Bisphosphonate-treatment of Secondary Chronic Osteomyelitis of the Jaw - a Case Report

Overview

Journal J Surg Case Rep

Publisher Oxford University Press

Specialty General Surgery

Date 2023 May 30

PMID 37251250

Authors

Diana Heimes

Peer W Kammerer

Affiliations

Soon will be listed here.

Abstract

Secondary chronic osteomyelitis (SCO) is caused by bacterial infection leading to progressive jawbone destruction. Antibiotics are used as first-line treatment; surgical therapy is usually extensive and may not provide a cure. Bisphosphonates have been reported to be successful in patients with primary nonbacterial osteomyelitis, and literature indicates promising results in SCO. A 38-year-old patient presented with a progressive mandible-destruction 17 years after wisdom tooth extraction. Several treatment attempts have been unsuccessful. Seeking a second opinion, the patient was then interdisciplinary treated with 90 mg of intravenous pamidronate every four weeks, three times. The patient did not experience side effects presenting a considerable improvement in mouth opening and reporting a dissolvent of signs of pain or infection. The MRI showed edema reduction and decreased contrast uptake. Therefore, bisphosphonate treatment of secondary chronic osteomyelitis of the jaw is a safe and effective option in selected cases after unsuccessful first- and second-line therapy.

References

Kim S, Jang H . Treatment of chronic osteomyelitis in Korea. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001; 92(4):394-8. DOI: 10.1067/moe.2001.117810. View

Girschick H, Finetti M, Orlando F, Schalm S, Insalaco A, Ganser G . The multifaceted presentation of chronic recurrent multifocal osteomyelitis: a series of 486 cases from the Eurofever international registry. Rheumatology (Oxford). 2018; 57(7):1203-1211. DOI: 10.1093/rheumatology/key058. View

Baur D, Altay M, Flores-Hidalgo A, Ort Y, Quereshy F . Chronic osteomyelitis of the mandible: diagnosis and management--an institution's experience over 7 years. J Oral Maxillofac Surg. 2015; 73(4):655-65. DOI: 10.1016/j.joms.2014.10.017. View

Roderick M, Shah R, Finn A, Ramanan A . Efficacy of pamidronate therapy in children with chronic non-bacterial osteitis: disease activity assessment by whole body magnetic resonance imaging. Rheumatology (Oxford). 2014; 53(11):1973-6. DOI: 10.1093/rheumatology/keu226. View

Bamberger D . Diagnosis and treatment of osteomyelitis. Compr Ther. 2000; 26(2):89-95. DOI: 10.1007/s12019-000-0017-6. View

Yang X, Zhou K, Shang W, Song K . Oral administration of alendronate and vitamin D3 for the treatment of chronic non-bacterial osteomyelitis of the jaw. Int J Oral Maxillofac Surg. 2020; 49(12):1595-1598. DOI: 10.1016/j.ijom.2020.06.017. View

Li X, Jia K, An J, Zhang Y . Application of pamidronate disodium for the treatment of diffuse sclerosing osteomyelitis of the mandible: A clinical study. Oral Surg Oral Med Oral Pathol Oral Radiol. 2020; 130(6):616-624. DOI: 10.1016/j.oooo.2020.06.023. View

Zhao Y, Wu E, Oliver M, Cooper A, Basiaga M, Vora S . Consensus Treatment Plans for Chronic Nonbacterial Osteomyelitis Refractory to Nonsteroidal Antiinflammatory Drugs and/or With Active Spinal Lesions. Arthritis Care Res (Hoboken). 2017; 70(8):1228-1237. PMC: 5938153. DOI: 10.1002/acr.23462. View

Rasmussen A, Andersen U, Jorgensen N, Schwarz P . Non-infectious osteomyelitis of the mandible in a young woman: a case report. J Med Case Rep. 2014; 8:44. PMC: 3942813. DOI: 10.1186/1752-1947-8-44. View

10.

van de Meent M, Pichardo S, Appelman-Dijkstra N, van Merkesteyn J . Outcome of different treatments for chronic diffuse sclerosing osteomyelitis of the mandible: a systematic review of published papers. Br J Oral Maxillofac Surg. 2020; 58(4):385-395. DOI: 10.1016/j.bjoms.2020.01.012. View

11.

Buch K, Thuesen A, Brons C, Schwarz P . Chronic Non-bacterial Osteomyelitis: A Review. Calcif Tissue Int. 2018; 104(5):544-553. DOI: 10.1007/s00223-018-0495-0. View

12.

Gonzalez Vazquez E, Martin Pedraz L, Galindo Zavala R, Diaz-Cordoves Rego G, Nunez Cuadros E . Is zoledronate a safe and effective treatment option in chronic nonbacterial osteomyelitis?. An Pediatr (Engl Ed). 2023; 98(2):142-145. DOI: 10.1016/j.anpede.2022.09.011. View

13.

Otto S, Troeltzsch M, Burian E, Mahaini S, Probst F, Pautke C . Ibandronate treatment of diffuse sclerosing osteomyelitis of the mandible: Pain relief and insight into pathogenesis. J Craniomaxillofac Surg. 2015; 43(9):1837-42. DOI: 10.1016/j.jcms.2015.08.028. View

14.

PELL G, SHAFER W, GREGORY G, PING R, SPEAR L . Garré's osteomyelitis of the mandible; report of case. J Oral Surg (Chic). 1955; 13(3):248-52. View

15.

Koryllou A, Mejbri M, Theodoropoulou K, Hofer M, Carlomagno R . Chronic Nonbacterial Osteomyelitis in Children. Children (Basel). 2021; 8(7). PMC: 8303960. DOI: 10.3390/children8070551. View

16.

Barasch A, Cunha-Cruz J, Curro F, Hujoel P, Sung A, Vena D . Risk factors for osteonecrosis of the jaws: a case-control study from the CONDOR dental PBRN. J Dent Res. 2011; 90(4):439-44. PMC: 3144129. DOI: 10.1177/0022034510397196. View

17.

Simm P, Allen R, Zacharin M . Bisphosphonate treatment in chronic recurrent multifocal osteomyelitis. J Pediatr. 2008; 152(4):571-5. DOI: 10.1016/j.jpeds.2007.08.047. View

18.

Allegra A, Innao V, Pulvirenti N, Musolino C . Antiresorptive Agents and Anti-Angiogenesis Drugs in the Development of Osteonecrosis of the Jaw. Tohoku J Exp Med. 2019; 248(1):27-29. DOI: 10.1620/tjem.248.27. View