Management strategy of a periodontist in treating a patient with bisphosphonate-related jaw osteonecrosis: a clinical case

Abstract

Relevance. Drug-related osteonecrosis of the jaws is a serious complication of antiresorptive therapy in patients with cancer, systemic osteoporosis, and Paget's disease, significantly impacting the patients' quality of life.Clinical case description. This article analyzes the progressive oral manifestations of a complication of antiresorptive therapy—drug-related osteonecrosis of the jaws—in a patient with breast cancer. The osteonecrosis was characterized by an exposed bone area in the upper jaw, periodontal inflammation, and a malodorous discharge from the mouth. The paper details the appropriate management strategy by the periodontist, tailored to the patient's individual characteristics.Conclusion. Early initiation of a conservative, comprehensive, and gentle treatment regimen can reduce inflammation in periodontal tissues, including the necrotic area, thus avoiding the need for high-risk surgical procedures.