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Biphosphonate-related osteonecrosis of the jaw (BRONJ) is a common complication of the therapy of malignant cancers. Drugs improve bone density and reduce hypercalcaemia in patients with primary tumours, as well as their metastases to the bones. A characteristic feature are emerging foci of osteonecrosis of the jaws, with secondary infection which is often actinomycotic. Actinomyces are Gramm-positive bacteria which colonize the mucous membrane and in favourable conditions are the cause of inflammation. BRONJ appears spontaneously or may be a consequence of surgical treatment in the area of the jaws. The case is presented of an 82-year-old woman after hysterectomy due to a cancerous lesion who had taken ibandronic acid for a long time. Because of the severe pain in the mandible and the advanced disease, surgical sequestration of the necrosis and antibiotic treatment of the actinomycosis were necessary.

Necrosis BRONJ of the mandible, complicated by Actinomyces infection – Case Report