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Article: Volume 41 Number 5 Page 449 - June 2014

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  Dent Update 2014; 41: 449-450

Case report:  Denosumab-Associated Osteonecrosis of the Jaw – A Case Report

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Abstract: Osteonecrosis of the jaw (ONJ) following bisphosphonate use is well documented. However, to our knowledge, there are few cases reported on ONJ related to the use of other pharmaceutical agents, such as denosumab – a monoclonal antibody that is prescribed for the treatment of osteoporosis and is used as an anti-cancer agent. Here we present the first case in the UK of a patient who has developed ONJ following treatment with denosumab. The purpose of this report is to highlight the potential effects of this monoclonal antibody on bone turnover and the subsequent results of osteonecrosis of the jaw. It is hoped that this will allow early recognition by medical and dental practitioners, and appropriate referral and treatment.

Clinical relevance: Readers should be aware of other causes of osteonecrosis of the jaw.

Author notes: Sheena Vyas, BDS, MFDS RCS(Ed), Broomfield Hospital, Mid Essex Health Trust, Sabina Hameed, BDS, MFDS RCS(Eng), Vaidyanathan Murugaraj, BDS, MFDS RCS(Eng), FFD RCSI(OSOM), Department of Oral and Maxillofacial Surgery, Royal Berkshire Hospital, Reading, RG1 5AN.

Objective: To understand the clinical implications of pulp exposure during complete excavation of deep carious lesions and discuss treatment techniques.