Mandibular fracture in medication-associated osteonecrosis following infliximab therapy: A case report.

Autor: Kolodziejwski WT; Multiprofessional Residency Program in Oncology and Hematology, Complexo Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil., Rosa CAL; Multiprofessional Residency Program in Oncology and Hematology, Complexo Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil., Guimarães AM; Multiprofessional Residency Program in Oncology and Hematology, Complexo Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil., da Silva PQM; Multiprofessional Residency Program in Oncology and Hematology, Complexo Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil., de Araujo MR; Multiprofessional Residency Program in Oncology and Hematology, Complexo Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil.; Post Graduate Program in Dentistry, Department of Stomatology, Universidade Federal do Paraná, Curitiba, Brazil.
Jazyk: angličtina
Zdroj: Special care in dentistry : official publication of the American Association of Hospital Dentists, the Academy of Dentistry for the Handicapped, and the American Society for Geriatric Dentistry [Spec Care Dentist] 2024 Jul 03. Date of Electronic Publication: 2024 Jul 03.
DOI: 10.1111/scd.13035
Abstrakt: Introduction: Medication-associated osteonecrosis of the jaws (MRONJ) is characterized by the presence of exposed bone or an intraoral or extraoral fistula in the maxillofacial region in patients with a history of treatment with anti-resorptive and anti-angiogenic drugs, such as monoclonal antibodies, and without a history of radiotherapy or metastatic diseases in the area.
Objective: The aim of this study is to report a case of a pathological mandibular fracture in an area of MRONJ in a patient diagnosed with Crohn's disease treated with infliximab.
Case Report: A 53-year-old male patient, an active smoker for 35 years, diagnosed with Crohn's disease, undergoing intravenous administration of infliximab 300 mg for 1 year and 3 months, with no previous history of anti-angiogenic or anti-resorptive medication, presenting with an extraoral fistula in the submandibular region for 4 months, with painful symptoms, diagnosed as MRONJ. He was initially treated conservatively, using antimicrobial photodynamic therapy (aPDT), antibiotic therapy, and the PENTO protocol. However, the patient evolved with a pathological fracture in the mandibular parasymphysis, requiring surgical reconstruction.
Final Considerations: Pathological fracture of the mandible is a complication of MRONJ that compromises the patient's quality of life. The management of patients with MRONJ is complex and challenging.
(© 2024 Special Care Dentistry Association and Wiley Periodicals LLC.)
Databáze: MEDLINE
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