Long-term use oral bisphosphonate-related osteonecrosis of the jaw without dental extraction in elderly: A case report

AbstractBisphosphonate-associated osteonecrosis of the jaws (BRONJ) may have significant morbidities ranging from minimal discomfort to significant loss of function. We report a case of jaw osteonecrosis resulting from long-term use of bisphosphonate. An 83-year-old female, a long-term user of alendronate, developed jaw osteonecrosis without a history of recent dental extraction. Facial bone computed tomography of the patient showed a destructive osteolytic change of the whole right mandible bone with adjacent soft tissue swelling. After surgical debridement, antibiotic treatment, and discontinuation of alendronate, the patient recovered very well. Although uncommon, BRONJ has gained extensive attentions. Physicians should be aware of the possibility of BRONJ among long-term bisphosphonate users, and a collaboration of clinical pharmacist may be helpful in early detection