Bisphosphonate are a class of drugs derived from pyrophosphate which are endogenous regulators of bone mineralization. Bisphosphonates osteonecrosis is an infectious and necrotizing progressive disesase with a low tendency to process of healing. The Authors describe a clinical case of bisphosphonates osteonecrosis of the mandible with 3.8 in total bony inclusion, deep located at the edge of the mandibular angle. Considering the nature of associated pathology, the trans-oral approach has been avoided in order to prevent infectious complications. The endoral approach would have also resulted in significant bony destruction, increasing the risk of pathologic fracture of the mandible. The external trans-cutaneus route, allowed the direct extraction of the tooth including the surrounding bone. The jaw strength was maintained by the application of a titanium plate. 12 months after surgery, the patient is asymptomatic and signs of residual disease are not present.
I bifosfonati sono una classe di farmaci derivati da analoghi strutturali del pirofosfato inorganico e hanno la funzione di regolatori endogeni della mineralizzazione ossea. L’Osteonecrosi da Bifosfonati dei Mascellari (OBM) è una patologia infettiva e necrotizzante a carattere progressivo con scarsa tendenza alla guarigione. Gli Autori descrivono un caso clinico di OBM con 3.8 in inclusione ossea profonda, localizzato a livello del bordo dell’angolo mandibolare. In considerazione del tipo di patologia associata è stato evitato l’approccio trans-orale con le relative possibili complicanze di tipo infettivo che avrebbe, inoltre, determinato una distruzione ossea importante tale da aumentare il rischio di frattura patologica della mandibola. L’approccio è stato per via esterna trans-cutanea e ha permesso l’estrazione del dente in inclusione ossea in modo diretto. La solidità mandibolare è stata mantenuta con l’applicazione preventiva di una placca in titanio. A distanza di 12 mesi dall’intervento la paziente è asintomatica e non presenta alcun segno di patologia residua
Bisphosphonates osteonecrosis of the mandible with 3.8 in total bony inclusion: a clinical case [Osteonecrosi da bifosfonati della mandibola con disodontiasi del 3.8.]
Galie' M;
2011
Abstract
Bisphosphonate are a class of drugs derived from pyrophosphate which are endogenous regulators of bone mineralization. Bisphosphonates osteonecrosis is an infectious and necrotizing progressive disesase with a low tendency to process of healing. The Authors describe a clinical case of bisphosphonates osteonecrosis of the mandible with 3.8 in total bony inclusion, deep located at the edge of the mandibular angle. Considering the nature of associated pathology, the trans-oral approach has been avoided in order to prevent infectious complications. The endoral approach would have also resulted in significant bony destruction, increasing the risk of pathologic fracture of the mandible. The external trans-cutaneus route, allowed the direct extraction of the tooth including the surrounding bone. The jaw strength was maintained by the application of a titanium plate. 12 months after surgery, the patient is asymptomatic and signs of residual disease are not present.I documenti in SFERA sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
