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Jaw osteonecrosis

Alessio Cortellini, Valentina Cocciolone, Azzurra Irelli, Francesco Pavese, Tina Sidoni, Alessandro Parisi, Paola Lanfiuti Baldi, Olga Venditti, Carla D'Orazio, Pierluigi Bonfili, Pietro Franzese, Luigi Zugaro, Lucilla Verna, Giampiero Porzio, Daniele Santini, Katia Cannita, Corrado Ficorella
The most frequent site of recurrence in breast cancer (BC) is the bone, particularly in patients with 'luminal-like' disease. Denosumab has been shown to prevent aromatase inhibitors (AIs) induced bone resorption in postmenopausal early BC patients and reduce skeletal-related events (SREs) in bone metastatic breast cancer (BMBC). A 'real life' analysis of 90 BMBC patients treated with denosumab was performed. Eighty-six patients (95.6%) had 'luminal-like' disease, 72 (80%) had bone metastases at the time of first recurrence of disease...
December 2018: Oncology Letters
Horaţiu Cristian Mânea, Horaţiu Constantin Urechescu, Nicolae Constantin Balica, Marius Octavian Pricop, Flavia Baderca, Mărioara Poenaru, Ioana Delia Horhat, Emilia Manuela Jifcu, Raluca Maria Cloşca, Cristian Andrei Sarău
INTRODUCTION: Osteonecrosis of the jaw (ONJ) is a multifactorial condition associated with bisphosphonates (BPs) treatment, head and neck irradiation, malignancy, chemotherapy, periodontal disease or trauma. The first cases of BPs-related ONJ (BRONJ) were reported over a decade ago. PATIENTS, MATERIALS AND METHODS: The study was retrospective and analyzed archived material. The study included 38 patients diagnosed and treated in the Clinic of Oral and Maxillofacial Surgery, Emergency City Hospital, Timişoara, Romania, for BRONJ, between 2013 and 2016...
2018: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
Yasuhiro Tsutani, Yoshihiro Miyata, Takeshi Masuda, Kazunori Fujitaka, Mihoko Doi, Yoshikazu Awaya, Shoichi Kuyama, Soichi Kitaguchi, Kazuhiro Ueda, Noboru Hattori, Morihito Okada
BACKGROUND: We evaluated the safety and efficacy of induction chemotherapy with bevacizumab followed by maintenance chemotherapy with bevacizumab for advanced non-small cell lung cancer (NSCLC) in this multicenter phase II study. METHODS: Chemotherapy-naïve patient with stage IIIB-IV or recurrent nonsquamous NSCLC were eligible. We planned approximately four cycles of induction cisplatin (75 mg/m2 ), pemetrexed (500 mg/m2 ), and bevacizumab (15 mg/kg) followed by maintenance with pemetrexed (500 mg/m2 ) and bevacizumab (15 mg/kg) until disease progression...
December 10, 2018: BMC Cancer
Solmaz Pourgonabadi, Ahmad Ghorbani, Zahra Tayarani Najarn, Seyed Hadi Mousavi
Objectives: Osteonecrosis of the jaw, as an exposed necrotic bone in the oral cavity, is one of the adverse effects of bisphosphonates, which have an affinity for bone minerals. This study investigates the cytotoxic effects of alendronate (ALN) as a nitrogen-containing bisphosphonate, on human dental pulp stem cells (hDPSCs). Materials and Methods: The mesenchymal stem cells (MSCs), obtained from third molar tooth pulps were characterized by immunophenotyping assay in order to identify surface markers to evaluate their expression...
September 2018: Iranian Journal of Basic Medical Sciences
Hüseyin Abdik, Ezgi Avşar Abdik, Selami Demirci, Ayşegül Doğan, Duygu Turan, Fikrettin Şahin
Bisphosphonate-induced osteonecrosis of the jaw (BIONJ) is a commonly encountered side effect of Bisphosphonates (BPs). Although certain aspects of BIONJ have been studied, the effects of BPs on the proliferation, differentiation, and maintenance of dental stem cells (DSC) in way that might account for development of BIONJ have not been evaluated. In the current study, Dental Pulp Stem Cells (DPSCs), Periodontal Stem Cells (PDLSCs), and human Tooth Germ Stem Cells (hTGSCs) were characterized and then each stem cell type were treated with selected BPs: Zoledronate (ZOL), Alendronate (ALE), and Risedronate (RIS)...
December 1, 2018: Molecular Biology Reports
Zsófia Bata, Enikő Vasziné Szabó, Zsuzsanna Tóth
Recently, drugs targeting the remodelling, vascular circulation and homeostasis of bone are frequently applied with an unquestionable benefit in the therapy of numerous severe medical conditions. Besides bisphosphonates, other antiresorptive and antiangiogenic drugs are also used, however, limited publications are focusing on data of their results. Increasing number of patients arrives the mentioned medication is increasing in the daily dental practice, especially when accurate anamnesis is taken. Our aim is to highlight the preventive considerations that help minimize the occurence of medication-related osteonecrosis of the jaw by presentating a complex dental rehabilitation of a patient at risk...
December 2018: Orvosi Hetilap
Ryota Kubo, Yoshiko Ariji, Tohru Taniguchi, Michihito Nozawa, Akitoshi Katsumata, Eiichiro Ariji
OBJECTIVES: The purpose of this study was to clarify which panoramic radiographic features can predict the development of bisphosphonate-related osteonecrosis of the jaw (BRONJ). METHODS: Participants included 24 patients treated with bisphosphonates (BP) for osteoporosis who developed osteonecrosis of the jaw (ONJ+ group). Controls included 179 patients treated with BP who did not have osteonecrosis (ONJ- group) and 200 patients with no history of BP administration (unmedicated group)...
May 2018: Oral Radiology
Takaaki Oda, Mikiko Sue, Yoshihiko Sasaki, Ichiro Ogura
OBJECTIVES: The aim of this study was to investigate the usefulness of diffusion-weighted magnetic resonance imaging (DWI) in oral and maxillofacial lesions, especially the utility of apparent diffusion coefficient (ADC) maps for differential diagnosis of these lesions. METHODS: Fifty-seven patients who underwent magnetic resonance imaging for diagnosis of oral and maxillofacial lesions were included in this prospective study. DWI was performed on a 1.5 T unit with b-factors of 0 and 800 s/mm2 , and ADC maps were generated...
September 2018: Oral Radiology
Qi-Zhang Wang, Ji-Yuan Liu, Jian Pan
Medication-related osteonecrosis of the jaw (MRONJ) is a severe complication of bisphosphonates (BPs) or other targeted agent therapies. MRONJ appears as exposed bone, pus, and swelling in the oral and maxillofacial regions. However, neither surgery nor conservative therapy can eliminate symptoms thoroughly. In addition to BPs, several antiresorptive and antiangiogenic agents, such as denosumab and bevacizumab, as well as targeted agents, such as sunitinib and temsirolimus, can cause osteonecrosis of  the  jaw according to the literature...
October 1, 2018: Hua Xi Kou Qiang Yi Xue za Zhi, Huaxi Kouqiang Yixue Zazhi, West China Journal of Stomatology
Ruri Komiya, Takahiro Wada, Fumihiko Tsushima, Kei Sakamoto, Tohru Ikeda, Akira Yamaguchi, Hiroyuki Harada, Motohiro Uo
Medication-related osteonecrosis of the jaw (MRONJ) is a serious adverse effect of antiresorptive agents like bisphosphonates. Abnormal concentrations of various trace metallic elements contained in bone minerals have been associated with MRONJ. In this study, we focused on trace metallic elements contained in the MRONJ sequestrum; their content and distribution were compared to those in osteomyelitis and non-inflammatory bones using inductively coupled plasma atomic emission spectroscopy (ICP-AES) and synchrotron radiation X-ray fluorescence analysis (SR-XRF)...
November 22, 2018: Journal of Bone and Mineral Metabolism
M Kamimura, A Taguchi, M Komatsu, H Koiwai, R Ashizawa, A Ichinose, K Takahara, S Uchiyama, H Kato
In osteoporosis patients receiving antiresorptive medications, stopping the drug and delaying tooth extraction has been suggested to reduce the risk of osteonecrosis of the jaw (ONJ). However, postponing tooth extraction for ≥ 2 months was associated with an increased risk of delayed wound healing beyond 8 weeks after extraction, a risk factor for developing ONJ. INTRODUCTION: A long waiting time before tooth extraction could result from concern about a potential increased risk of osteonecrosis of the jaw (ONJ) in osteoporosis patients...
November 20, 2018: Osteoporosis International
Stefano Storelli, Giulia Palandrani, Cristian Dondi, Luigi Tagliatesta, Alessandro Rossi
Osteonecrosis of the jaw is a rare complication that have been associated with the use of bisphosphonates (BP). A 77 years old patient presented in April 2013 asking for a consultation. She reported that in May 2009, she underwent an implant rehabilitation with 8 implants and an immediately loaded fixed prosthesis in the maxilla. After few months the patient started to report pain and purulent secretions, that were neglected by the clinician for several years. She decided to refer to the Dental Clinic after another acute pain episode...
November 19, 2018: Journal of Oral Implantology
Kenneth E Fleisher, Malvin N Janal, Nicole Albstein, James Young, Vanessa Bikhazi, Shlomit Schwalb, Mark Wolff, Robert S Glickman
OBJECTIVE: Osteonecrosis of the jaw (ONJ) is commonly associated with antiresorptive therapy. There have been numerous reports of ONJ unrelated to antiresorptive therapy (ONJuat ), confounding risk assessment. This study aimed to determine if ONJuat is associated with one or more particular comorbidities. STUDY DESIGN: This was a retrospective case-control study of patients with ONJuat and delayed healing (DH). Each case was matched for patient age and gender, as well as location of ONJuat or DH lesion to a control patient who had a history of dentoalveolar surgery with uneventful healing and no history of antiresorptive therapy...
October 5, 2018: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Erdem Kilic, Ozge Doganay
Bisphosphonate (BP) drugs are used to preserve bony tissue in patients diagnosed with osteoporosis and metastatic bone disease. However, these drugs are associated with rare but serious complications. The most commonly encountered adverse effect is bisphosphonate-related osteonecrosis of the jaw (BRONJ). Diagnosis and treatment of teeth that are likely to cause infection and the replacement or adjustment of dentures or restorations that could lead to trauma are the key steps that can be taken before the initiation of BP therapy in order to prevent the development of BRONJ...
November 2018: General Dentistry
Rokas Gelazius, Lukas Poskevicius, Dalius Sakavicius, Vaidas Grimuta, Gintaras Juodzbalys
Objectives: The review aims to study dental implant placement purposefulness for patients who have been treated or are on treatment with bisphosphonate medication. Material and Methods: Structured search strategy was applied on electronic databases: MEDLINE, PubMed, PubMed Central and ResearchGate. Scientific publications in English between 2006 and 2017 were identified in accordance with inclusion, exclusion criteria. Publication screening, data extraction, and quality assessment were performed...
July 2018: Journal of Oral & Maxillofacial Research
Fiona McDonnell, Clare Steel
Osteonecrosis of the jaws (ONJ) can be a serious complication of radiation and anti-resorptive therapies. At present, patients due to undergo radiotherapy are required to have a dental assessment to treat current or anticipated dental disease prior to commencing treatment. However no agreed guidelines are in place for those due to start anti-resorptive therapy for cancer. More patients are now being treated with various drug therapies and new combinations of drugs with unknown long-term effects, with many patients now surviving their disease for longer periods of time...
September 1, 2018: Primary Dental Journal
Scott Bragg, Jennifer Bain, Anita Ramsetty
Osteoporosis management has undergone several paradigm shifts over the past 20 years because of emerging technologies and new treatments and decision support tools to guide risk assessment. Practice guidelines in the United States and abroad differ widely on recommendations for screening, prevention, and management. Screening has evolved, with improvements in bone mineral density testing, vertebral fracture assessment, trabecular bone scores, and decision support tools. All of these have improved the identification of patients at high risk of fractures...
November 2018: FP Essentials
Antimo Moretti, Alessandro de Sire, Claudio Curci, Giuseppe Toro, Francesca Gimigliano, Giovanni Iolascon
BACKGROUND: Denosumab is a fully human IgG2 monoclonal antibody that, neutralizing the receptor activator of nuclear factor kappa-Β ligand (RANKL), inhibits the osteoclast-mediated bone resorption. It is yet to be defined if denosumab can reduce osteoporosis-related disability and improve health related quality of life (HRQoL) in patients with fragility fractures. OBJECTIVE: To assess the effectiveness of denosumab in reducing back pain related disability and improving HRQoL in osteoporotic post-menopausal women with vertebral fractures...
November 8, 2018: Current Medical Research and Opinion
Shin-Ichi Yamada, Hiroshi Kurita, Eiji Kondo, Shigeru Suzuki, Fumihiro Nishimaki, Nobuhiko Yoshimura, Masafumi Morioka, Shutaro Ishii, Takahiro Kamata
OBJECTIVES: The purpose of this study was to investigate the treatment outcomes and prognostic factors of medication-related osteonecrosis of the jaw (MRONJ) in Japanese patients. PATIENTS AND METHODS: Among 409 cases, treatment outcomes and prognostic factors were investigated in 275 patients. In statistical analyses, the 1-year cumulative curative rate was calculated with the Kaplan-Meier method, and significance was examined with the Wilcoxon test. Cox's proportional hazards regression analysis was used for the multivariate analysis...
November 8, 2018: Clinical Oral Investigations
T Hasegawa, S Hayashida, E Kondo, Y Takeda, H Miyamoto, Y Kawaoka, N Ueda, E Iwata, H Nakahara, M Kobayashi, S Soutome, S I Yamada, I Tojyo, Y Kojima, M Umeda, S Fujita, H Kurita, Y Shibuya, T Kirita, T Komori
Root amputation, immunosuppressive therapy, mandibular tooth extraction, pre-existing inflammation, and longer duration of treatment with bone-modifying agents were significantly associated with an increased risk of medication-related osteonecrosis of the jaw. Hopeless teeth should be extracted without drug holiday before the development of inflammation in cancer patients receiving high-dose bone-modifying agents. INTRODUCTION: No studies have comprehensively analyzed the influence of pre-existing inflammation, surgical procedure-related factors such as primary wound closure, demographic factors, and drug holiday on the incidence of medication-related osteonecrosis of the jaw (MRONJ)...
November 7, 2018: Osteoporosis International
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