Fig 3.

A 67-year-old woman (patient 2) with metastatic breast cancer treated with pamidronate and later zoledronate presented with a nonhealing extraction socket.

A, The orthopantomogram demonstrates the nonhealing extraction socket in the right posterior mandible (*) with sclerosis in the adjacent body and ramus of the mandible (arrow) and generalized thickening of the lamina dura in the mandible (arrowhead) and maxilla.

B, Axial CT demonstrates the osseous sclerosis, as well as narrowing the mandibular canal (*), thin periosteal new bone anteriorly (arrow) and generalized thickening of the lamina dura in the mandible (arrowhead).

C, Tc99m-HDP bone scan demonstrates increased radiotracer uptake in the right hemimandible corresponding with the area of sclerosis, which had increased over the last 3 years.