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Less-Invasive Technique for Non-stabilized Mandibular Fracture in Mouse Models
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Elderly man with mandibular pain.

Kevin C Lee1, Bridget M Ferguson1

  • 1Division of Oral and Maxillofacial Surgery, NewYork-Presbyterian/Columbia University Medical Center, New York City, New York, USA.

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|January 13, 2019
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Summary
This summary is machine-generated.

A patient with multiple myeloma on pamidronate developed mandibular pain and ulceration. This case highlights medication-related osteonecrosis of the jaw (MRONJ) as a critical differential diagnosis.

Keywords:
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Area of Science:

  • Oral and Maxillofacial Surgery
  • Oncology
  • Pharmacology

Background:

  • A 77-year-old male with a history of multiple myeloma, treated with pamidronate, presented with symptoms suggestive of a severe oral pathology.
  • The patient exhibited fever, purulent drainage, and right mandibular pain, alongside anesthesia of the lower lip and chin.

Observation:

  • Clinical examination revealed a 15 mm ulceration on the lingual aspect of the mandible associated with tooth #31, which had grade 2 mobility.
  • A maxillofacial CT scan demonstrated significant osseous destruction of the right mandibular body.

Findings:

  • The clinical presentation and imaging findings are highly suggestive of medication-related osteonecrosis of the jaw (MRONJ).
  • Differential diagnoses considered included odontogenic abscess, benign fibro-osseous lesion, and metastatic malignancy.

Implications:

  • This case underscores the importance of considering MRONJ in patients with multiple myeloma undergoing bisphosphonate therapy who present with mandibular pathology.
  • Early recognition and appropriate management are crucial to prevent complications and improve patient outcomes in MRONJ cases.