Bisphosphonate therapy and osteonecrosis of the jaw complicated with a temporal abscess in an elderly woman with rheumatoid arthritis: a case report

Abstract

Licia Manzon,1 Evaristo Ettorre,1 Giovanni Viscogliosi,1 Stefano Ippoliti,1 Fabio Filiaci,2 Claudio Ungari,2 Giovanni Fratto,1 Alessandro Agrillo2 1Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences, 2Department of Odontology and Maxillofacial Surgery, “Sapienza” University, Rome, Italy Abstract: Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is an adverse drug reaction described as the progressive destruction and death of bone tissue of the mandible or maxilla, in the course of bisphosphonate therapy. Orally administered bisphosphonates, widely used for the treatment of osteoporosis, are rarely associated with BRONJ. Instead, the risk greatly increases whether the patient is concomitantly taking steroid and/or immunosuppressant agents. The aims of this paper are to briefly discuss the evidence of the associations between bisphosphonate therapy and BRONJ, and the effects of co-occurring factors such as the presence of rheumatoid arthritis, dental surgery, and concomitant corticosteroid therapy. In particular, we present the case of an elderly woman with BRONJ suffering from rheumatoid arthritis, with a recent dental extraction and with a very unusual complication: a temporal abscess, who was successfully treated. Keywords: bisphosphonate-related osteonecrosis of the jaw, BRONJ, adverse reaction, steroidsA Letter to Editor has been received and published for this article

Keywords

• Bisphosphonate-related osteonecrosis of the jaw (BRONJ)
• oral
• steroids
• temporal abscess