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Dr. Steven E. Smullin (Oral and Maxillofacial Surgery): A 65-year-old woman was seen in the oral surgery clinic of this hospital because of a nonhealing ulcer of the mandible.
Three years earlier, the patient had been referred to the oral and maxillofacial surgery clinic for evaluation and extraction of three teeth: the mandibular right cuspid and first bicuspid and the mandibular left second bicuspid. Dental extractions were performed on an outpatient basis with local anesthesia. The right mandibular teeth were extracted nonsurgically; the mandibular left second bicuspid required a surgical extraction with flap elevation and bone removal. At a postoperative
Differential Diagnosis
Bisphosphonate-Related Osteonecrosis of the Jaw
Dr. Thomas B. Dodson's Diagnosis
Pathological Discussion
Discussion of Management
Use of Bisphosphonates in Multiple Myeloma
Management of Bisphosphonate-Related Osteonecrosis
Anatomical Diagnosis
Source Information
From the Departments of Oral and Maxillofacial Surgery (T.B.D.), Oncology (N.S.R.), Radiology (P.A.C.), and Pathology (A.E.R.), Massachusetts General Hospital; the Department of Radiology, Massachusetts Eye and Ear Infirmary (P.A.C.); the Department of Oral and Maxillofacial Surgery, Harvard School of Dental Medicine (T.B.D.); and the Departments of Oncology (N.S.R.), Radiology (P.A.C.), and Pathology (A.E.R.), Harvard Medical School.
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