Medication-Related Osteonecrosis of the Jaw Associated with Palatal Bone and Soft Tissue Trauma: A Case Report

  • Singh, Harpreet (Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida, College of Dentistry) ;
  • Saleh, Wafaa (Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida, College of Dentistry) ;
  • Cha, Seunghee (Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida, College of Dentistry) ;
  • Katz, Joseph (Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida, College of Dentistry) ;
  • Ruprecht, Axel (Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida, College of Dentistry)
  • Received : 2019.01.23
  • Accepted : 2019.03.19
  • Published : 2019.03.30


The aim of this case report is to present a case of 68-year-old male with a history of multiple myeloma and the intravenous use of Zometa (zoledronic acid) who had developed medication-related osteonecrosis of the jaw (MRONJ) following a hot pizza burn to the palate. Clinical and radiographic findings revealed grade 1 MRONJ of the right side of the hard palate. Soft tissue trauma and delayed epithelialization may be associated with some cases of MRONJ. Patients on anti-resorptive medications or anti-angiogenic drugs should be informed of the risk of bone exposure and subsequent MRONJ secondary to physical/chemical insults to the bone and soft tissue in the oral cavity.

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Fig. 1. Clinical photograph showing the exposed bone on the right palatal area with minor inflammation.

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Fig. 2. Medication-related osteonecrosis of the jaw of the maxilla. The cone beam computed tomography scan shows an irregular lytic lesion with bony sequestrum on the posterior right area of the palate (arrow).

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Fig. 3. Medication-related osteonecrosis of the jaw of the maxilla. The left side was visualized for comparison.


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