title: Bisphosphonate-Related Osteonecrosis of the Jaw After Tooth Extraction.
abstract: Bisphosphonates are widely used for treatment or prevention of bone diseases characterized by high osteoclastic activity. Among the oral medicines used to treat osteoporosis, alendronate has been often used. Despite of the low rate of complications on its use, cases of osteonecrosis of the jaw have been reported on literature after tooth extractions. The main symptoms include pain, tooth mobility, swelling, erythema, and ulceration. The risk factors related to osteonecrosis of the jaw associated with bisphosphonate are exposition time to the medicine, routes of administration, and oral surgical procedures performed. The aim of this work is to report a case of a patient showing osteonecrosis of the jaw associated with the use of oral bisphosphonates after tooth extractions. The patient was treated through the suspension of the alendronate with the removal of the necrotic tissue and the foci of infection. After a year's follow-up, the patient showed no recurrence signs. From the foregoing, the interruption of the alendronate use and the surgical treatment associated to antibiotic therapy showed effective on the patient's treatment.
authors.affiliation: *Oral and Maxillofacial Surgery of Batista Memorial Hospital †Oral and Maxillofacial Surgery of Doctor José Frota Institute ‡Oral and Maxillofacial Surgery of Doctor José Frota Institute §Stomatology and Oral and Maxillofacial Surgery of Federal University of Ceará dental school-UFC, Fortaleza, Ceará, Brazil.
authors.forename: Ney Robson Bezerra
authors.initials: NR
authors.lastname: Ribeiro
authors.forename: Leonardo de Freitas
authors.initials: Lde F
authors.lastname: Silva
authors.forename: Diego Matos
authors.initials: DM
authors.lastname: Santana
authors.forename: Renato Luiz Maia
authors.initials: RL
authors.lastname: Nogueira
mesh_terms: D000284:Administration, Oral; D000368:Aged; D019386:Alendronate / Q000008:administration & dosage / Q000009:adverse effects*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use; D059266:Bisphosphonate-Associated Osteonecrosis of the Jaw / Q000209:etiology*; D050071:Bone Density Conservation Agents / Q000008:administration & dosage / Q000009:adverse effects*; D002710:Chlorhexidine / Q000627:therapeutic use; D002981:Clindamycin / Q000627:therapeutic use; D003646:Debridement / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008336:Mandibular Diseases / Q000139:chemically induced*; D009067:Mouthwashes / Q000627:therapeutic use; D015663:Osteoporosis, Postmenopausal / Q000188:drug therapy; D014081:Tooth Extraction / Q000009:adverse effects*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D000891:Anti-Infective Agents, Local; D050071:Bone Density Conservation Agents; D009067:Mouthwashes; D002981:Clindamycin; D002710:Chlorhexidine; D019386:Alendronate