Medication-related osteonecrosis of the jaws (MRONJ) is a serious condition often linked with antiresorptive, immune modulating, and antiangiogenic drugs, initially associated with bisphosphonates but now including a broader range of medications. Tocilizumab, an interleukin-6 (IL-6) receptor-inhibiting monoclonal antibody used for conditions like rheumatoid arthritis and recently for COVID-19 to reduce IL-6 activity and alleviate symptoms, has raised concerns over its potential to induce MRONJ, particularly in post-COVID-19 patients. A case involving a 36-year-old male who developed tooth mobility and pain in the right maxillary posterior region after COVID-19 treatment with tocilizumab and dexamethasone is highlighted. Despite treatments like antibiotics, the necrosis persisted until more extensive surgery was performed, leading to improvement without recurrence over 2 years. This case emphasizes the need for awareness and research into the risk of MRONJ in patients treated with tocilizumab after COVID-19, underlining the importance for healthcare professionals to recognize and manage this complication.
Keyphrases
- rheumatoid arthritis
- sars cov
- coronavirus disease
- monoclonal antibody
- juvenile idiopathic arthritis
- disease activity
- rheumatoid arthritis patients
- respiratory syndrome coronavirus
- signaling pathway
- interstitial lung disease
- ankylosing spondylitis
- minimally invasive
- healthcare
- low dose
- chronic pain
- adverse drug
- bone mineral density
- neuropathic pain
- emergency department
- drug induced
- pain management
- body composition
- systemic sclerosis
- depressive symptoms
- bone regeneration