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https://www.readbyqxmd.com/read/28289268/meaning-and-limitation-of-cortical-bone-width-measurement-with-dentascan-in-medication-related-osteonecrosis-of-the-jaws
#1
Eiji Iwata, Masaya Akashi, Megumi Kishimoto, Junya Kusumoto, Takumi Hasegawa, Shungo Furudoi, Takahide Komori
Mandibular cortical bone measurement with x-ray imaging is known to be a potentially useful tool in the detection of dimensional changes caused by bisphosphonate. The primary purpose of this study was to assess the meaning and limitation of cortical bone measurement with computed tomography (CT) in patients with medication-related osteonecrosis of the jaw (MRONJ). The investigators obtained DentaScan images of the mandible from 15 patients with MRONJ, 15 patients with a history of antiresorptive agent administration without symptoms of MRONJ (non-MRONJ), and 15 control subjects...
February 15, 2017: Kobe Journal of Medical Sciences
https://www.readbyqxmd.com/read/28281587/mronj-risk-reduction-pathway-360-degree-survey
#2
A Muthukrishnan, S Al-Ismail, G Bertelli, P Browne
Introduction Bisphosphonates and denosumab reduce the risk of skeletal events in some malignancies (for example, breast, myeloma). These drugs carry a significant risk of a difficult-to-manage side effect of medication related osteonecrosis of the jaw (MRONJ). Preventive dental screening and treatment reduces the incidence of MRONJ. A managed clinical network (MCN) has been used to provide a MRONJ risk reduction pathway. A 360 degree survey was undertaken to assess the effectiveness of the pathway.Aim The aim of the 360 degree survey was to evaluate if this preventive pathway fulfilled its aims based on patient and stakeholder responses...
March 10, 2017: British Dental Journal
https://www.readbyqxmd.com/read/28241916/the-prevention-of-medication-related-osteonecrosis-of-the-jaw
#3
Philipp Poxleitner, Monika Engelhardt, Rainer Schmelzeisen, Pit Voss
BACKGROUND: Medication-related osteonecrosis of the jaw (MRONJ) is a preventable complication of antiresorptive treatment. It arises in 1-20% of patients with bone metastases of solid tumors and hematologic malignancies and in 0.1-2% of patients being treated for osteoporosis with bisphosphonates. Depending on the underlying disease and medication dosage, the risk of MRONJ can be elevated even in the first year of antiresorptive treatment. The treatment of MRONJ is difficult and often involves surgery of the jaw...
February 3, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28220264/treatment-of-stage-ii-medication-related-osteonecrosis-of-the-jaw-with-necrosectomy-and-autologous-bone-marrow-mesenchymal-stem-cells
#4
Pit Jacob Voss, Akihiko Matsumoto, Esteban Alvarado, Rainer Schmelzeisen, Fabian Duttenhöfer, Philipp Poxleitner
Treatment strategies for medication-related osteonecrosis of the jaw (MRONJ) remain controversial. Although the AAOMS suggests a conservative approach, a surgical management with necrosectomy is often required when conservative management has failed. Moreover, recent studies have shown promising results using an early stage surgical treatment. Over the past decade, cell-based bone regeneration utilizing bone marrow mesenchymal stem cells (MSCs) received increased attention. MSCs are known to promote wound healing and induce new bone formation in compromised tissue...
February 20, 2017: Odontology
https://www.readbyqxmd.com/read/28174631/medication-related-osteonecrosis-of-the-jaws-caused-lethal-sepsis-in-an-edentulous-patient-with-multiple-systemic-factors
#5
Keisuke Yamashiro, Aki Sato, Fumihiko Okazaki, Makoto Nakano, Koichi Sawaki, Yasuhisa Hirata, Eiki Yamachika, Seiji Iida, Shogo Takashiba
Medication-related osteonecrosis of the jaw (MRONJ) is developed even in the patients who are edentulous and treated with short-term bisphosphonate therapy and oral administration. It sometimes causes lethal sepsis in patients who have multiple health problems such as diabetes, cirrhosis, steroid use for interstitial pneumonia, sepsis, and spinal disk herniation.
February 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28162845/role-of-microbiological-culture-and-polymerase-chain-reaction-pcr-of-actinomyces-in-medication-related-osteonecrosis-of-the-jaw-mronj
#6
Sappasith Panya, Riham Fliefel, Florian Probst, Matthias Tröltzsch, Michael Ehrenfeld, Sören Schubert, Sven Otto
We hypothesized that local infection plays a critical role in the pathogenesis of medication-related osteonecrosis of the jaw (MRONJ). Recent developments in molecular methods have revolutionized new approaches for the rapid detection of microorganisms including those difficult to culture. The aim of our study is to identify the bacterial profiles in MRONJ by microbiological culture and polymerase chain reactions (PCR). A retrospective analysis was performed on MRONJ patients from 2008 to 2014. The bacterial profile from MRONJ bone samples was determined using microbiological culture and PCR...
March 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28159588/bacterial-diversity-in-medication-related-osteonecrosis-of-the-jaw
#7
Fredrik Hallmer, Tore Bjørnland, Gunilla Andersson, Jonas P Becktor, Anne K Kristoffersen, Morten Enersen
OBJECTIVE: The aim was to study the association between microflora and medication-related osteonecrosis of the jaw (MRONJ) by using culture-independent molecular techniques to detect bacteria in necrotic bone lesions. STUDY DESIGN: Included were 18 consecutive patients with MRONJ, 10 with osteoporosis and 8 cancer patients. Bone biopsies were retrieved from the center of the necrotic bone and from visually healthy bone, and 16 S rRNA gene fragments from bacterial DNA were amplified with polymerase chain reaction...
December 7, 2016: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
https://www.readbyqxmd.com/read/28149479/prophylaxis-and-antibiotic-therapy-in-management-protocols-of-patients-treated-with-oral-and-intravenous-bisphosphonates
#8
REVIEW
Elena-Beatriz Bermúdez-Bejarano, María-Ángeles Serrera-Figallo, Aida Gutiérrez-Corrales, Manuel-María Romero-Ruiz, Raquel Castillo-de-Oyagüe, José-Luis Gutiérrez-Pérez, Daniel Torres-Lagares
INTRODUCTION: Osteonecrosis of the jaw (MRONJ) linked to bisphosphonate treatment has specific characteristics that render its therapeutic management challenging for clinicians. Poor response to standard treatment makes it essential to take special precautions when treating this type of disease; therefore, antibiotic prophylaxis and/or antibiotic therapy have been proposed as effective and helpful tools in these situations. OBJECTIVES: This article seeks to assess published evidence in order to evaluate the different protocols used for antibiotic prophylaxis and/or antibiotic therapy in the general context of patients treated with bisphosphonates...
January 2017: Journal of Clinical and Experimental Dentistry
https://www.readbyqxmd.com/read/28126996/awareness-of-medication-related-osteonecrosis-of-the-jaws-mronj-amongst-general-dental-practitioners
#9
N Tanna, C Steel, S Stagnell, E Bailey
Background Recent evidence suggests that medication-related osteonecrosis of the jaw (MRONJ) can be caused by a number of anti-resorptive and anti-angiongenic agents not limited to bisphosphonates. A working knowledge of these medications is important for dental practitioners.Methods A total of 129 general dental practitioners (GDPs) were surveyed regarding their awareness of MRONJ and its causes.Results More than 90% of the GDPs sampled were unaware of anti-resorptive and anti-angiogenic medications other than bisphosphonates that had the potential to cause MRONJ...
January 27, 2017: British Dental Journal
https://www.readbyqxmd.com/read/28108142/identifying-mronj-affected-bone-with-digital-fusion-of-functional-imaging-fi-and-cone-beam-computed-tomography-cbct-case-reports-and-hypothesis
#10
Gayathri Subramanian, Evelyne Kalyoussef, Meredith Blitz-Goldstein, Jessenia Guerrero, Nasrin Ghesani, Samuel Y P Quek
Surgical debridement of medication-related osteonecrosis of the jaw (MRONJ) lesions is far less predictable than lesion resection. Margins for surgical debridement are guided by surrogate markers of bone viability, such as bleeding and bone fluorescence, which limit debridement to visibly necrotic bone. In contrast, surgical resection is extensive, including a substantial portion of surrounding bone. The concept that the MRONJ lesion is a composite of affected but viable ("compromised") and necrotic bone is supported by histopathological data...
March 2017: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
https://www.readbyqxmd.com/read/28101496/medication-related-osteonecrosis-of-the-jaw-a-preliminary-retrospective-study-of-130-patients-with-multiple-myeloma
#11
Woo-Sung Choi, Jae-Il Lee, Hyun-Joong Yoon, Chang-Ki Min, Sang-Hwa Lee
BACKGROUND: Multiple myeloma (MM) is characterized by a neoplastic proliferation of plasma cells primarily in the bone marrow. Bisphosphonates (BP) are used as supportive therapy in the management of MM. This study aimed to analyze the incidence, risk factors, and clinical outcomes of medication-related necrosis of the jaw (MRONJ) in MM patients. METHODS: One hundred thirty MM patients who had previous dental evaluations were retrospectively reviewed. Based on several findings, we applied the staging and treatment strategies on MRONJ...
December 2017: Maxillofacial Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28087282/short-term-perioperative-teriparatide-therapy-for-the-prevention-of-medication-related-osteonecrosis-of-the-jaw-a-randomized-controlled-preclinical-study-in-rats
#12
Mohammad Zandi, Arash Dehghan, Amirhossein Mohammadi-Mofrad, Payam Amini, Farshid Vahdatinia
OBJECTIVE: Dentoalveolar procedures in patients receiving bisphosphonates and other antiresorptive agents are associated with an increased risk of medication-related osteonecrosis of the jaw (MRONJ). The aim of present study was to evaluate the effects of perioperative teriparatide (TPD) therapy in prevention of MRONJ. SUBJECTS AND METHODS: Two protocols of TPD therapy were studied. For protocol A, 25 TPD-treated (AT) and 25 control (AC) rats received 5 weekly injection of 0...
December 19, 2016: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28078129/osteonecrosis-of-the-jaw-associated-with-ziv-aflibercept
#13
Hani Mawardi, Peter Enzinger, Nadine McCleary, Reshma Manon, Alessandro Villa, Nathaniel Treister, Sook-Bin Woo
Medication-related osteonecrosis of the jaw (MRONJ) has been associated with medications that include bisphosphonates (BPs), denosumab, bevacizumab and sunitinib. Ziv-aflibercept is a recombinant human vascular endothelial growth factor (VEGF) receptor which has been used to treat patients with various advanced solid tumors. We report three patients without a history of the use of medications known to cause MRONJ presenting with jaw osteonecrosis typical for MRONJ following therapy with ziv-aflibercept. All patients had metastatic gastrointestinal cancer treated with ziv-aflibercept and were evaluated for MRONJ because of exposed bone in the oral cavity...
December 2016: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28061356/clinical-differences-in-autofluorescence-between-viable-and-nonvital-bone-a-case-report-with-histopathologic-evaluation-performed-on-medication-related-osteonecrosis-of-the-jaws
#14
Ilaria Giovannacci, Marco Meleti, Domenico Corradi, Paolo Vescovi
Medication-related osteonecrosis of the jaws (MRONJ) is an adverse side effect of several drug therapies, including bisphosphonates (BPs). Osteonecrosis of the jaw specifically related to BP therapy is usually referred to using the acronym BRONJ. However, no consensus has yet been reached regarding the most appropriate management of BRONJ. The greatest success rates have been recorded with surgical removal of necrotic bone. In particular, erbium:yttrium-aluminum-garnet (Er:YAG) laser-assisted surgery has shown significantly better results than conventional surgical approaches...
December 15, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28042979/does-the-addition-of-bone-morphogenetic-protein-2-to-platelet-rich-fibrin-improve-healing-after-treatment-for-medication-related-osteonecrosis-of-the-jaw
#15
Jung-Hyun Park, Jin-Woo Kim, Sun-Jong Kim
PURPOSE: To investigate the effect of the addition of bone morphogenetic protein 2 (BMP-2) to leukocyte-rich and platelet-rich fibrin (L-PRF) on the treatment of medication-related osteonecrosis of the jaws (MRONJ), this study compared the healing outcome of combined use of BMP-2 and L-PRF with single use of L-PRF. PATIENTS AND METHODS: Of 55 patients who were diagnosed with MRONJ, 25 were treated with L-PRF alone and 30 were treated with L-PRF and recombinant human BMP-2...
December 11, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28034471/pentoxifylline-a-review-of-its-use-in-osteoradionecrosis
#16
REVIEW
A J Lyons, P A Brennan
Pentoxifylline has been used to treat complications related to fibrosis for over 20 years. Formerly used to treat those after radiotherapy such as osteoradionecrosis (ORN), it is now being tried for medication-related osteonecrosis of the jaw (MRONJ), which can occur after prolonged use of bisphosphonates. We review theories on the formation of fibrosis in patients with ORN, discuss the pharmacology of pentoxifylline and vitamin E, and report published outcomes. To our knowledge no prospective randomised controlled trial has investigated the benefits of these agents in cases of ORN, but reported outcomes in many published case series are encouraging...
December 26, 2016: British Journal of Oral & Maxillofacial Surgery
https://www.readbyqxmd.com/read/27924427/treatment-of-medication-related-osteonecrosis-of-the-jaws-mronj-with-ultrasonic-piezoelectric-bone-surgery-a-case-series-of-20-treated-sites
#17
Cornelio Blus, Giulio Giannelli, Serge Szmukler-Moncler, Germano Orru
PURPOSE: There is no consensus on how to successfully treat medication-related osteonecrosis of the jaws (MRONJ). We report here on the application of piezoelectric bone surgery to treat MRONJ in combination with antibiotherapy and on its possible benefit. MATERIEL AND METHODS: A cohort of 18 consecutive patients has been treated for MRONJ; they involved 20 sites, 15 in the mandible, and five in the maxilla. Surgical removal of the necrotic areas and debridement was performed with a powerful piezoelectric surgery device (max 90 W) in combination with antibiotherapy...
December 6, 2016: Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/27856150/comparison-of-auto-fluorescence-and-tetracycline-fluorescence-for-guided-bone-surgery-of-medication-related-osteonecrosis-of-the-jaw-a-randomized-controlled-feasibility-study
#18
O Ristow, S Otto, C Geiß, V Kehl, M Berger, M Troeltzsch, S Koerdt, B Hohlweg-Majert, C Freudlsperger, C Pautke
Recent studies have indicated that bone shows auto-fluorescence under an appropriate fluorescence lamp. The aim of this preliminary study was to compare the success rates of the established tetracycline fluorescence-guided bone surgery with auto-fluorescence-guided bone surgery in the treatment of medication-related osteonecrosis of the jaw (MRONJ). Forty patients suffering from MRONJ were referred for surgical treatment and were divided randomly into two groups: auto-fluorescence (n=20) or tetracycline fluorescence (n=20) guided bone surgery...
February 2017: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/27843453/medication-related-osteonecrosis-of-the-jaws-considerations-on-a-new-antiresorptive-therapy-denosumab-and-treatment-outcome-after-a-13-year-experience
#19
Gianfranco Favia, Angela Tempesta, Luisa Limongelli, Vito Crincoli, Eugenio Maiorano
Medication-related osteonecrosis of the jaw (MRONJ) is a serious complication in patients receiving antiresorptive therapies for bone neoplastic localizations and osteoporosis. The aim of this study was to evaluate the clinicopathological features of MRONJ in a cohort of patients treated by new antiresorptive drugs (denosumab) and the corresponding outcome after 13-year maximum follow-up. Overall, 244 patients affected by MRONJ were treated from 2003 to 2015. After clinical and radiological examinations, all lesions were staged according to a dimensional staging system and then surgically treated...
2016: International Journal of Dentistry
https://www.readbyqxmd.com/read/27837344/platelet-rich-fibrin-may-reduce-the-risk-of-delayed-recovery-in-tooth-extracted-patients-undergoing-oral-bisphosphonate-therapy-a-trial-study
#20
Takuya Asaka, Noritaka Ohga, Yutaka Yamazaki, Jun Sato, Chiharu Satoh, Yoshimasa Kitagawa
OBJECTIVES: The aim of the present study was to evaluate the effectiveness of platelet-rich fibrin (PRF) as a wound-healing accelerator in patients undergoing oral bisphosphonate therapy and requiring tooth extractions. MATERIALS AND METHODS: A total of 102 patients were divided into a PRF group and control group. The patients received oral bisphosphonate therapy for osteoporosis for an average of 32 months. Blood was collected and PRF was introduced into the socket of the PRF group only...
November 11, 2016: Clinical Oral Investigations
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