%0 Case Reports
%T Mandibular fracture in medication-associated osteonecrosis following infliximab therapy: A case report.
%A Kolodziejwski WT
%A Rosa CAL
%A Guimarães AM
%A da Silva PQM
%A de Araujo MR
%J Spec Care Dentist
%V 0
%N 0
%D 2024 Jul 3
%M 38961587
暂无%R 10.1111/scd.13035
%X <B>BACKGROUND: </B>Medication-associated osteonecrosis of the jaws (MRONJ) is characterized by the presence of exposed bone or an intraoral or extraoral fistula in the maxillofacial region in patients with a history of treatment with anti-resorptive and anti-angiogenic drugs, such as monoclonal antibodies, and without a history of radiotherapy or metastatic diseases in the area.<BR><B>OBJECTIVE: </B>The aim of this study is to report a case of a pathological mandibular fracture in an area of MRONJ in a patient diagnosed with Crohn's disease treated with infliximab.<BR><B>METHODS: </B>A 53-year-old male patient, an active smoker for 35 years, diagnosed with Crohn's disease, undergoing intravenous administration of infliximab 300 mg for 1 year and 3 months, with no previous history of anti-angiogenic or anti-resorptive medication, presenting with an extraoral fistula in the submandibular region for 4 months, with painful symptoms, diagnosed as MRONJ. He was initially treated conservatively, using antimicrobial photodynamic therapy (aPDT), antibiotic therapy, and the PENTO protocol. However, the patient evolved with a pathological fracture in the mandibular parasymphysis, requiring surgical reconstruction.<BR><B>CONCLUSIONS: </B>Pathological fracture of the mandible is a complication of MRONJ that compromises the patient's quality of life. The management of patients with MRONJ is complex and challenging.