Table 1:

Patient data

PatientAge, yearsSexUnderlying ConditionPresentationLocationBisphosphonateBiopsyManagement
165FMultiple myelomaNonhealing extraction socket/necrotic boneLeft maxillaZoledronateNecrotic boneCurettage, antibiotics, hyperbaric oxygen therapy
267FMetastatic breast cancerPain; nonhealing extraction socketRight posterior mandiblePamidronate changed to zoledronateNot doneAnalgesia; antibiotics
360FMetastatic breast cancerNonhealing extraction site; later complicated by infection and fistula formationLeft posterior mandible, third molarPamidronateChronic osteomyelitisCurettage; antibiotic therapy
477FMultiple myelomaMultifocal exposed boneBilateral body and symphysis of mandiblePamidronate changed to zoledronateOsteonecrosis, extensive bacterial and inflammatory cell infiltration (Fig 5C)Mouth wash, antibiotics, surgical debridement
564MMultiple myelomaChronic nasal infection/sinusitis; painCentral maxillaClodronate and pamidronate in the pastNot doneLong-term antibiotics
661MMetastatic prostate cancerPainful bone exposure; subsequent loosening of teeth and spontaneous sequestration of the left mandibleBilateral mandibular bodiesZoledronateNot doneMouth rinses, antibiotics; filing of sharp bone spicule; removal of sequestra; extraction of tooth
775FMetastatic breast cancerInfection, subcutaneous fistula; painful bone exposureInitially anterior mandible, subsequently bilateral mandibular bodiesZoledronateActive osteomyelitisIV antibiotics, then oral; marginal mandibulectomy
852FMetastatic breast cancerNonhealing extraction socket; painful bone exposureFirst left mandibular molarZoledronateSequestrum and chronically inflamed mucosaMouth rinses; antibiotics; analgesia; debridement of extraction site
979MMetastatic prostate cancerInfection; painRight posterior mandibleAlendronate changed to an injectable bisphosphonateNot doneAntibiotics; mouth rinses
1054FMetastatic breast cancerPainAnterior mandibleZoledronateNot doneNone
1182FOsteoporosisNonhealing extraction socketLeft maxillaAlendronateNecrotic bone coated with bacterial coloniesAntibiotics, debridement
1270FOsteoporosisNonhealing extraction socketRight posterior mandibleAlendronateNot doneCurettage, antibiotics
1385FOsteoporosisNonhealing extraction socket; infectionLeft posterior mandibleAlendronateNecrotic bone coated with bacteriaCurettage, antibiotics
1474MOsteoporosisInfected exposed bone; painRight posterior body of mandibleAlendronateNot doneAntibiotics, mouth washes, incision and drainage
1554FMetastatic breast cancerPain, swelling, exposed bone, loose teeth; palatonasal and palatoantral fistula, sinusitisMaxilla, bilateralZoledronate, alendronate, and pamidronate in the pastOsteonecrosis and acute osteomyelitis, abundant bacteria associated with bone infiltrationMultiple dental extractions, bilateral subtotal maxillectomy; antibiotics
  • Note:—M indicates male; F, female.