Temporomandibular joint chondrosarcoma: Case report.

Tumours of the temporomandibular joint (TMJ) often mimic common conditions of the TMJ, such as TMJ dysfunction syndrome, leading to a delay in the diagnosis. Chondrosarcoma of the TMJ is a rare tumour, with only 18 cases described in the literature. The initial surgical attempt at removal is of important, as aggressive excision offers the best chance for successful treatment. Chondrosarcoma present at the surgical resection margins has a poor prognosis. We present a case of chondrosarcoma of the right TMJ. In our case, combined diagnostic techniques consisting of a panoramic radiograph, computed tomography (CT) and magnetic resonance imaging (MRI) made an accurate preoperative assessment possible and significantly influenced the treatment provided.

Bisphosphonate-related osteonecrosis of the jaw in patients with multiple myeloma.

PURPOSE: To review the main clinical-radiographic, therapeutic, and preventive aspects of osteonecrosis related to intravenous bisphosphonate therapy in patients with multiple myeloma. MATERIALS AND METHODS: Between 2005 and 2006, we studied four patients with previous diagnosis of multiple myeloma treated with intravenous zoledronic acid, presenting nonhealing extraction sockets and intraoral exposed bone. We assessed the location of lesions, the relation with previous history of dento-alveolar surgery procedures, the clinical features, the treatments carried out, and the outcomes achieved. RESULTS: All the patients were treated with chlorhexidine mouthwashes and oral amoxycillin-clavulanic acid for long periods of time. Two patients did not respond to the conservative management and needed surgical bone debridement. CONCLUSIONS: Dental extractions seem to contribute the development of osteonecrosis of the jaw in patients with multiple myeloma treated with intravenous bisphosphonate therapy. Whereas the pathologic mechanisms are not known, these patients should undergo frequent check-ups before, during, and after bisphosphonate therapy. The management must be symptomatic and palliative, including systemic antibiotics, control of pain, and chlorhexidine mouthwashes during long periods of time.

Bisphosphonate-related osteonecrosis of the jaw in patients with multiple myeloma

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Purpose: To review the main clinical-radiographic, therapeutic, and preventive aspects of osteonecrosis related to intravenous bisphosphonate therapy in patients with multiple myeloma.Materials and methods: Between 2005 and 2006, we studied four patients with previous diagnosis of multiple myelomatreated with intravenous zoledronic acid, presenting nonhealing extraction sockets and intraoral exposed bone. We assessed the location of lesions, the relation with previous history of dento-alveolar surgery procedures, the clinical features, the treatments carried out, and the outcomes achieved.Results: All the patients were treated with chlorhexidine mouthwashes and oral amoxycilin-clavulanic acid for long periods of time. Two patients did not respond to the conservative management and needed surgical bone debridement.Conclusions: Dental extractions seem to contribute the development of osteonecrosis of the jaw in patients withmultiple myeloma treated with intravenous bisphosphonate therapy. Whereas the pathologic mechanisms are notknown, these patients should undergo frequent check-ups before, during, and after bisphosphonate therapy. Themanagement must be symptomatic and palliative, including systemic antibiotics, control of pain, and chlorhexidinemouthwashes during long periods of time (AU)