Abstract

GARCIA GARCIA, Blas; DEAN FERRER, Alicia; DIAZ JIMENEZ, Nelida  and  ALAMILLOS GRANADOS, Francisco Jesús. Osteonecrosis of the jaw associated with denosumab in a patient with osteoporisis. Rev Esp Cirug Oral y Maxilofac [online]. 2015, vol.37, n.3, pp.148-152. ISSN 2173-9161.  https://dx.doi.org/10.1016/j.maxilo.2014.02.003.

Since the introduction of drugs acting on bone remodeling, numerous cases of drug-induced osteonecrosis of the jaw (ONJ) have been reported. Until recently these cases were exclusively associated with the administration of bisphosphonates. With the introduction of new antiresorptive agents such as denosumab, several cases of ONJ associated with its treatment have been recently reported. The case is presented of an 84 year-old osteoporotic female patient who developed mandibular osteochemonecrosis after the placement of 6 implants five months after the administration of denosumab. A panoramic radiograph and CT, showed mandibular crestal bone loss and peri-implant exposure. Conservative treatment with antibiotics and discontinuing denosumab, and starting treatment with teriparatide, decreased the necrotic bone infection and new bone remodeling could be observed. The pathogenesis of denosumab-induced ONJ is not clearly defined, but it seems that the success rate in healing after drug discontinuation is higher than in bisphosphonates-induced ONJ.

Keywords : Denosumab; Osteonecrosis; Osteoporosis; Jaws.

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