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The Establishment of a Murine Mandibular Molar Extraction Socket Healing Model

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Published on: January 13, 2023

[Delayed wound healing post molar extraction].

R H Schepers¹, J G A M De Visscher

¹Uit de afdeling Mondziekten, Kaak- en Aangezichtschirurgie van het Medisch Centrum Leeuwarden.

Nederlands Tijdschrift Voor Tandheelkunde

|March 14, 2009

Summary

This summary is machine-generated.

A painful, non-healing tooth extraction site was initially diagnosed as bisphosphonate-induced osteonecrosis. Further examination revealed the true cause was a non-Hodgkin lymphoma, highlighting the importance of thorough diagnosis.

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Area of Science:

Oral surgery
Oncology
Pathology

Background:

Bisphosphonates are commonly prescribed for osteoporosis and other bone conditions.
Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a known complication.
Maxillary osteonecrosis can present with non-healing extraction sites and pain.

Observation:

A patient using oral bisphosphonates for 3 years presented with a painful, non-healing extraction site of the second left maxillary molar.
Initial conservative treatment for suspected bisphosphonate-induced osteonecrosis was ineffective, with increased pain and decreased healing after one month.
A biopsy was performed due to persistent symptoms and lack of improvement.

Findings:

Histopathologic examination of the biopsy revealed a non-Hodgkin lymphoma.
The clinical presentation mimicked bisphosphonate-induced osteonecrosis but was ultimately caused by an underlying malignancy.

Implications:

This case underscores the critical need for comprehensive differential diagnosis in patients with oral lesions, especially those on bisphosphonate therapy.
Early and accurate diagnosis is crucial for effective treatment and improved patient outcomes.
Oncologic conditions should be considered in the differential diagnosis of refractory oral lesions, even when bisphosphonate-induced osteonecrosis is suspected.