Osteonecrosis of the maxilla related to long-standing methamphetamine abuse: a possible new aspect in the etiology of osteonecrosis of the jaw

Abstract

Two possible mechanisms, alone or in combination, could possibly lead to MA-related ONJ. Self-extraction of teeth as a psychopathologic behavior of self-destruction among MA abusers results in wounds that allow unhindered invasion of microorganisms causing osteomyelitis and ONJ, while on the other hand, the heating of white phosphor releases toxic phosphorous vapor, which could be inhaled and consequently cause ONJ of the maxilla. However, since the worldwide prevalence of MA abuse is remarkably high, a relationship between MA abuse and ONJ will offer a new aspect in the etiology of ONJ and might present a further therapeutic challenge.

Meth Mouth—A Growing Epidemic in Dentistry?

“…Rustemeyer et al, published a case report of a patient with an extended osteonecrosis of the maxilla after self-extraction of teeth and chronic methamphetamine abuse for 20 years. The authors concluded that (I) the self-extraction of the teeth in combination with bacterial wound contamination and (II) the inhalation of toxic phosphorus vapor, after heating white phosphor, might be responsible for ONJ development is this patient [ 26 ]. Hypothesis (II) is very interesting and might be a very relevant aspect since phosphor is an essential substitute for the illegal manufacture of “meth”.…”

Chemical and Radiation-Associated Jaw Lesions

“…Chronic use of recreational or illicit drugs such as cocaine, amphetamine and methamphetamine are established independent risk factors for osteonecrosis, termed Recreational drug induced osteonecrosis (RDIO) 29-32 . It is more common in the maxilla 29 .…”

“…It is more common in the maxilla 29 . The incidence of recreational drug induced osteonecrosis is unknown because many addicts do not seek medical care.…”

Морфофункциональное Состояние Нижнечелюстных Костей Лабо-Раторных Белых Крыс При 1- И 3-Месячном Воздействии Бис-Фосфонатов В Дозах, Вызывающих Остеонекротические Изменения

“…Кроме того, эти вещества применяются в онкологии для терапии костных метастазов, сочетающихся с синдромом гиперкальциемии. Однако известно, что эти препараты могут вызывать тяжелые осложнения остеонекрозы челюстей [1,2,3]. Подобные процессы исследователи наблюдают у лиц, употребляющих метамфетамин кустарного производства, при изготовлении, которого применяется красный фосфор.…”