Charbel F Kachouh, Adam M Aboukhalil, Rosine H Hajj Chehadeh, Robert S Daccache, Hiam Y Wehbe, Samar A Bou Jaoude
Medication-related osteonecrosis of the jaw (MRONJ) is an adverse event that most commonly occurs in patients undergoing bisphosphonate therapy and remains a significant challenge for dentists. Its clinical presentation varies according to the stages of the disease, depending on clinical and radiological findings. We report the case of an 81-year-old man presenting with a cutaneous fistula and purulent drainage from the lower right side of the mandible. The patient was under chemotherapy and receiving zoledronic acid treatment, administered as an intravenous injection every six months for 10 years. Oral manifestations of MRONJ can present with diverse lesions requiring careful clinical evaluation, accurate diagnosis, and appropriate management.