Management strategy of a periodontist in treating a patient with bisphosphonate-related jaw osteonecrosis: a clinical case
https://doi.org/10.33925/1683-3759-2024-894
Abstract
Relevance. Drug-related osteonecrosis of the jaws is a serious complication of antiresorptive therapy in patients with cancer, systemic osteoporosis, and Paget's disease, significantly impacting the patients' quality of life.
Clinical case description. This article analyzes the progressive oral manifestations of a complication of antiresorptive therapy—drug-related osteonecrosis of the jaws—in a patient with breast cancer. The osteonecrosis was characterized by an exposed bone area in the upper jaw, periodontal inflammation, and a malodorous discharge from the mouth. The paper details the appropriate management strategy by the periodontist, tailored to the patient's individual characteristics.
Conclusion. Early initiation of a conservative, comprehensive, and gentle treatment regimen can reduce inflammation in periodontal tissues, including the necrotic area, thus avoiding the need for high-risk surgical procedures.
About the Authors
D. D. Teremov
Tver State Medical University
Russian Federation
Russian Federation
Daniil D. Teremov, DDS, PhD-student, Department of Periodontology, Department of Dentistry for Adults, Dental Clinic
Tver
V. A. Rumyantsev
Tver State Medical University
Russian Federation
Russian Federation
Vitaly A. Rumyantsev, DMD, PhD, DSc, Professor, Head of the Department of Periodontology
Tver
References
1. Kaprin AD, Starinskiy VV, Shashzadova AO. Malignant neoplasms in Russia in 2022 (morbidity and mortality). M.: P.A. Herzen Moscow State Medical Research Institute, 2023. p. 252 (In Russ.). https://oms66.ru/uchastnikam-sistemy-oms/dokumenty/13160/?special_version=Y&ysclid=lsj1521ilv853812922
2. Bujko MA, Atrushkevich VG. Osteonecrosis of the jaws as a complication of bisphosphonate therapy in dental practice. Osteoporoz i osteopatii. 2013;16(2):19-21. (In Russ). https://doi.org/10.14341/osteo2013219-21
3. Spevak EM, Tsimbal AN. Bisphosphonate osteonecrosis of the jaws. current state of the problem. Kazanskij medicinskij zhurnal. 2017;98(1):91-95 (In Russ.). Available from: https://cyberleninka.ru/article/n/bisfosfonatnye-osteonekrozy-chelyustey-sovremennoe-sostoyanie-problemy/viewer
4. Vermeer JA, Jansen ID, Marthi M, Coxon FP, McKenna ChE, Sun sh, et al. Jaw bone marrow-derived osteoclast precursors internalize more bisphosphonate than long-bone marrow precursors. Bone. 2013;57(1):242-251. doi: 101016/j.bone.2013.08.007
5. Rumyancev VA, Avakova DR, Blinova AV. Host response modulation in periodontology and implantology: potential of anti-inflammatory, antibacterial therapy and promising dosage forms. Review. Parodontologiya. 2019;24(4):372-377. (In Russ.). doi: 10.33925/1683-3759-2019-24-4-372-377
Supplementary files
Review
For citations:
Teremov DD, Rumyantsev VA. Management strategy of a periodontist in treating a patient with bisphosphonate-related jaw osteonecrosis: a clinical case. Parodontologiya. 2024;29(2):199-205. (In Russ.) https://doi.org/10.33925/1683-3759-2024-894
Views:
361
Email this article 