Antiresorptive medication induced osteonecrosis of the maxilla with facial disfigurement: a case report

A 77-year-old male presented to our clinic with right cheek swelling, pain, and discharge for 1 month. Oral cavity examination revealed a draining fistula in the hard palate and a tender mass over the right cheek. An enhanced computed tomography scan of the paranasal sinuses showed an enhancing mass with maxillary bone destruction. Fine needle aspiration revealed the presence of pus cells and mucoid material with negative malignant cells. Debridement of loose necrotic tissue resulted in bone necrosis. Therefore, we diagnosed the patient with osteomyelitis induced by antiresorptive medications. A multicourse antibiotic regimen based on culture and sensitivity was initiated, and the patient showed a clinical and radiological response to healing. The patient later developed facial disfiguration due to soft tissue and bone defects with dysfunction of oral competence.