Managing Medication-Related Osteonecrosis Of The Jaw: Post-Extraction Abscess

Medication-related osteonecrosis of the jaw (MRONJ) is a severe complication associated with antiresorptive and antiangiogenic therapies. It often presents with non-healing extraction sites, exposed bone, and secondary infection, significantly impacting patient quality of life. Early recognition and appropriate management are crucial to prevent disease progression and minimize morbidity. This case involves a female patient who presented with a draining abscess from the site of an extraction that had occurred 12 months earlier. Her medical history revealed long-term use of bisphosphonates for osteoporosis. Clinical examination showed intraoral swelling, mucosal inflammation, and pus discharge. Radiographic imaging confirmed that, indeed, the source was the site of an extraction that had occurred one year earlier. Based on clinical and radiographic findings, a diagnosis of MRONJ was made. The patient was managed with antimicrobial therapy, chlorhexidine rinses, and conservative surgical debridement, leading to symptomatic improvement. This case highlights the pathophysiology of MRONJ, risk factors, and the challenges in diagnosis and treatment. A multidisciplinary approach involving dentists, oral surgeons, and physicians is essential for optimal patient care. Early diagnosis and individualized management strategies can improve patient outcomes in MRONJ. Preventive measures and patient education remain key in reducing the incidence of this condition.