Bisphosphonate-associated osteonecrosis of the jaw: a six-year history of a case.

Patients with multiple myeloma are usually treated with IV bisphosphonates soon after diagnosis. Bisphosphonate administration has been associated with bisphosphonate-associated osteonecrosis of the jaw (BONJ). BONJ can occur spontaneously; the most common spontaneous site is at the lingual aspect of the posterior mandible. The condition can continue to expose more bone well after bisphosphonates have been discontinued. This report describes the development and progression of a spontaneous BONJ of the mandible in an individual with multiple myeloma. The area of exposed bone slowly increased in size and eventually became mobile. Removal of the sequestrum provided a temporary respite from exposed bone and resolution of symptoms, but there was a recurrence of exposed bone that required further sequestrum removal.