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[Avascular mandibular necrosis].

M Magremanne1, L Dufrasne, C Vervaet

  • 1Service de stomatologie et chirurgie maxillofaciale, CUB, hôpital Erasme, université libre de Bruxelles (ULB), 808, route de Lennik, 1070 Bruxelles, Belgique. michele.magremanne@hap.be

Revue De Stomatologie Et De Chirurgie Maxillo-Faciale
|September 29, 2007
PubMed
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Jaw osteonecrosis, a rare condition, can occur without typical risk factors like radiation. This case highlights bone infarction due to underlying vascular issues, emphasizing the need for broader diagnostic considerations.

Area of Science:

  • Oral and Maxillofacial Surgery
  • Vascular Surgery
  • Pathology

Background:

  • Jaw osteonecrosis is typically linked to radiotherapy, but is otherwise rare.
  • This case presents an unusual etiology for jawbone necrosis.

Observation:

  • A 52-year-old patient developed exposed mandible and bone loss post-tooth extraction.
  • The patient had a history of cardiovascular disease, including endarterectomy and bypass surgery, but no radiotherapy or bisphosphonate use.
  • Diagnosis was bone infarction superimposed on chronic osteomyelitis.

Findings:

  • Bone infarction, often caused by blood coagulation disorders, can manifest as jaw osteonecrosis.
  • Cardiovascular disease and related interventions may represent an underrecognized risk factor for jawbone necrosis.

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  • Symptoms of jaw necrosis are often non-specific, with imaging being diagnostically useful only late in the disease progression.

    • Implications:

    • Highlights the importance of considering vascular etiologies in jaw osteonecrosis, especially in patients with cardiovascular risk factors.
    • Suggests that comprehensive patient history, including vascular interventions, is crucial for diagnosing rare cases of jaw osteonecrosis.
    • Underscores the limited efficacy of current treatments for jaw osteonecrosis, necessitating further research into underlying mechanisms and therapeutic strategies.