Clinical Management of Maxillary and Mandibular Medication-Related Osteonecrosis of the Jaw Associated with Zoledronic Acid in a Patient with Multiple Myeloma: A Case Report

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Published: May 27, 2026
DOI: https://doi.org/10.52600/2763-583X.bjcr.2026.6.1.bjcr190
Keywords:
Bisphosphonate-Associated Osteonecrosis of the Jaw, Multiple Myeloma, Zoledronic Acid, Platelet-Rich Fibrin

Main Article Content

Nathália Cardoso
Evangelical University of Goiás (UniEVANGÉLICA)
https://orcid.org/0009-0001-5859-7351
Isadora Zanini
Universidade Evangélica de Goiás (UniEVANGÉLICA)
Leandro Henrique Monção
Evangelical University of Goiás (UniEVANGÉLICA)
https://orcid.org/0009-0007-1673-2002
Bruna Ferreira
Evangelical University of Goiás (UniEVANGÉLICA)
Geovana Larissa Mota
Evangelical University of Goiás (UniEVANGÉLICA)
https://orcid.org/0009-0004-2138-1882
Maria Júlia Manso
Evangelical University of Goiás (UniEVANGÉLICA)
https://orcid.org/0009-0007-3010-7529
Glenda Pelegrine
Evangelical University of Goiás (UniEVANGÉLICA)
Marcelo Rodrigues Azenha
Ribeirão Preto School of Dentistry, University of São Paulo (FORP-USP)
Wilson José Mariano Júnior
Evangelical University of Goiás (UniEVANGÉLICA)
Sátiro Watanabe
Federal University of Goiás
Renan de Barros e Lima Bueno
Evangelical University of Goiás (UniEVANGÉLICA)
https://orcid.org/0000-0002-4612-8216

Abstract

Medication-related osteonecrosis of the jaws (MRONJ) is a complication associated with antiresorptive agents, including zoledronic acid. This condition occurs most frequently in patients undergoing treatment for malignant neoplasms, such as multiple myeloma. Diagnosis is primarily clinical and should be based on a thorough patient history, particularly regarding the use of antiresorptive medications, in conjunction with clinical examination and appropriate imaging studies. This report presents a clinical case of MRONJ in the maxillary region of a 78-year-old patient who received zoledronic acid for three years as part of multiple myeloma management. Sequestrectomy was selected as the surgical intervention, followed by the application of a Platelet-Rich Fibrin (PRF) membrane to the surgical site to serve as a protective barrier, control infection, and promote tissue repair. The patient demonstrated a favorable clinical outcome following these procedures. A carefully planned, appropriately indicated, and well-executed clinical approach offers a safe and effective alternative for the management of MRONJ. Prevention, early diagnosis, and individualized, multidisciplinary management are essential for achieving therapeutic success in these cases.

Article Details

How to Cite
Cardoso, N., Zanini, I., Monção , L. H., Ferreira, B., Mota, G. L., Manso, M. J., Pelegrine, G., Azenha, M. R., Mariano Júnior, W. J., Watanabe, S., & Bueno, R. de B. e L. (2026). Clinical Management of Maxillary and Mandibular Medication-Related Osteonecrosis of the Jaw Associated with Zoledronic Acid in a Patient with Multiple Myeloma: A Case Report. Brazilian Journal of Case Reports, 6(1), bjcr190. https://doi.org/10.52600/2763-583X.bjcr.2026.6.1.bjcr190
Issue
Vol. 6 No. 1 (2026): January/December - 2026
Section
Clinical Case Reports
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This work is licensed under a Creative Commons Attribution 4.0 International License.

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Author Biographies

Nathália Cardoso, Evangelical University of Goiás (UniEVANGÉLICA)

Evangelical University of Goiás (UniEVANGÉLICA), Anápolis, Goiás, Brazil

Isadora Zanini, Universidade Evangélica de Goiás (UniEVANGÉLICA)

Evangelical University of Goiás (UniEVANGÉLICA), Anápolis, Goiás, Brazil.

Leandro Henrique Monção , Evangelical University of Goiás (UniEVANGÉLICA)

Evangelical University of Goiás (UniEVANGÉLICA), Anápolis, Goiás, Brazil.

Bruna Ferreira, Evangelical University of Goiás (UniEVANGÉLICA)

Evangelical University of Goiás (UniEVANGÉLICA), Anápolis, Goiás, Brazil.

Geovana Larissa Mota, Evangelical University of Goiás (UniEVANGÉLICA)

Evangelical University of Goiás (UniEVANGÉLICA), Anápolis, Goiás, Brazil.

Maria Júlia Manso, Evangelical University of Goiás (UniEVANGÉLICA)

Evangelical University of Goiás (UniEVANGÉLICA), Anápolis, Goiás, Brazil.

Glenda Pelegrine, Evangelical University of Goiás (UniEVANGÉLICA)

Evangelical University of Goiás (UniEVANGÉLICA), Anápolis, Goiás, Brazil.

Marcelo Rodrigues Azenha, Ribeirão Preto School of Dentistry, University of São Paulo (FORP-USP)

Ribeirão Preto School of Dentistry, University of São Paulo (FORP-USP), Ribeirão Preto, São Paulo, Brazil.

Wilson José Mariano Júnior, Evangelical University of Goiás (UniEVANGÉLICA)

Evangelical University of Goiás (UniEVANGÉLICA), Anápolis, Goiás, Brazil.

Renan de Barros e Lima Bueno, Evangelical University of Goiás (UniEVANGÉLICA)

Evangelical University of Goiás (UniEVANGÉLICA), Anápolis, Goiás, Brazil.

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