DOI:

10.37988/1811-153X_2023_2_86

Features of management of patients with osteonecrosis of the jaw caused by taking bisphosphonates: a clinical case

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Authors

  • 1 Tver State Medical University, 170100, Tver, Russia
  • 2 Mechnikov North-West State Medical University, 191015, Saint-Petersburg, Russia

Abstract

Chronic osteonecrosis is a pathological process in the jaw bones affecting all its elements. This pathology has many etiological factors, one of which is the intake of drugs belonging to the group of bisphosphonates. Their use is associated with the treatment of a number of oncological diseases and is part of a comprehensive therapy that affects bone metabolism. Faced with such a condition, a dentist should make an accurate diagnosis and plan an adequate comprehensive treatment. Objective: to estimate treatment efficacy and to follow the dynamics of clinical course of osteonecrosis of the lower jaw caused by zoledronic acid intake.
Materials and methods.
We describe the peculiarities of patient treatment, in whom osteonecrosis of the lower jaw on the left side was revealed amidst treatment of malignant neoplasm of the thyroid gland by zoledronic acid. X-ray diagnostics, clinical and biochemical blood tests, local and general medicamentous treatment, local ultraviolet ozone therapy, surgical treatment with erbium laser were carried out. The patient follow-up was from 2018 to 2022.
Results.
Tooth extraction surgery triggered the process of osteonecrosis of the lower jaw, with the accession of an oral infection. Both for diagnosis and for dynamic monitoring of the course of osteonecrosis and treatment planning, computed tomography may be a promising method of X-ray examination. An integrated approach to treatment using ozone therapy and high-intensity erbium laser makes it possible to achieve process stabilization and has a predictably favorable prognostic potential.
Conclusion.
The presented experience will help both practicing doctors and researchers in the field of dentistry to understand the pathogenesis and clinical picture, to develop new methods of treatment and prevention of this pathology.

Key words:

bisphosphonate osteonecrosis, bisphosphonates, zoledronic acid, osteonecrosis of the jaw, treatment, diagnosis

For Citation

[1]
Moiseev D.A., Shvetsov D.S., Losyeva A., Tcelykovskaia O.B., Ustimenko A.Yu., Girfanov A.R. Features of management of patients with osteonecrosis of the jaw caused by taking bisphosphonates: a clinical case. Clinical Dentistry (Russia).  2023; 26 (2): 86—92. DOI: 10.37988/1811-153X_2023_2_86

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Received

March 3, 2023

Accepted

May 23, 2023

Published on

July 6, 2023