Some 200 years ago, workers developed gingivitis, periodontal disease, alveolar
crest bone sequestra, and draining fistulae after exposure to phosphorous fumes
and phosphorous paste in the manufacture of the friction match. Many also
suffered loss of teeth and pathologic fracture of the mandible. Known as
“phossy jaw,” the constellation rather abruptly vanished following
the International Berne Convention of 1906. Today, “bis-phossy
jaw” (bisphosphonate-induced osteonecrosis of the jaw) has surfaced with
pathologic fractures and other features common to its predecessor,
“phossy jaw.” This modern equivalent is reported with
ever-increasing frequency and is presented here in the format of a brief
historical review and a case report that includes segmental en bloc extirpation
of necrotic mandible and pain-free salvage. Computerized imagery and
three-dimensional printing technology were successfully chosen to create and
apply a custom titanium bone plate, without free-tissue transfer.
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