{Reference Type}: Case Reports
{Title}: Mandibular fracture in medication-associated osteonecrosis following infliximab therapy: A case report.
{Author}: Kolodziejwski WT;Rosa CAL;Guimarães AM;da Silva PQM;de Araujo MR;
{Journal}: Spec Care Dentist
{Volume}: 0
{Issue}: 0
{Year}: 2024 Jul 3
暂无{DOI}: 10.1111/scd.13035
{Abstract}: <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.