Management of bisphosphonate related osteonecrosis of jaw (BRONJ) with topical drug delivary using custom made tray: A case report

Abstract

Bisphosphonates (BPs) are effective inhibitors of osteoclast mediated bone resorption and thus frequently used in patients with multiple myeloma, osteoporosis, metabolic bone diseases and metastatic bone cancer. Inspite of its benefits, patients are at increased risk of developingBRONJ which adversely affects their quality of life. BPs induced inhibition of osteoclast function may cause defect in jaw bone physiologic remodeling which along with its antiangiogenic properties may predispose the patient to osteonecrosis of jaw. Here, we present a case in which patient with BRONJ who is terminally ill and only conservative management can be given responded favourably to topical medication using custom trays. Keywords: Bronj, Bisphosphonates, Zolendronate, Osteonecrosis, Custom made tray.