MEDICATION-RELATED OSTEONECROSIS OF THE JAW AFTER A SINGLE DOSE OF DENOSUMAB

Medication-related osteonecrosis of the jaw (MRONJ) is a severe adverse effect of antiresorptive (bisphosphonates and denosumab) and antiangiogenic therapy of oncologic and osteoporotic patients. We report a case of an 85-years-old female patient who developed MRONJ 4 months after a single subcutaneous injection of denosumab therapy (Prolia 60 mg) for osteoporosis. The patient presented painful fistula with purulent secretion in the posterior region of the mandible, with no bone exposure, showing a small bony sequestrum only revealed by computerized tomography. The patient was conservatively managed with amoxicillin 500 mg/potassium clavulanate 125 mg and paracetamol 500 mg/codeine phosphate 7.5 mg. Complete healing was observed after 21 days of treatment, and no surgical intervention was required. The patient did not present new events after 1 year of follow-up, with no use of removable denture.