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Jaw osteonecrosis

V Mendes, G O Dos Santos, M D Calasans-Maia, J M Granjeiro, V Moraschini
The purpose of this overview was to assess the methods, quality, and outcomes of systematic reviews conducted to evaluate the impact of bisphosphonates on dental implants and the risk of developing bisphosphonate-related osteonecrosis of the jaw after dental implant surgery. An electronic search without date or language restriction was performed in the PubMed/MEDLINE, Cochrane CENTRAL, Web of Science, and LILACS databases (to January 2018). Eligibility criteria included systematic reviews that evaluated the impact of bisphosphonates on implant outcomes...
October 9, 2018: International Journal of Oral and Maxillofacial Surgery
Andreas Stavropoulos, Kristina Bertl, Peter Pietschmann, Nikolaos Pandis, Morten Schiødt, Björn Klinge
OBJECTIVES: A considerable portion of the adult population has received and/or is receiving treatment with antiresorptive drugs (ARDs). It is thus relevant to assess possible side effects of ARD intake in connection to various aspects of implant therapy. The aim of this study was to answer the focused question "In patients with systemic intake of ARDs, what is the outcome and complication rate of implant therapy including associated bone grafting procedures comparing to patients without systemic intake of ARDs?" MATERIALS AND METHODS: Original studies fulfilled predefined inclusion criteria (e...
October 2018: Clinical Oral Implants Research
Olga Di Fede, Vera Panzarella, Rodolfo Mauceri, Vittorio Fusco, Alberto Bedogni, Lorenzo Lo Muzio, Sipmo Onj Board, Giuseppina Campisi
Medication-related osteonecrosis of the jaw (MRONJ) is a serious adverse reaction of antiresorptive and antiangiogenic agents; it is a potentially painful and debilitating condition that can considerably affect the quality of life of patients. Furthermore, even if its epidemiology and pathogenesis have still not been fully clarified, several risk factors related to MRONJ have been recognized in prevention protocols. Three main risk factors are as follows: (i) the type of ONJ-related medications: antiresorptive (e...
2018: BioMed Research International
Gabriel N Hortobagyi, Ming Zheng, Ramon Mohanlal
BACKGROUND: Zoledronic acid (ZA), a potent bisphosphonate used for treatment of bone metastasis, has high bone affinity. This post hoc analysis evaluated the effects of long-term treatment and reduction in dosing frequency of ZA on bone saturation. MATERIALS AND METHODS: Pharmacokinetic data from three independent studies, OPTIMIZE-2 (patients receiving ≥9 doses of bisphosphonates) and two phase I studies, CZOL4460503 and CZOL4460506 (patients who were bisphosphonate naïve/bisphosphonate free for ≥1 year after previous dosing), were pooled...
October 8, 2018: Oncologist
Mehmet Ali Altay, Alexandra Radu, Sean E Pack, Nelli Yıldırımyan, Andres Flores-Hidalgo, Dale A Baur, Faisal A Quereshy
OBJECTIVES: This study aimed to evaluate and report the outcomes associated with the management of patients who were treated surgically for medication-related osteonecrosis of the jaw (MRONJ). METHODS: Demographic and medical profiles of patients with a diagnosis of MRONJ were created. The type of surgical treatment, complications, and treatment outcomes were identified. RESULTS: Twenty-one patients with an average age of 68.42 years (range 40-90 years) were included...
October 9, 2018: Cranio: the Journal of Craniomandibular Practice
Grethe Jonasson, Ingmarie Skoglund, Marianne Rythén
The alveolar bone has a unique capacity to follow the teeth's movements. It is formed around erupting teeth and their periodontal ligaments: the more the teeth have erupted, the larger the alveolar process. Throughout life the teeth erupt and migrate in an occlusal and mesial direction to compensate for attrition, an evolutionary trait. After tooth extraction, the alveolar process is resorbed to varying degrees. The mandibular alveolar bone mirrors skeletal bone condition. Due to fast bone turnover (which is the fastest in the whole skeleton), low bone mass and increased fracture risk may first be seen here...
September 28, 2018: Archives of Oral Biology
David Steybe, Pit Jacob Voss, Michael Andreas Ermer, Marc Anton Fuessinger, Rainer Schmelzeisen, Philipp Poxleitner
BACKGROUND: Necrotizing fasciitis has been reported as a complication secondary to bisphosphonate-related osteonecrosis of the jaw (BRONJ) in a low number of patients. The only report of such a case in an osteoporosis patient found in current literature was related to short-term bisphosphonate but long time corticosteroid and methotrexate treatment. CASE PRESENTATION: In this article, we report a case of necrotizing fasciitis secondary to osteonecrosis of the jaw related to long-term oral bisphosphonate treatment in an osteoporosis patient additionally suffering from poorly controlled type 2 diabetes...
October 5, 2018: Oral and Maxillofacial Surgery
Kenichi Ogata, Mayu Matsumura, Masafumi Moriyama, Wataru Katagiri, Hideharu Hibi, Seiji Nakamura
Recently, several studies have demonstrated that intravenous administration of mesenchymal stem cells (MSCs) improve medication-related osteonecrosis of the jaw (MRONJ), and paracrine effects of secretomes from MSCs have been hypothesized as the primary contributors. These secretomes in conditioned media from human MSCs (MSC-CM) were previously demonstrated to promote bone and tissue regeneration. Because MSC-CM contain cytokines monocyte chemoattractant protein (MCP)-1, insulin growth factor (IGF)-1, and vascular endothelial growth factor (VEGF) at relatively higher concentrations than other factors, these cytokines were considered as relevant active factors for tissue regeneration...
March 2018: JBMR Plus
Aline Guillot, Charlotte Joly, Philippe Barthélémy, Emeline Meriaux, Sylvie Negrier, Damien Pouessel, Christine Chevreau, Hakim Mahammedi, Nadine Houede, Guilhem Roubaud, Gwenaelle Gravis, Sophie Tartas, Laurence Albiges, Cécile Vassal, Mathieu Oriol, Fabien Tinquaut, Sophie Espenel, Wafa Bouleftour, Stéphane Culine, Karim Fizazi
BACKGROUND: About one-third of patients with renal cell carcinoma (RCC) have detectable metastases at diagnosis. Among them, bone is the second most frequent metastatic site. Treatment of metastatic RCC mostly relies on anti-angiogenic (AA) therapies and, more recently, immunotherapy. Skeletal-related events (SREs) can be prevented with bone-targeted therapies such as denosumab (Dmab), which has demonstrated superiority when compared with zoledronic acid in solid tumors. However, there is limited available data on Dmab toxicity in combination with AA therapies in patients with kidney cancer...
September 6, 2018: Clinical Genitourinary Cancer
Matthias Zirk, Charlotte Wenzel, Johannes Buller, Joachim E Zöller, Max Zinser, Franziska Peters
OBJECTIVES: A central role of infections in the treatment of MRONJ patients is widely accepted. An investigation of the MRONJ lesions' biofilms as potential pathogens seems logical. MATERIALS AND METHODS: We investigated the clinical data of our MRONJ patients who received surgery in advanced stage of the disease. Special attention was granted to the local colonizers harvested from osseous MRONJ specimens and submucosal putrid infections. RESULTS: Eleven out of 71 patients presented a spontaneous onset of the disease and for 60 out of 71 patients a trigger was detected...
October 1, 2018: Clinical Oral Investigations
Alfredo Fabrizio Lo Faro, Raffaele Giorgetti, Francesco Paolo Busardò, Giovanni Lodi, Valeria Martini, Alberto Pispero, Marcello Iriti, Elena Maria Varoni
A method for the extraction and quantification of zoledronic acid (ZA) from human bone was set up and validated. This method allowed the quantification of ZA from jawbone sequestrations of patients affected by bisphosphonate-related osteonecrosis of the jaw (BRONJ) associated with ZA treatment. The analyte was extracted from the bone tissues with phosphoric acid and derivatized using trimethylsilyl diazomethane (TMS-DAM). ZA tetramethyl phosphonate was then quantified by liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS), showing high accuracy, repeatability and selectivity...
September 20, 2018: Journal of Pharmaceutical and Biomedical Analysis
Sunita Mc De Sousa, David Jesudason
Denosumab is a monoclonal antibody against the receptor activator of nuclear factor kappa-B ligand (RANKL) with potent antiresorptive activity. In Australia, it is available alongside bisphosphonates as a first-line osteoporosis therapy on the Pharmaceutical Benefits Scheme (PBS). Denosumab is often preferred because of ease of administration, tolerability and safety/efficacy in patients with restricted renal function. Some dentists and clinicians may find denosumab attractive because of its reversibility, possibly allowing for dental procedures between injections or after a short interruption of therapy with a theoretically smaller risk of osteonecrosis of the jaw...
September 30, 2018: Clinical Endocrinology
Akrivoula Soundia, Danny Hadaya, Sanjay M Mallya, Tara L Aghaloo, Sotirios Tetradis
OBJECTIVE: The aim of this study was to explore the radiographic appearance of stage 0 medication-related osteonecrosis of the jaws (MRONJ) and examine 5 radiographic parameters (trabecular sclerosis, cortical erosion, periosteal reaction, sequestration, and crater-like defect) as predictors of progression to bone exposure. STUDY DESIGN: Twenty-three patients with a history of antiresorptive therapy, no bone exposure, and nonspecific signs and symptoms were included...
August 29, 2018: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Fredrik Hallmer, Gunilla Andersson, Bengt Götrick, Gunnar Warfvinge, Jonas Anderud, Tore Bjørnland
OBJECTIVES: Medication-related osteonecrosis of the jaw (MRONJ) has a wide range of prevalence, and a standard therapy has not yet been established. The aim of this study was to analyze the prevalence and initiating factors of MRONJ and the outcomes of surgical therapy. STUDY DESIGN: In a prospective cohort study, all patients diagnosed with MRONJ in the Region of Skåne, in Sweden, were included. Predictor variables (comorbidity, site, stage, gender) and initiating factors (tooth extraction, periodontitis) were recorded...
August 31, 2018: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Harry Karna, Jaime Gonzalez, Harveen S Radia, Parish P Sedghizadeh, Reyes Enciso
The purpose of this systematic review with meta-analysis was to assess the effectiveness of dental interventions in preventing or reducing the incidence of medication-related osteonecrosis of the jaw (MRONJ) in cancer patients receiving antiresorptive therapy, compared to similar control groups receiving no intervention. Randomized controlled trials (RCT), case-controls and cohorts on cancer patients with primary outcome being the prevalence of MRONJ were included. Four electronic databases were searched (Cochrane Library, PubMed, EMBASE and Web of Science) up to February 12, 2018...
October 2018: Oral Oncology
Danny Hadaya, Akrivoula Soundia, Ioannis Gkouveris, Sarah M Dry, Tara L Aghaloo, Sotirios Tetradis
PURPOSE: Medication-related osteonecrosis of the jaw (MRONJ) is a rare but severe side effect of antiresorptive medications. Most animal models use tooth extraction as an instigating local factor to induce MRONJ, with varied results. However, these teeth are healthy and absent of dental disease, a rare finding that does not reflect clinical practices. The authors hypothesized that extraction of teeth with periapical inflammation would lead to MRONJ in rats treated with high-dose bisphosphonates...
August 22, 2018: Journal of Oral and Maxillofacial Surgery
Rodolfo Mauceri, Vera Panzarella, Laura Maniscalco, Alberto Bedogni, Maria Ester Licata, Antonino Albanese, Francesca Toia, Enzo Maria Giuseppe Cumbo, Giuseppina Mazzola, Olga Di Fede, Giuseppina Campisi
Introduction: The management of bisphosphonate-related osteonecrosis of the jaw (BRONJ), with no evidence-based guidelines, remains controversial. We aimed to evaluate the efficiency of a conservative surgical treatment combining Er,Cr:YSGG laser and platelet-rich plasma (PRP) for the treatment of BRONJ in cancer patients. Methods: We performed a longitudinal cohort study. Inclusion criteria were (1) age ≥ 18 years; (2) cancer diagnosis; (3) treatment with NBP because of the underlying cancer...
2018: BioMed Research International
Taggreed Wazzan, Deeba Kashtwari, Wejood F Almaden, Yan Gong, Yiqing Chen, Jan Moreb, Joseph Katz
Risk factors for medication-related osteonecrosis of the jaws (MRONJ) include type and duration of antiresorptive drugs, dental trauma, local anatomy, systemic underlying conditions and therapy, smoking, and the presence of periodontal disease. However, there is a lack of studies elucidating the role of periodontal disease as risk predictor. In the present study, the dental charts of 100 multiple myeloma (MM) patients and 16 MM patients who developed MRONJ were studied. Information about age, gender, smoking history, diabetes, steroid drug intake, type and duration of bisphosphonate (BP) treatments, MRONJ status, missing teeth, periapical lesions, widening of the periodontal ligament, and periodontal status was collected...
September 8, 2018: Special Care in Dentistry
Alexandre T Assaf, Vivien Amberg, Ralf Smeets, Johannes Wikner, Henning Hanken, Jan Semmusch, Florian Ewald, Ashkan Rashad, Reinhard E Friedrich
BACKGROUND/AIM: The purpose of this study was to evaluate a potential widening of the periodontal space as an initial measurable imaging criterium on panoramic radiographs in patients with the diagnosis of antiresorptive drug related osteonecrosis of the jaw (ARONJ). PATIENTS AND METHODS: A retrospective analysis of panoramic radiographs of 16 patients (12 females and 4 males; mean age is 70.5 years, standard deviation is 14 years) was performed, over a period of 12 months with the diagnosis of ARONJ...
September 2018: Anticancer Research
Arash Khojasteh, Mohammad Mehdi Dehghan, Pantea Nazeman
OBJECTIVES: Bisphosphonates (BPs) are anti-resorptive medications with inhibitory effects on osteoclasts which decrease bone turnover. The present study aimed to assess the early effects of BPs on peri-implant bone. MATERIALS AND METHODS: Twelve female mongrel dogs were assigned to one control and two experimental groups as follows: 12 months of oral alendronate (ALN, 3.5 mg/kg/week) or intravenous (IV) pamidronate (PAM, 1 mg/kg/week) for experimental groups...
September 5, 2018: Clinical Oral Investigations
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