Medication-induced osteonecrosis of the maxilla, potentiated by fungical infection: Case report

Abstract

Osteonecrosis of the jaws induced using bisphosphonates refers to a condition characterized by the exposure of necrotic bone, usually in the face region and commonly originating from trauma. Osteonecrosis induced by bisphosphonates has its highest prevalence in the mandible and may be initially manifested by ulcerations in the oral mucosa, which expose the underlying bone due to its poor vascularization and the use of bisphosphonates. Bisphosphonates are indicated for the treatment of several comorbidities, such as malignant tumors, bone metastases, osteoporosis. Actinomycosis is rarely a pathological concern due to the low virulence of the organism, but it can manifest itself when associated with other pathologies such as osteonecrosis. The clinical case presents a patient who made prolonged use of bisphosphonates associated with low-intensity trauma evolving to maxillary osteonecrosis potentiated by actnomyses. This article aims to demonstrate the connection between actinomycosis and chronic osteonecrosis and the importance of correct diagnosis for correct treatment.