Mandibular Osteonecrosis: A Case Report Emphasizing the Role of Advanced Imaging and Multidisciplinary Management

Abstract

Introduction: Radiolucent lesions in the jaws are frequent findings in radiographic studies, making an accurate diagnosis crucial to differentiate among various pathologies. Osteonecrosis of the jaw is an uncommon condition characterized by bone cell death, which can be confused clinically and radiographically with other disorders. Objective: To emphasize the importance of timely diagnosis through the use of advanced imaging tools and a multidisciplinary approach in the management of osteonecrosis of the jaw. Case Description: An 81-year-old male patient with a history of controlled hypertension presented to the teaching clinic of the Facultad of Odontología of the Universidad Autonoma of Sinaloa for a second opinion. He reported a lesion on the lower mandibular border with purulent exudate lasting approximately 7 months, with no improvement following previous dental extractions, antibiotic therapy, and endodontic treatment. Diagnosis: Orthopantomography and cone-beam computed tomography (CBCT) identified an extensive radiolucent lesion in the right lower mandibular border. The maxillofacial surgery department established a diagnosis of mandibular osteonecrosis. Treatment: Osteotomy of the lower mandibular border with curettage of the mandibular body was performed, followed by completion of the previously initiated endodontic treatment. Results: After two years of follow-up, the patient remains asymptomatic and free of recurrence, with radiographic evidence of bone repair. Conclusions: Mandibular osteonecrosis requires a high degree of clinical suspicion and the use of advanced imaging studies for differential diagnosis. A multidisciplinary approach is essential for successful management and prevention of complications.