[Oradlist] Osteoporotic mandible

[Koenig, Lisa]

Dear colleagues, I received the attached today from an oral surgeon colleague.  He writes:

"70 some y/o female; on Prednisone 15mg (dermatomyositis) for years and Fosamax for more than 5  years.  C/O jaw pain; responds to oral antibiotics. Blood cultures negative, Body scan shows no other defects; Multiple myeloma blood work is negative; biopsy by another OS is non specific (some question about adequacy of specimen).

Clinical exam shows two areas of mucosal ulceration and apparently, necrotic bone (lingual tori areas). Teeth are firm.

Pan does not look typical of BIONJ, at least to me."


It would seem to me that the mucosal ulceration and apparent necrotic bone are suggestive of BRONJ.  I have seen a  multiple myeloma case that looked similar to this but apparently that has been ruled out.  I would appreciate your comments.
Thanks, Lisa

Lisa J. Koenig BChD, DDS, MS
Program Director, Oral Medicine and Oral Radiology
Marquette University School of Dentistry, Rm: 370
PO Box 1881
Milwaukee, WI 53201-1881
Tel: (414) 288-5675
Fax: (414) 288-6081
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