A patient who abuses methamphetamine or cocaine may develop osteonecrosis of the jaw.
Clinical features:
(1) onset of osteonecrosis of the jaw
(2) history of methamphetamine and/or cocaine
(3) exclusion of other diagnoses
(4) other signs of drug abuse including poor oral health
Possible mechanisms:
(1) vasoconstriction with ischemia
(2) exposure to red or white phosphorus (vapors or drug contaminant from methamphetamine production)
(3) self-extraction of teeth
Differential diagnosis:
(1) osteomyelitis of the jaw
(2) other causes of medication-related osteonecrosis of the jaw (MRONJ)
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Specialty: Otolaryngology