department of Medicine IV-Hematology/Oncology, Ludwig Maximilians University of Munich, Munich, Germany.
authors: Fuat
authors: F
authors: Oduncu
authors: Institute of Pathology, Ludwig Maximilians University of Munich, Munich, Germany.
authors: Doris
authors: D
authors: Mayr
authors: Department of Oral and Maxillofacial Surgery, Ludwig Maximilians University of Munich, Munich, Germany.
authors: Michael
authors: M
authors: Ehrenfeld
authors: Department of Oral and Maxillofacial Surgery, Ludwig Maximilians University of Munich, Munich, Germany.
authors: Christoph
authors: C
authors: Pautke
authors: Department of Oral and Maxillofacial Surgery, Ludwig Maximilians University of Munich, Munich, Germany.
authors: Sven
authors: S
authors: Otto
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001641:Bicuspid / Q000473:pathology; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D004164:Diphosphonates / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D000077557:Ibandronic Acid; D008297:Male; D008339:Mandibular Neoplasms / Q000150:complications* / Q000175:diagnosis; D008963:Molar / Q000473:pathology; D009101:Multiple Myeloma / Q000150:complications* / Q000175:diagnosis; D009361:Neoplasm Invasiveness; D010014:Osteolysis / Q000188:drug therapy; D012391:Root Resorption / Q000209:etiology*; D033581:Stem Cell Transplantation / Q000379:methods; D014086:Tooth Mobility / Q000209:etiology
chemical_list: D000970:Antineoplastic Agents; D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D000077557:Ibandronic Acid
keywords: Bisphosphonates; multiple myeloma; root resorption