Baaroun Vanessa, Elbhar Samantha, Rémond Carole, Guessoum Ines, Rochefort Juliette, Lescaille Geraldine, Boucher Yves, Zanini Marjorie
Department of Oral Surgery, School of Dentistry, Université Paris Cité, Paris, France.
Pitie Salpêtrière Hospital, Paris, France.
Clin Exp Dent Res. 2025 Aug;11(4):e70168. doi: 10.1002/cre2.70168.
Osteonecrosis of the jaws (MRONJ) is a frequent side effect of antiresorptive (AR) drugs used in oncology. MRONJ may have endodontic consequences, as reported in this clinical case.
A 64-year-old woman being treated with antiresorptive (AR) drugs targeting bone metastasis of a primitive breast cancer consulted at the dental service of Pitié-Salpêtrière Hospital. She first experienced symptomatic apical periodontitis followed by symptomatic irreversible pulpitis, which were initially explained as resulting from occlusal trauma. Despite endodontic treatment, exacerbation of the symptomatology was noted. MRONJ was suspected, and the affected tooth was extracted.
The presence of necrotic bone during the surgery confirmed the diagnosis. Surgical treatment led to complete healing and total disappearance of clinical and radiological signs at 4 months.
MRONJ can induce alterations in adjacent tooth vascularization and secondary pulpal disease. Early diagnosis is difficult because early-stage MRONJ occurs without clear radiographic signs.
颌骨骨髓炎（MRONJ）是肿瘤学中使用的抗吸收（AR）药物常见的副作用。如本临床病例报道，MRONJ可能会产生牙髓病学后果。
一名64岁女性，因原发性乳腺癌骨转移接受抗吸收（AR）药物治疗，前往皮提耶-萨尔佩特里埃医院牙科就诊。她最初出现有症状的根尖周炎，随后出现有症状的不可逆性牙髓炎，最初被解释为咬合创伤所致。尽管进行了牙髓治疗，但症状仍加重。怀疑为MRONJ，拔除了患牙。
手术中发现坏死骨，确诊为MRONJ。手术治疗导致4个月时临床和放射学体征完全愈合且完全消失。
MRONJ可导致相邻牙齿血管化改变和继发性牙髓疾病。早期诊断困难，因为早期MRONJ在没有明确放射学征象的情况下发生。
