Obermeier Katharina Theresa, Frank Thomas, Hildebrandt Tim, Otto Sven, Poxleitner Philipp, Dewenter Ina
Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery, Ludwig-Maximilians-University (LMU), Lindwurmstrasse 2a, 80337 Munich, Germany.
J Pers Med. 2025 Apr 1;15(4):138. doi: 10.3390/jpm15040138.
Obinutuzumab is a glycoengineered type II anti-CD-20 monoclonal antibody, which can be applied as immunotherapy in patients with follicular lymphoma. To our knowledge, this is the first reported case in the literature describing osteonecrosis of the jaw associated with CD20 monoclonal antibody therapy. The following case report describes a 39-year-old female patient under maintaining therapy with Obinutuzumab developing osteonecrosis of the jaw after tooth extraction. The necrotic area was located in the right mandible and was rated as a stage II osteonecrosis. This case report should draw attention to the importance of dental follow-ups during aftercare of patients with Non-Hodgkin's Lymphoma as well as to the relevant precautions for performing tooth extractions in such patients. As Obinutuzumab seems to be a contributing factor in the development of MRONJ, special attention has to be drawn to tooth extractions in such patients, which should only be performed with perioperative antibiosis, the least amount of trauma possible, always including the smoothening of sharp residual bone segments and a saliva-proof wound closure, as well as constant dental follow-ups.
奥滨尤妥珠单抗是一种糖基化工程改造的II型抗CD - 20单克隆抗体，可用于滤泡性淋巴瘤患者的免疫治疗。据我们所知，这是文献中首次报道的与CD20单克隆抗体治疗相关的颌骨坏死病例。以下病例报告描述了一名39岁女性患者，在接受奥滨尤妥珠单抗维持治疗期间拔牙后发生颌骨坏死。坏死区域位于右下颌骨，被评定为II期骨坏死。该病例报告应引起人们对非霍奇金淋巴瘤患者术后牙科随访的重要性以及此类患者拔牙相关预防措施的关注。由于奥滨尤妥珠单抗似乎是药物相关颌骨坏死发生的一个促成因素，对此类患者的拔牙必须给予特别关注，拔牙时应仅在围手术期使用抗生素，尽可能减少创伤，始终包括打磨尖锐的残留骨段和进行防唾液的伤口闭合，以及持续的牙科随访。
