New bone formation in the mandibular corpus after mucosal healing in a patient with medication related osteonecrosis of the jaw after treatment by bisphosphonates for multiple myeloma: a case report and pictorial review

Objective: First cases of osteonecrosis of the jaw in patient exposed to bisphosphonates were presented in 2003. Bisphosphonates related osteonecrosis of the jaw (BRONJ) was further extended to medication-related osteonecrosis of the jaw (MRONJ) to include antiresorptive and anti-angiogenic drugs. Some directives were described for the treatment of this disease in function of its gravity. Treatments of high stage of MRONJ are subject to discussion because of their morbidity. Complete healing is difficult to reach and often needs combination of invasive and non-invasive treatment. Case report: We report and illustrate a clinical case of new bone formation after MRONJ on pamidronate and zoledronate treatment for multiple myeloma. The treatment of choice was sequestrectomy and conservative treatment. Discussion: The consensus to reach a complete healing after MRONJ is not already known. More studies are needed.