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MELIAN RIVAS, Andrés Noah  e  ROJAS DONAIRE, Javiera Alejandra. Conservative treatment of refractory medication-related osteonecrosis of the jaw using the PENTO protocol: A case report. Odontoestomatología [online]. 2021, vol.23, n.38, e406.  Epub 30-Set-2021. ISSN 0797-0374.

A 78-year-old patient seeks care for unresolved bleeding on the left maxillary alveolar ridge. He had a history of bone metastasis treated with IV zoledronic acid, which was discontinued after medical discharge and previous surgical treatment of osteonecrosis of the jaws in the affected site. Continuity disruption with inflammation at the bone ridge was observed, with blood, purulent, and necrotic exudate. The radiograph showed diffuse and osteolytic radiolucency of the affected area, and necrotic tissue was detected at a microscopic level. The affected area was rinsed with 0.12% chlorhexidine, 400 mg amoxicillin/clavulanic acid and pentoxifylline was administered every 12 hours, and tocopherol 1000 IU every 24 hours. The area was evaluated after a month. Antibiotic therapy was discontinued, and the patient continued to be monitored every two weeks. At six months, there is complete resolution, and mucosal and bone tissue healed without recurrence.

Palavras-chave : Medication-Related Osteonecrosis of the Jaw; Bisphosphonates; Pentoxifylline; Tocopherol.

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