Medication-related osteonecrosis of the jaw (MRONJ) treated with piezosurgery – case report and review of literature

Abstract

Medication-related osteonecrosis of the jaw (MRONJ) is a recently described adverse effect associated with anti-resorptive and anti-angiogenic agents. The objective of this article is to report a case of MRONJ treated surgically using a ultrasonic device (piezosurgery). Case report: A 66 year-old female being treated with a bisphosphonate (alendronate) for more than 4 years developed MRONJ of the lower jaw after dental extraction. Two debridement attempts of necrotic bone tissue and primary intention closure with conventional techniques were performed, without success. Finally, treatment with antibiotics and piezosurgery leaded to disease remission. Conclusion: Even though more studies are needed to create a protocol that might include this therapeutic modality, specially when there was no success with conservative management or conventional treatment techniques, the use of ultrasonic devices is an option for treatment of MRONJ.