2026 Poster Presentations
P082: OSTEONECROSIS OF A TORUS PALATINUS SECONDARY TO BISPHOSPHONATE THERAPY: A CASE REPORT AND LITERATURE REVIEW
Hannah L Walsh, BS; Neil Mundi, MD, FRCSC; Intent Medical Group, Northwest Community Hospital
Background: Medication-related osteonecrosis of the jaw (MRONJ) is a known complication of long-term bisphosphonate therapy, most commonly affecting the mandible and, less frequently, the maxilla. Involvement of a torus palatinus is rare with few cases documented in the literature. This case report highlights a rare presentation and its successful surgical management of total resection of the necrotic torus and reconstruction of the surgical defect using a vascularized local flap.
Clinical Presentation and Management: A 67-year-old female with a history of prolonged bisphosphonate use for osteoporosis presented with ulcerations and exposed bone along the hard palate. Clinical indications and imaging confirmed osteonecrosis of a torus palatinus with associated mucosal breakdown. Surgical intervention included total resection of necrotic mucosa and the torus palatinus, followed by reconstruction using a palatal island flap pedicled on the greater palatine vessels. Postoperative recovery was uncomplicated with successful flap integration and no evidence of recurrent disease.
Conclusion: The objective of this case report is to highlight the unique surgical and reconstructive approach employed in the management of medication-related osteonecrosis of the jaw occurring at the rare site of the torus palatinus. Compared to conservative measures or limited debridement, this report highlights the advantage of complete excision of necrotic torus palatinus in conjunction with vascularized tissue reconstruction. The use of a local vascularized flap, such as the palatal artery island flap, provides reliable soft tissue coverage and supports favorable postoperative healing.