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JAMA Clinical Challenge
November 27, 2013

Jaw Lesion and Discomfort

Author Affiliations
  • 1Division of Periodontology, Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts
  • 2Department of Periodontology, School of Graduate Dentistry, Rambam Health Care Campus, Faculty of Medicine, Technion, IIT, Haifa, Israel
JAMA. 2013;310(20):2195-2196. doi:10.1001/jama.2013.282405

A 57-year-old woman reports experiencing discomfort and a lesion around her mandibular incisor teeth for the past 3 months. She had received the bisphosphonate zoledronate for treatment of metastatic renal carcinoma for several months before the lesion appeared. The patient reports no trauma or acute process around the area. On examination, the teeth are mobile, and an area of exposed bone tissue in the mandible is detected (Figure). There is no tenderness on palpation or profound gingival bleeding. The teeth are splinted for the patient’s comfort.