RESUMO
Introduction: Bisphosphonates consist of a range of drugs used in the treatment of osteopathy or some osteotropic malignancies. Medication-related osteonecrosis of the jaw (MRONJ) is a serious adverse consequence of their use. Conventional treatment is not always effective, so it is necessary to resort to the use of adjuvant therapies. This study aimed to evaluate the effectiveness of the association of surgery, antibiotic therapy and low-level laser (LLL) therapy as a treatment strategy for MRONJ through the presentation of a clinical case. Case Presentation: A 49-year-old female patient presented for the diagnosis and treatment of bone lesions in the maxillae. The patient reported that she had used zoledronate for 1 year. Five years later there were 2 painless bone lesions on both sides of the maxilla, following the extraction of the first upper molars. Clinical, tomographic and histopathologic examination established the diagnosis of MRONJ. The treatment consisted of the curettage of the necrotic bone, antibiotic and thirteen LLL therapy sessions. Integral mucosal healing was observed after a two-month follow-up and no symptoms were detected. The patient was evaluated at 6 and 12 postoperative months without complications. Conclusion: The combination of surgery, antibiotic therapy, and LLL therapy has shown to be effective in the treatment of MRONJ.
RESUMO
Bone reconstruction to reestablish bone width and height is required in case of bone atrophy. A 45-year-old white woman was referred to the oral clinical surgery of Aracatuba Dental School, University Estadual Paulista-UNESP, in 2013 with the main complain of bone exposure at the superior right site of the maxilla after 1-year reconstruction with bone block allograft. Bone block was removed besides the dental implant next to the bone allograft. Complication of bone allograft could jeopardize treatment planning.
