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Bisphosphonate therapy and osteonecrosis of the jaw complicated with a temporal abscess in an elderly woman with rheumatoid arthritis: a case report

Authors Manzon L, Ettorre E, Viscogliosi G, Ippoliti S, Filiaci F, Ungari C, Fratto G, Agrillo A

Received 14 May 2014

Accepted for publication 14 June 2014

Published 25 August 2014 Volume 2014:9 Pages 1409—1413

DOI https://doi.org/10.2147/CIA.S67726

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 4


Licia Manzon,1 Evaristo Ettorre,1 Giovanni Viscogliosi,1 Stefano Ippoliti,1 Fabio Filiaci,2 Claudio Ungari,2 Giovanni Fratto,1 Alessandro Agrillo2

1Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences, 2Department of Odontology and Maxillofacial Surgery, “Sapienza” University, Rome, Italy

Abstract: Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is an adverse drug reaction described as the progressive destruction and death of bone tissue of the mandible or maxilla, in the course of bisphosphonate therapy. Orally administered bisphosphonates, widely used for the treatment of osteoporosis, are rarely associated with BRONJ. Instead, the risk greatly increases whether the patient is concomitantly taking steroid and/or immunosuppressant agents. The aims of this paper are to briefly discuss the evidence of the associations between bisphosphonate therapy and BRONJ, and the effects of co-occurring factors such as the presence of rheumatoid arthritis, dental surgery, and concomitant corticosteroid therapy. In particular, we present the case of an elderly woman with BRONJ suffering from rheumatoid arthritis, with a recent dental extraction and with a very unusual complication: a temporal abscess, who was successfully treated.

Keywords: bisphosphonate-related osteonecrosis of the jaw, BRONJ, adverse reaction, steroids


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