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Medication-related osteonecrosis of the jaw in an older patient with multiple myeloma

Larissa Couto de Freitas1, Vanessa Silvestre de Aquino Silva1, Marta Miyazawa1

  • 1School of Dentistry, Federal University of Alfenas, Alfenas, Minas Gerais, Brazil.

Gerodontology
|February 28, 2025
PubMed
Abstract

Insights

This case study highlights medication-related osteonecrosis of the jaw (MRONJ) in a multiple myeloma patient treated with bisphosphonates. Successful management involved antibiotics and surgery, emphasizing collaborative care to prevent MRONJ.

Area of Science:

  • Oncology
  • Oral Surgery
  • Pharmacology

Background:

  • Multiple myeloma (MM) treatment frequently involves bisphosphonates (BPs).
  • Bisphosphonates carry risks including renal insufficiency and medication-related osteonecrosis of the jaw (MRONJ).

Observation:

  • A 67-year-old female with MM receiving intravenous pamidronate developed MRONJ post-tooth extraction.
  • The patient presented with symptoms of MRONJ following dental surgery.

Findings:

  • MRONJ was successfully treated with clindamycin, surgical debridement, and sequestrum removal.
  • After three years, the patient remained asymptomatic with no radiographic signs of MRONJ recurrence.

Implications:

  • Managing patients on antiresorptive therapy undergoing dental procedures is complex.
  • Interprofessional collaboration between general practitioners, oncologists, and hematologists is crucial for optimal MRONJ risk reduction and patient care.
Keywords:
bisphosphonatesmedication‐related osteonecrosis of the jawmultiple myeloma

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