Jaw osteonecrosis management around a dental implant inserted 2 years before starting treatment with zoledronic acid.
Bisphosphonates (BP) are a type of drug known to inhibit bone resorption through complex interventions. Their primary mechanism of action is aimed at the cellular level, inhibiting osteoclast activity and so bone resorption. BPs are widely used, with many patients receiving continuous treatment for years. But it is well known that these drugs can produce osteonecrosis of the jaw (ONJ). Zoledronic acid (ZA) is an intravenous BP used in the treatment and prophylaxis of bone disease in patients with malignant tumors with bone implication. ZA is the most potent BP in clinical development. This report describes the case of a 62-year-old woman with breast cancer antecedents which relapsed, who had received a maxillary dental implant two years before the start of therapy with zoledronic acid. She later developed osteonecrosis of the jaw (ONJ), which began in the peri-implant area, and was treated for stage 3 ONJ by sub-total maxillectomy. Key words:Bisphosphonates, zoledronic acid, osteonecrosis of the jaw, peri-implantitis, maxillectomy.
Oral and Maxillofacial Surgery Service, Virgen de las Nieves University Hospital, Granada, Spain.
Ana-Belén
AB
Marín-Fernández
Oral and Maxillofacial Surgery Service, Virgen de las Nieves University Hospital, Granada, Spain.
Blas
B
García Medina
Pharmacological Research in Dentistry Group, Master in Periodontology and Implant Dentistry, Faculty of Dentistry, University of Granada, Granada, Spain.
Antonio
A
Aguilar-Salvatierra
Director of Pharmacological Research in Dentistry Group and Master of Periodontology and Implant Dentistry, Department of Special Care in Dentistry, Faculty of Dentistry, University of Granada, Granada, Spain.
Alberto
A
Jiménez-Burkhardt
Director of Pharmacological Research in Dentistry Group and Master of Periodontology and Implant Dentistry, Department of Special Care in Dentistry, Faculty of Dentistry, University of Granada, Granada, Spain.
Gerardo
G
Gómez-Moreno