Akademik Veri Yönetim Sistemi
açbid, Antalya, Türkiye, 10 - 14 Mayıs 2023, ss.175-176
Objective: BRONJ is typically a chronic soft tissue wound exposing the underlying jawbone,
that persists over 8 weeks in patients taking bisphosphonates.Contemporary research focuses
on pathogenesis of the disease, various conservative and surgical treatment modalities and
their clinical implications. In this case we aimed to evaluate our management of BRONJ cases
stage2-3.
Case: A 24-year-old male patient applied to our clinic with the complaint of pain in the
mandible. After anamnesis, it was learned that the patient had stage 4 lung cancer.It was
learned that intravenous bisphosphonate medication(he had been using for 7 months).The
patient’s tooth was extracted from the posterior left mandible 1 month ago by an external
center clinic.During the examination, exposed bone and pus flow was observed in that area.
Combined antibiotic amoxicillin-metranidazole was prescribed to suppress the infection.When
the patient came to the examination 3 months later,a decrease in pus flow and an increase in
sequestration were observed and sequestretomy was performed.PRP was applied to the area
after sequestrectomy.When the patient came to the examination after 2 weeks,it was seen that
the complaint of pain decreased and the wound area healed.
Conclusion: In general,a thorough dental examination is recommended,and if necessary dental
treatment is completed before starting bisphosphonates.However, patients were usually late
for referral to oral surgery as most of them had stage II or stage III BRONJ at presentation.At
these stages,after the formation of sequestra,the application of sequestretomy gave positive
results.It has also been observed that applying PRP to the surgical area accelerates the healing
of the wound.