Clinical Significance
This patient presented a complex history and required some creative solutions. The SoS overdenture was a good option, restoring more
Hands OnRemovable overdenture
Section snippets
Background
Bisphosphonate-related osteonecrosis of the jaw (BRONJ) can be triggered by invasive dental procedures and infection. Dentate patients with BRONJ may have limited options for treatment of progressive oral conditions such as caries, periodontal disease, and occlusal dysfunction. For example, nonsurgical endodontic treatment may be used as an alternative to extraction to minimize the risk of triggering BRONJ. A patient with a pathologic mandibular fracture, which is a rare complication of BRONJ,
Case Report
Man, 78, initially came for treatment of intraoral and extraoral drainage from infected bone in the right mandible (Fig 1). Bone resection was done, with a titanium bone plate inserted. He developed medication-related osteonecrosis of the right mandible and suffered fracture of the initial mandibular titanium plate that required its replacement. The patient also developed a deformity of the contour of the right lower face and inferior mandible. The surgeon opted to perform routine restorative
Discussion
Although the options for treatment of this patient were limited by the history of BRONJ, treatment for a pathologic mandibular fracture, multiple missing teeth, and advanced dental caries has been successful for over 5 years. He is highly satisfied with the SoS appliance, which has improved his speech, mastication, and cosmetic appearance.
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Login GR: A 5-year perspective on a removable overdenture appliance for a patient with osteonecrosis of the jaw, a mandibular resection, and rampant caries. J Prosthet Dent 116:172-175, 2016
Reprints available from G Login, 209 Harvard St, Suite 402, Brookline, MA 02446; e-mail: [email protected]