Radical surgical treatment of bisphosphonate related osteonecrosis of the jaw

We describe a case of a 64-year-old female diagnosed with multiple myeloma in 2001. She was treated with pamidronate and subsequently zolodronic acid before developing spontaneous bisphosphonate related osteonecrosis (BRONJ) of the left maxilla in December 2008. Over the next two years the BRONJ was treated conservatively but gradually became more symptomatic. About three years after her last dose of zolodronic acid with her symptoms increasing, she underwent radical surgical excision of all diseased bone and flap reconstruction. The patient is now six months postoperative and symptom free.