title: Bisphosphonate-related osteonecrosis of the palatal torus.
abstract: BACKGROUND
  Bisphosphonates are widely used for the treatment of osteoporosis and other bone-degrading disorders; however, bisphosphonate therapy is an important risk factor for osteonecrosis of the jaws.
  
  
  METHODS
  We report a rare case of bisphosphonate-related osteonecrosis of the palatal torus.
  
  
  RESULTS
  The patient was a 72-year-old woman with osteoporosis who had received 35 mg alendronate sodium hydrate once every week for 6 years. She had a 2-month history of oral pain because of intractable mucositis and ulceration of the palatal torus, with no history of malignant disease, radiation therapy, chemotherapy, steroid use, or recent dentoalveolar surgery. A CT scan showed a bony prominence at the midportion of the hard palate with erosion of its cortex. Her condition was diagnosed as stage 2 bisphosphonate-related osteonecrosis of the jaw caused by trauma, and she was advised to discontinue alendronate. She was prescribed oral antibiotics for 5 days and an oral antibacterial rinse. The mucositis with ulceration healed in approximately 10 weeks, but left a small scar.
  
  
  CONCLUSIONS
  Although osteonecrosis of the palatal torus associated with bisphosphonate use is a rare condition, otolaryngologists should consider this condition in the differential diagnosis of intractable ulceration of the hard palate.
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Kaneko
authors.forename: Haruo
authors.initials: H
authors.lastname: Takahashi
mesh_terms: D000368:Aged; D019386:Alendronate / Q000009:adverse effects; D059266:Bisphosphonate-Associated Osteonecrosis of the Jaw / Q000175:diagnosis* / Q000628:therapy; D050071:Bone Density Conservation Agents / Q000009:adverse effects; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D010024:Osteoporosis / Q000188:drug therapy; D021362:Palate, Hard / Q000187:drug effects*; D014057:Tomography, X-Ray Computed
chemical_list: D050071:Bone Density Conservation Agents; D019386:Alendronate