Abstract

Background: Medication-related osteonecrosis of the jaw (MRONJ) is a severe adverse drug reaction related with exposure to antiresorptive or antiangiogenic agents. Pain control is one of the main treatment goals.

Methods: We report the case of a 63-year-old man with MRONJ who was treated for bone metastases from lung adenocarcinoma. After 11 months of denosumab treatment, he complained of right mandible pain and was diagnosed with stage 2 MRONJ. Although bone necrosis progression was controlled by conservative treatment, the patient still suffered from refractory pain. Pulsed radiofrequency of the mandibular branch of the trigeminal nerve was done for the patient.

Results: Pulsed radiofrequency of the mandibular branch of the trigeminal nerve resulted in successful pain control that remained effective until the patient expired.

Conclusion: This is the first report of using pulsed radiofrequency of the mandibular branch of the trigeminal nerve to treat intractable pain associated with MRONJ.