Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2011:2011:568246.
doi: 10.1155/2011/568246. Epub 2011 Jul 2.

Multiple myeloma and bisphosphonate-related osteonecrosis of the mandible associated with dental implants

Luis Junquera  1 , Lorena Gallego, Alejandro Pelaz
Affiliations
Case Reports

Multiple myeloma and bisphosphonate-related osteonecrosis of the mandible associated with dental implants

Luis Junquera et al. Case Rep Dent. 2011.

Abstract

Multiple myeloma (MM) is a malignant plasma cell disorder and more than 30% of patients with this pathology develop osteolytic lesions in the jaw. Either pamidronate or zoledronic acid is recommended in patients with MM who have one or more lytic lesions. However, bisphosphonate-related osteonecrosis of the jaws (BRONJ) has been described as a complication associated with their use. Otherwise, the use of endosseous implants in oral rehabilitation is a well-established procedure, with good long-term success although systemic factors may affect the bone healing around dental implants. We report the first case reported of MM adjacent to a mandibular dental implant in a patient who developed BRONJ in the same area after intravenous zoledronate treatment. We discuss possible pathogeny of this particular and interesting phenomena.

PubMed Disclaimer

Figures

Figure 1
Figure 1
(a) Panoramic radiograph revealing periapical radiolucency in endodontically treated left mandibular premolar, when patient was completely healthy (March 2006). (b) Panoramic radiograph showing dental implants before final restoration. Implants were completely osseointegrated, and no mandibular lesions were observed (September 2006).
Figure 2
Figure 2
(a) Panoramic radiograph showed a large lytic lesion adjacent to the left implant and second left mandibular molar, diagnosed as MM (March 2007). (b) A new panoramic radiograph performed seven months after starting therapy revealed a complete regression of the mandibular lesion, supporting previous diagnosis of mandibular involvement of MM.
Figure 3
Figure 3
An extensive area of necrotic bone (arrow) is exposed adjacent to the left implant with purulent discharge (September 2008).
Figure 4
Figure 4
(a) A panoramic radiography showing only low-diffusion radiolucency around the left implant. (b) Computerized tomography image revealing necrotic bone involving left mandibular implant (September 2008).
Figure 5
Figure 5
(a) Exposed necrotic bone around the left implant after three months of antibiotherapy. (b) Image of the resected specimen of bone sequestrum including left implant.
See this image and copyright information in PMC

References

    1. Rajkumar SV. Multiple myeloma. Current Problems in Cancer. 2009;33(1):7–64. - PMC - PubMed
    1. Kyle RA, Gertz MA, Witzig TE, et al. Review of 1027 patients with newly diagnosed multiple myeloma. Mayo Clinic Proceedings. 2003;78(1):21–33. - PubMed
    1. Segundo AV-L, Falcão MFL, Correia-Lins Filho R, Soares MSM, López J, Küstner EC. Multiple Myeloma with primary manifestation in the mandible: a case report. Medicina Oral, Patologia Oral y Cirugia Bucal. 2008;13(4):232–234. - PubMed
    1. Roodman GD. Skeletal imaging and management of bone disease. Hematology/The Education Program of the American Society of Hematology. American Society of Hematology. Education Program. 2008:313–319. - PubMed
    1. Nowjack-Raymer RE, Sheiham A. Association of edentulism and diet and nutrition in US adults. Journal of Dental Research. 2003;82(2):123–126. - PubMed

Publication types

LinkOut - more resources