Abstract
Recently, many cases of bisphosphonate-related osteonecrosis of the jaw ( BRONJ ) have been reported. BRONJ is usually caused by invasive dental procedures, such as tooth extraction, advanced periodontal disease and prosthetic trauma.
We report a case of spontaneous osteonecrosis of the maxilla induced by internal use of a bisphosphonate that was successfully managed by surgical treatment. A 77-year-old female visited our department with a chief complaint of swelling of the right maxilla. Oral examination revealed mild swelling and pus discharge at the right upper gum, and radiographic examination showed osteonecrosis. She had taken BP pills for 3 years beginning in 2009 because of osteoporosis. We found that the diagnosis was spontaneous BRONJ on reviewing her medical history. After treatment of antibiotics and local irrigation, we removed the sequestrum. Histopathological examination revealed sequestration with attachment of bacteria. She has been followed for 20 months since surgery and continues to do well.
