Fig 4. A 60-year-old woman (patient 3) with widely metastatic breast cancer treated with pamidronate presented with a nonhealing extraction site in the left posterior mandible.

A, Orthopantomogram demonstrates the nonhealing extraction site in the left posterior mandible (*) and sclerosis of the left ramus and angle of the mandible (arrowhead).

B, Orthopantomogram, 23 months later with intervening curettage, demonstrates disorganized bone formation in the extraction socket of the lower left third molar, progressive sclerosis of the left ramus, and angle of the mandible (arrow) with further encroachment on the left mandibular canal (arrowhead).