Abstract
Objective. The acronym MRONJ has been created in order to identify “Medication-Related Osteonecrosis of the Jaw,” observed after the use of Bisphosphonates, RANK ligand inhibitor, and antiangiogenic medications. Only a case of osteonecrosis of the jaw in a Chron's disease patient following a course of Bisphosphonate and Adalimumab therapy has been recently described, so that it has been supposed that also this medication could promote manifestation of osteonecrosis. Clinical Case. On August, 2014, a 63-year-old female with a history of idiopathic arthritis treated with medical treatment with Adalimumab from 2010 to 2013 presented referring pain in the right mandible. Results. This patient presented with nonexposed osteonecrosis of the jaw after placement, on September, 2010, of four titanium fixtures in the mandible. Conclusions. The authors suggest that the biologic therapy with an anti-TNF-α antibody might promote the manifestation of osteonecrosis and compromise oral healing capacity of the bone.
Highlights
Osteonecrosis of the jaw related to Bisphosphonate (BRONJ) and, recently, Denosumab related osteonecrosis of the jaws (DRONJ) and other medicaments such as antiangiogenic agents (MRONJ) has been described [1,2,3]
Just one case of osteonecrosis of the jaw in a Crohn’s disease patient following a course of Bisphosphonate and Adalimumab therapy has been recently described, so that it has been supposed that this medication could promote manifestation of osteonecrosis [5]; to the best of our knowledge, we describe the first case of osteonecrosis of the jaws that could be consequent to the use of Adalimumab to treat idiopathic arthritis in a woman
Osteonecrosis of the jaw can be usually observed as an adverse reaction to some medications or to radiotherapy: histologically, it appears similar to osteomyelitis, and it is not clear whether infection is the cause or consequence of bone exposure [6,7,8]
Summary
The acronym MRONJ has been created in order to identify “Medication-Related Osteonecrosis of the Jaw,” observed after the use of Bisphosphonates, RANK ligand inhibitor, and antiangiogenic medications. A case of osteonecrosis of the jaw in a Chron’s disease patient following a course of Bisphosphonate and Adalimumab therapy has been recently described, so that it has been supposed that this medication could promote manifestation of osteonecrosis. On August, 2014, a 63year-old female with a history of idiopathic arthritis treated with medical treatment with Adalimumab from 2010 to 2013 presented referring pain in the right mandible. This patient presented with nonexposed osteonecrosis of the jaw after placement, on September, 2010, of four titanium fixtures in the mandible. The authors suggest that the biologic therapy with an anti-TNF-α antibody might promote the manifestation of osteonecrosis and compromise oral healing capacity of the bone
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