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Jaw osteonecrosis

Yehuda Zadik
About half of individuals diagnosed with medication-related osteonecrosis of the jaw (MRONJ) are multiple myeloma (MM) patients, and most are treated using antibiotics for long-term courses. The penicillin group is recommended as the empiric drug of choice, and quinolones, metronidazole, clindamycin, doxycycline, and erythromycin as alternatives. This paper suggests the macrolide clarithromycin as the empiric antibiotic therapy of MRONJ in MM patients because of its better pharmacologic properties in comparison to erythromycin, and the beneficial effect of this agent in MM...
September 2018: Oral Oncology
Christian M Schmitt, Mayte Buchbender, Rainer Lutz, Friedrich-Wilhelm Neukam
AIM: In this systematic review, we aimed to assess the impact of endosseous implants on the formation of an osteonecrosis of the jaw, as well as implant survival rates for patients under bisphosphonate (BP), antiresorptive and radiation therapy. MATERIALS AND METHODS: An electronic search was performed using PubMed, Embase, and Medline databases with the logical operators: "dental implant", "antiresorptive", "bisphosphonate", "irradiation", "radiotherapy", "radiation", "necrosis" and "survival"...
2018: European Journal of Oral Implantology
Amerigo Giudice, Selene Barone, Carmen Giudice, Francesco Bennardo, Leonzio Fortunato
OBJECTIVE: The aim of this study was to evaluate the efficacy of platelet-rich fibrin (PRF) after bone surgery compared to surgery alone in the treatment of medication-related osteonecrosis of the jaw (MRONJ). STUDY DESIGN: A total of 47 patients with diagnosis of stage II or III of MRONJ were recruited at the Academic Hospital of Magna Graecia University of Catanzaro and allocated to 2 groups: In the first, patients were treated with PRF in addition to surgery (PRF group), in the other, only bone surgery was performed (non-PRF group)...
June 30, 2018: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Tamaki Tamanuki, Tomoyoshi Aoyagi, Akiyuki Murano, Hiroshi Matsuzaki
An 83-year-old woman underwent mastectomy for breast cancer of the right breast in 2008. In addition to hormone therapy and irradiation, zoledronate was started for bone metastasis 6 months postoperatively. Five years after the operation, the patient developed osteonecrosis of the jaw, and underwent sequestrectomy because of uncontrollable pain in the mandible. The patient visited our hospital for a 1-week history of fever and right facial swelling with pain, and was diagnosed with right mandibular cellulitis...
August 2018: Molecular and Clinical Oncology
Chang-Hee Lee, Seung Hyun Son, Chae Moon Hong, Ju Hye Jeong, Shin Young Jeong, Sang-Woo Lee, Jaetae Lee, Tae-Geon Kwon, Byeong-Cheol Ahn
Purpose: Bisphosphonate (BP) is the first-line therapy for the management of osteoporosis. BP-related osteonecrosis of the jaw (BRONJ) and atypical femoral fracture (AFF) are increasingly common comorbidities in patients with osteoporosis under long-term BP treatment. The aim of this study was to evaluate the incidence and risk factors for AFF features on bone scintigraphy in patients with BRONJ. Methods: Among total of 373 BRONJ patients treated between September 2005 and July 2014, 237 (220 women, 17 men; median age 73 years) who underwent three-phase bone scintigraphy were enrolled for this retrospective study...
August 2018: Nuclear Medicine and Molecular Imaging
Henrik Holtmann, Julian Lommen, Norbert R Kübler, Christoph Sproll, Majeed Rana, Patrick Karschuck, Rita Depprich
Objective This study was performed to determine whether the results of prevailing in vivo and in vitro studies offer a reliable model for investigation of medication-related osteonecrosis of the jaw (MRONJ). Methods Embase, Medline, and the Cochrane Library were searched for articles published from September 2003 to June 2017 involving experimental approaches to the pathogenesis of MRONJ. In vivo and in vitro trials were analyzed with respect to the scientific question, study design, methodology, and results...
August 9, 2018: Journal of International Medical Research
(no author information available yet)
No abstract text is available yet for this article.
October 2017: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Sung-Mok Jung, Sujeong Han, Hye-Young Kwon
OBJECTIVE: To examine the incidence rates and association between dose-intensity, stratified by exposure duration, of bisphosphonates and the risk of osteonecrosis of the jaw among Korean osteoporotic patients older than 50 years. STUDY DESIGN AND SETTING: Using the population-based National Health Insurance Claims Data of Korea from January 1, 2006, through December 3, 2012, 13,730 new bisphosphonate users as of 2006 were identified. Truncated age-standardized incidence rate estimation and multivariate logistic regression analyses were conducted...
2018: Frontiers in Pharmacology
Terresa Kim, Sol Kim, Minju Song, Cindy Lee, Hideo Yagita, Drake W Williams, Eric C Sung, Christine Hong, Ki-Hyuk Shin, Mo K Kang, No-Hee Park, Reuben H Kim
Medication-related osteonecrosis of the jaw (MRONJ) is a rare but detrimental intraoral lesion that predominantly occurs in patients with long-term use of anti-resorptive agents such as bisphosphonate and denosumab, a human anti-RANKL monoclonal antibody (Ab). Surgical intervention such as tooth extraction is a known risk factor for MRONJ, which is often performed to eliminate pre-exiting pathological inflammatory condition such as periodontal diseases. Nonetheless, it remains unknown whether pre-existing periodontal disease condition exacerbates, or removal of such condition ameliorates, MRONJ development following tooth extraction...
July 27, 2018: American Journal of Pathology
Sven Otto, Christoph Pautke, Tim Van den Wyngaert, Daniela Niepel, Morten Schiødt
Medication-related osteonecrosis of the jaw (MRONJ) is primarily an adverse side effect of denosumab or bisphosphonates (particularly when used at high doses to prevent skeletal-related events [SREs] in patients with cancer and bone metastases) or possibly anti-angiogenic cancer treatment. While the implementation of preventive measures over recent years has reduced the risk of MRONJ in patients with bone metastases due to cancer, it is imperative to balance the risk of MRONJ against the beneficial effects of treatment with denosumab or bisphosphonates on the skeletal health of patients...
June 18, 2018: Cancer Treatment Reviews
Katsuhiko Nakatsukasa, Hiroshi Koyama, Yoshimi Ouchi, Hisako Ono, Kouichi Sakaguchi, Takayuki Matsuda, Makoto Kato, Takashi Ishikawa, Kimito Yamada, Mana Yoshimura, Kei Koizumi, Teruhisa Sakurai, Hideo Shigematsu, Shunji Takahashi, Shinichiro Taira, Masato Suzuki, Kazutaka Narui, Naoki Niikura, Yoshie Hasegawa, Daishu Miura, Eiichi Konishi, Tetsuya Taguchi
BACKGROUND: Aromatase inhibitors (AI) have been established as the gold-standard therapy for postmenopausal patients. Worldwide, adjuvant denosumab at a dose of 60 mg twice per year reduces the risk of clinical fractures in postmenopausal patients with breast cancer who received AI. However, the efficacy of denosumab in the treatment of AI-associated bone loss had not been prospectively evaluated in Japan. Previously, we reported the 12-month effect of denosumab in Japanese patients for the first time; the primary endpoint was the change in the percentage of bone mineral density (BMD) of the lumbar spine from baseline to 12 months...
July 27, 2018: Breast Cancer: the Journal of the Japanese Breast Cancer Society
A Shuster, V Reiser, L Trejo, C Ianculovici, S Kleinman, I Kaplan
The purpose of this study was to compare the histopathological parameters of chronic/suppurative osteomyelitis, medication-related osteonecrosis of the jaw (MRONJ), and osteoradionecrosis (ORN), and to examine the hypothesis that distinct histological features can be related to a specific disease, allowing for diagnosis based on microscopic evaluation alone. One hundred and ten samples were reviewed by two examiners in a blinded fashion, and a semi-quantitative histomorphometric analysis was performed. The parameters evaluated included the presence or absence of necrotic bone, inflammation, reactive bone formation, bacteria, and osteoclasts...
July 24, 2018: International Journal of Oral and Maxillofacial Surgery
Sakiko Soutome, Saki Hayashida, Madoka Funahara, Yuki Sakamoto, Yuka Kojima, Souichi Yanamoto, Masahiro Umeda
Methods for preventing medication-related osteonecrosis of the jaw (MRONJ) in cancer patients who have received high-dose bisphosphonate (BP) or denosumab (Dmab) have not yet been established. Tooth extraction after starting medication has been believed to be a major risk factor for MRONJ, and therefore this procedure tends to be avoided. This study investigated the risk factors for MRONJ, with a special reference to the correlation between tooth extraction and development of MRONJ. One hundred and thirty-five cancer patients who were administrated high-dose BP or Dmab were enrolled in the study...
2018: PloS One
Chul-Hong Koo, Jae-Hoon Lee
Background: Bisphosphonate (BP) has the ability to thicken the cortical bone. In addition, it has been reported that the cortical bone thickened by BP has relation to the medication-related osteonecrosis of the jaw (MRONJ). Therefore, the objective of this article is to analyze the ratio as well as thickness of cortical bone in the mandible using computed tomography (CT) and to evaluate it as the predictive factor of MRONJ. Methods: The thickness of the cortical bone was measured on a paraxial view of the CT showing the mental foramen in 95 patients: 33 patients with MRONJ (3 males, 30 females), 30 patients taking BP without MRONJ (2 males, 28 females), and 32 controls (9 males, 28 females)...
December 2018: Maxillofacial Plastic and Reconstructive Surgery
Elisabetta Merigo, Luigi Cella, Aldo Oppici, Maria Cristina Arbasi, Fabio Clini, Matteo Fontana, Carlo Fornaini
Introduction: The proper therapeutic plan for medication-related osteonecrosis of the Jaw (MRONJ) is still lacking long-term data up to today. They were several high-technological appliances proposed for the different intervention steps, in addition to tissue repair promoters. The reason for proposing an integrated technique is justified, beyond better compliance of the patients associated to the pain and inflammation reduction and bleeding control, there is also achieving better hard and soft tissues healing...
2018: Journal of Lasers in Medical Sciences
Giacomo Oteri, Giuseppina Campisi, Vera Panzarella, Ilaria Morreale, Riccardo Nucera, Olga Di Fede, Antonio Picone, Antonia Marcianò
The study presents a report of 58 metastatic cancer patients who developed osteonecrosis of the jaws after being treated with zoledronic acid and taxanes, plus corticosteroids. A retrospective analysis of data registered in the archives of two Italian osteonecrosis of the jaws treatment centers, who are based at the University of Messina and at the University of Palermo, was performed in order to study, in these patients, demographic data and characteristics such as frequency of cancer location, lines of therapy, frequency of cancer drugs, presence/absence of oral trigger, number, location, and stage of jaw osteonecrosis...
2018: BioMed Research International
W Y Zhang, B Xuan, Y X Guo, J Zhang
Objective: To further study the effects of distal-less homeobox gene 5 (Dlx-5) and Msh homeobox 1 (Msx-1) in the pathogenic mechanism of bisphosphonate related osteonecrosis of the jaw (BRONJ) . Methods: Twenty-four SD rats were divided into two groups, the experimental group was injected intraperitoneally with zoledronic acid for 12 weeks (0.2 mg/kg, three times a week), and the control group was injected with saline solution for 12 weeks. The first mandibular molars were extracted after 12 weeks. All of the animals were sacrificed eight weeks after teeth extraction...
July 9, 2018: Zhonghua Kou Qiang Yi Xue za Zhi, Zhonghua Kouqiang Yixue Zazhi, Chinese Journal of Stomatology
Shoichiro Kitajima, Susumu Mizuno, Ryo Kogiso, Chiaki Tsuji
No abstract text is available yet for this article.
July 6, 2018: Internal Medicine
Suad Aljohani, Robert Gaudin, Julian Weiser, Matthias Tröltzsch, Michael Ehrenfeld, Gabriele Kaeppler, Ralf Smeets, Sven Otto
PURPOSE: Osteonecrosis of the jaw has been recently reported in patients receiving denosumab for the treatment of metastatic bone disease and osteoporosis. It is essential to investigate this disease as a new osteonecrosis entity in order to recognize its optimal management strategies. MATERIALS AND METHODS: A total of 63 cases of denosumab-related osteonecrosis of the jaw (DRONJ) diagnosed at two clinical centres were retrospectively reviewed. Demographics, comorbidities, antiresorptive medication use, local preceding event, location, DRONJ stage, treatment and treatment outcomes were analyzed...
May 31, 2018: Journal of Cranio-maxillo-facial Surgery
Roberto Sacco, Nicola Sacco, Umar Hamid, Syed Hasan Ali, Mark Singh, John St J Blythe
Background: Osteonecrosis of the jaw (ONJ) has been reported to be associated with patients receiving primarily bisphosphonate (BP) therapies. However, lately it has been documented that other medications, such as RANK ligand inhibitor (denosumab) and antiangiogenic drug, can cause ONJ. Micro-osseous-vascular reconstruction of the jaws in patients affected by medication-related osteonecrosis of the jaw represents a viable option of treatment for patients affected by stage III of the disease...
2018: BioMed Research International
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