Medication Related Osteonecrosis of the Jaw in osteoporosis patient treated with oral bisphosphonates: Case Report

Gürkan Köseoğlu B. , Koltuk M. , Baygın M., Kayhan H., Koçak Berberoğlu H.

Turkish Association of Oral and Maxillofacial Surgery 26th International Scientific Congress, Girne, Cyprus (Kktc), 28 April - 02 May 2019, pp.204-205

  • Publication Type: Conference Paper / Summary Text
  • City: Girne
  • Country: Cyprus (Kktc)
  • Page Numbers: pp.204-205


Bisphosphonates are used to treat osteoporosis or to inhibit bone metastasis in cancer patients and

in Paget’s disease. Use of these medications may cause necrotic areas in jaw bones where intense

remodelation occurs. MRONJ mostly seen in intravenous route, oral route is known as safer. In

following case 75-year-old female patient administered our clinic with complaint of jaw pain and

difficulty in nutrition. She had only osteoporosis with no other disease, but her general situation

wasn’t quite good. It is learnt that she ibandronic acid for 4 years with oral route. In intraoral

examination bone necrosis with purulent leakage was seen at left posterior mandible. Patient take

1.200,00 EU Penicillin V 2 tablets for a day along 2 weeks. In control session there was no notable

recovery, so 500 mg Ornidazole is added to antibiotherapy. End of one month there wasn’t any

recovery but also patient started to have gastrointestinal problems due to antibiotic use for 4

months. For that, antibiotherapy was totally finished and essential oil protocol which includes

myrrh, coconut oil, palmrosa,neem and niaouli oils was initiated. In one week control session,

purulent leakage decreased and mucosal recovery was noted. Patient perform this protocol for 3

month and as a consequence infection pacificated and patient is prevented for any gastrointestinal

complication due to antibiotic use.