Abstract
Bisphosphonates (BPs) inhibit bone resorption and are widely used to treat skeletal complications in patients with the bone metastasis from malignant tumors, osteoporosis, and bone lesions of multiple myeloma. Osteonecrosis of the jaw (ONJ) has been associated with the use of BP. In Japan, zoledronic acid has been used to treat bone lesions of multiple myeloma and bone metastasis from malignant tumors since April 2006. Zoledronic acid has strong bone antiresorptive activity as compared with other BPs such as pamidronate. The number of patients given zoledronic acid and the frequency of ONJ are expected to increase in Japan.We report a patient with ONJ who was given zoledronic acid to prevent bone lesions of multiple myeloma. A 78-year-old man was referred to our hospital to undergo evaluation of bilateral asymptomatic bone exposure of the maxillary molar regions. MR imaging showed a low-signal-density area in the left maxillary molar region. Histopathologically, a biopsy specimen showed sequestration with attachment of bacteria. A final diagnosis of ONJ was made. Conservative follow-up is being continued, and no symptoms have developed.
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