Author/Authors :
Qaisi, Mohammed Oral-Head & Neck Oncology Microvascular Surgery - Division of Oral & Maxillofacial Surgery and Division of Otolaryngology - Jr. Hospital of Cook County, Chicago, USA , Hargett, Jamie University of Mississippi Medical Center, Jackson, MS, USA , Loeb, Matthew Advanced General Dentistry - University of Mississippi Medical Center, Jackson, MS, USA , Brown, Jeffrey Department of Oral & Maxillofacial Surgery - University of Mississippi Medical Center, Jackson, MS, USA , Caloss, Ronald Department of Oral-Maxillofacial Surgery & Pathology - University of Mississippi Medical Center, Jackson, MS, USA
Abstract :
Bisphosphonates have been used for years in the treatment of patients with distant bony metastasis and in the prevention of
osteoporosis. One of main side effects of these medications is the development of bisphosphonate related osteonecrosis of the
jaw (BRONJ) in a small subset of patients. A new class of medications with a shorter half-life, known as receptor activator of
nuclear factor kappa-B ligand (RANKL) inhibitors, was introduced with the hopes of avoiding this side effect. However, reports
of osteonecrosis of the jaw after the use of RANKL inhibitors have also been documented. We report on a patient who developed
a life threatening osteonecrosis of the jaw with sepsis shortly after switching from a bisphosphonate to a RANKL inhibitor for
osteoporosis treatment. This patient developed several soft tissue defects including spontaneous necrosis of the soft palate. To our
knowledge this is the first time this presentation has been described.
