A rare case of bevacizumab-related osteonecrosis of the jaw associated with dental implants

• Published in: International journal of implant dentistry Vol. 5; no. 1; pp. 1 - 6
• Main Authors: Maluf, Gustavo, Caldas, Rogério Jardim, Fregnani, Eduardo Rodrigues, da Silva Santos, Paulo Sérgio
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.10.2019; Springer Nature B.V; SpringerOpen
• Subjects: Angiogenesis inhibitors; Antiangiogenics; Bevacizumab; Biomedical materials; Breast cancer; Case Report; Dental implants; Dentistry; Immunotherapy; Jaw; Medicine; Monoclonal antibodies; Osteonecrosis; Ozone; Placement; Surgical implants; Targeted cancer therapy; Therapy; Transplants & implants; Jaw; Osteonecrosis; Angiogenesis inhibitors; Bevacizumab
• ISSN: 2198-4034; 2198-4034
• DOI: 10.1186/s40729-019-0188-0

Background Medication-related osteonecrosis of the jaw (MRONJ) is characterized by the development of bone necrosis in the jaws of patients receiving antiresorptive and/or antiangiogenic medications. No scientific reports have been published yet on bevacizumab-related osteonecrosis of the jaw (BeRONJ) when associated with dental implant placement and adjuvant ozone therapy. Case presentation A 54-year-old female patient with a history of metastatic breast cancer and bevacizumab use presented with a dental infection. Dental extraction followed immediately by dental implant placement was planned after suspension of the bevacizumab treatment. The patient presented with pain, drainage of purulent secretion, and bone exposure 5 weeks post-surgery. Complete healing was achieved at postoperative 7 months. Conclusions The combination of adjuvant ozone therapy and surgical debridement was effective for the treatment of MRONJ; however, the risk of MRONJ may persist after the suspension of bevacizumab for 28 days.