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G Favia, A Tempesta, L Limongelli, V Crincoli, E Maiorano
Medication-related osteonecrosis of the jaw (MRONJ) is a severe side effect of antiresorptive (bisphosphonates and denosumab) and anti-angiogenic therapy used in the management of oncologic and, less frequently, osteoporotic patients. While there is good international agreement on the diagnostic and staging criteria of MRONJ and the cessation of antiresorptive/anti-angiogenic treatments, the gold standard of treatment is still controversial, in particular between non-surgical and surgical approaches. The former usually includes antiseptic mouth rinse, cyclic antibiotic therapy, low-level laser therapy and periodic dental checks; the latter consists of surgical necrotic bone removal...
March 2018: Oral Diseases
Márcio Diniz-Freitas, Javier Fernández-Feijoo, Pedro Diz, Xiana Pousa, Jacobo Limeres
INTRODUCTION: Osteonecrosis of the jaw associated with bisphosphonates is currently called medication-related osteonecrosis of the jaw (MRONJ), given that in addition to bisphosphonates, jaw osteonecrosis has been related to the administration of other antiresorptive and antiangiogenic drugs, such as denosumab, sunitinib, bevacizumab and ipilimumab. CASE PRESENTATION: A 77-year-old patient with osteoporosis treated with subcutaneous injections of denosumab at an interval of 6 months is presented...
February 26, 2018: Journal of Clinical Periodontology
D Patel, V Patel
No abstract text is available yet for this article.
February 23, 2018: British Dental Journal
Kelly McGowan, Saso Ivanovski, Caroline Acton
BACKGROUND: Osteonecrosis of the jaw (ONJ) is a serious complication of both radiation and antiresorptive therapies. This study aimed to determine how many patients have been treated for medication-related osteonecrosis of the jaws (MRONJ) and osteoradionecrosis (ORN), and whether the number of diagnoses has decreased over time with improved awareness and preventative measures. METHODS: Medical records at the Royal Brisbane & Women's Hospital, Gold Coast University Hospital, and Robina Hospital were reviewed to identify patients diagnosed with MRONJ and ORN between January 2003 - May 2017...
February 12, 2018: Australian Dental Journal
Matias-Ferrán Escobedo, Luis García-Consuegra, Silvia Gay, Lorena Álvarez, Sonsoles Olay, Giuliano Ascani, Luis Junquera
Background: This study aims to evaluate the influence of changes in the teaching contents on medication-related osteonecrosis of the jaw may have on the knowledge and the capacity for practical case resolution about this pathology. Material and Methods: A cross-sectional descriptive study was conducted through a survey divided into four sections: degree of means of knowledge acquisition, habitual practice and ability to solve clinical cases. The total number of respondents (n = 225) was divided into two groups: Group A (Year 2015-2016) and Group B (Year 2016-2017)...
December 2017: Journal of Clinical and Experimental Dentistry
Mohammad Zandi, Arash Dehghan, Najmeh Zandipoor, Payam Amini, Shideh Doulati
OBJECTIVE: To evaluate the effects of different doses and durations of teriparatide therapy on MRONJ resolution in rats. SUBJECTS AND METHODS: A total of 120 rats that had been affected with MRONJ (after six weekly zoledronate injections and tooth extraction) were randomly divided into eight subgroups: 2, 10, and 20 μg/kg/day teriparatide were administered to L4, M4, and H4 for 4 weeks, and to L8, M8, and H8 for 8 weeks, respectively. C4 and C8 received saline for 4 and 8 weeks, respectively...
December 30, 2017: Journal of Cranio-maxillo-facial Surgery
Akira Baba, Tazuko K Goto, Hiroya Ojiri, Mutsumi Takagiwa, Chiho Hiraga, Masahiro Okamura, Sho Hasegawa, Yumi Okuyama, Nobuhiro Ogino, Hideomi Yamauchi, Yuko Kobashi, Shinji Yamazoe, Yohei Munetomo, Takuji Mogami, Takeshi Nomura
OBJECTIVES: Antiresorptive agent-related osteonecrosis of the jaw (ARONJ)/medication-related osteonecrosis of the jaw (MRONJ) include both bisphosphonate-related osteonecrosis of jaw (BRONJ) and denosumab-related osteonecrosis of jaw (DRONJ). The purpose of this study is to study radiological characteristics of ARONJ/MRONJ. These imaging features may serve as one useful aid for assessing ARONJ/MRONJ. METHODS: CT scans of 74 Japanese patients, who were clinically diagnosed by inclusion criteria of ARONJ/MRONJ, obtained between April 1, 2011 and September 30, 2016, were evaluated...
February 13, 2018: Dento Maxillo Facial Radiology
Luca Ramaglia, Agostino Guida, Vincenzo Iorio-Siciliano, Alessandro Cuozzo, Andrea Blasi, Anton Sculean
OBJECTIVE: The most debated topic about medication-related osteonecrosis of the jaws (MRONJ) is its therapy, as there are no definitive guidelines. The aims of this systematic review were (a) to outline the best therapeutic approach according to the stage at diagnosis and (b) to perform a meta-analysis to assess whether the drug-holiday protocol may be or not an effective method in the management of MRONJ patients. MATERIALS AND METHODS: The systematic review was performed following the PRISMA principles...
January 13, 2018: Clinical Oral Investigations
Lieselotte De Bruyn, Ruxandra Coropciuc, Wim Coucke, Constantinus Politis
OBJECTIVE: This study aimed to investigate the bacterial population in patients with medication-related osteonecrosis of the jaw (MRONJ) after treatment with doxycycline and metronidazole. STUDY DESIGN: A total of 38 patients with MRONJ (age range 55-88, mean age 73 + 8.82 standard deviation) treated with doxycycline first and with metronidazole second were enrolled in this study. Two swabs were taken at the margin of the infected MRONJ lesion after applying pressure on the marginal mucosa, and visible pus was secreted...
December 11, 2017: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
J G Messer, J L Mendieta Calle, J M Jiron, E J Castillo, C Van Poznak, N Bhattacharyya, D B Kimmel, J I Aguirre
OBJECTIVE: Investigate role of dose/duration of zoledronic acid (ZOL), a powerful anti-resorptive (pAR), on prevalence of medication-related osteonecrosis of the jaw (MRONJ) in rice rats (Oryzomys palustris), a species with natural susceptibility to food impaction-induced localized periodontitis (FILP). We hypothesize that ZOL induces MRONJ lesions in rice rats with FILP, and that the prevalence of MRONJ rises with increasing dose and duration of ZOL treatment. METHODS: We performed a toxicology experiment with clinically-relevant doses of ZOL in female rats (N=230) fed standard (STD) rodent chow...
December 28, 2017: Bone
Daniele Rosella, Piero Papi, Giorgio Pompa, Mario Capogreco, Francesca De Angelis, Stefano Di Carlo
Objectives: The aim of this study was to evaluate and assess knowledge and attitude of dental students about medication-related osteonecrosis of the jaw (MRONJ), to optimize future training programs in this field. Materials and Methods: A cross-sectional study was administrated. Ninety-eight participants agreed to complete an anonymous questionnaire. It was divided into two sections: the first section was about general information such as interviewer's gender and date of birth; the second section included questions about bisphosphonates (BPs), others medication associated to osteonecrosis of the jaw (ONJ), risk factors, and prevention of osteonecrosis...
October 2017: European Journal of Dentistry
Srinivas Rao Myneni Venkatasatya, Howard H Wang, Swetha Alluri, Sebastian G Ciancio
PURPOSE: This is a review of the literature on nonsurgical treatment of non-healing medication related osteonecrosis of the jaw (MRONJ) utilizing a phosphate buffer-stabilized 0.1% chlorine dioxide mouthrinse. METHODS: A literature search in PubMed revealed only six case reports. MRONJ lesion site description, patient's medication history, the healing time, and the MRONJ treatment protocol followed by those authors were recorded. Additional literature review of the scientific mechanism, risks and benefits, safety and efficacy of the phosphate buffer-stabilized 0...
December 2017: American Journal of Dentistry
V Patel, J Mansi, S Ghosh, J Kwok, M Burke, D Reilly, N Nizarali, C Sproat, K Chia
Medication-related osteonecrosis of the jaw (MRONJ) has most commonly been associated with bisphosphonates. The routine uses of these drugs are now well established predominantly in metastatic cancer with bone involvement, multiple myeloma, hypercalcaemia, osteoporosis and Paget's disease. Recently, however, the use of bisphosphonates in early breast cancer has shown a reduction in breast cancer recurrence and breast cancer deaths. This new indication for their use approximates to a further 20,000 women per year in the UK being prescribed bisphosphonates...
December 15, 2017: British Dental Journal
Victor Lousan do Nascimento Poubel, Carolina Amália Barcellos Silva, Luis André Mendonça Mezzomo, Graziela De Luca Canto, Elena Riet Correa Rivero
PURPOSE: There is much concern about the increasing number of patients with medication-related osteonecrosis of the jaw (MRONJ), and many studies have been published in an attempt to understand the pathophysiology of this condition. This study aimed to systematically review the literature on MRONJ arising in rodents under antiresorptive drug therapy after tooth extraction. METHODS: A search of electronic databases, including LILACS, PROQUEST, PubMed, SCOPUS, and the Web of Science...
November 20, 2017: Journal of Cranio-maxillo-facial Surgery
Masaya Akashi, Satoshi Wanifuchi, Eiji Iwata, Daisuke Takeda, Junya Kusumoto, Shungo Furudoi, Takahide Komori
PURPOSE: The appearance of osteoradionecrosis (ORN) and medication-related osteonecrosis of the jaw (MRONJ) is similar, but clinically important differences between ORN and MRONJ exist. The aim of this study was to compare the clinical data between ORN and MRONJ and to reveal the critical differences between these diseases. METHODS: We retrospectively reviewed the epidemiological data, clinical findings, and treatment in 27 ORN and 61 MRONJ patients. Radiographic signs before the initiation of treatment were also assessed...
March 2018: Oral and Maxillofacial Surgery
Hoda Abel Mahedi Mohamed, Charlotte Emilie Nor Nielsen, Morten Schiodt
OBJECTIVE: The aim of this study was to report cases of medication-related osteonecrosis of the jaws (MRONJ) associated with targeted therapy (TT) with or without concomitant antiresorptive treatment, among the Copenhagen ONJ cohort, which includes all consecutive cases of MRONJ seen in Copenhagen. STUDY DESIGN: We retrospectively studied the treatment of 204 consecutive patients with MRONJ, seen between January 2010 and May 2016, to identify those associated with TT...
February 2018: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Andre Peisker, Gregor F Raschke, Mina D Fahmy, Arndt Guentsch, Korosh Roshanghias, Kai C König, Stefan Schultze-Mosgau
BACKGROUND: Despite the benefits related to the use of bisphosphonates and denosumab, medication-related osteonecrosis of the jaw (MRONJ) is a serious complication. The purpose of this study was to investigate the utility of 4 biochemical markers including serum c-terminal telopeptide cross-link of type I collagen (s-CTX), serum osteocalcin (s-OC), serum parathormon (s-PTH), and serum bone-specific alkaline phosphatase (s-BAP) as useful clinical tools to help assess the risk for MRONJ prior to invasive oral surgery...
March 2018: Journal of Craniofacial Surgery
H Devlin, J Greenwall-Cohen, J Benton, T L Goodwin, A Littlewood, K Horner
Introduction Oral bisphosphonates are the most commonly prescribed anti-resorptive drugs used in the treatment of osteoporosis, but osteonecrosis of the jaw is a serious complication. The early diagnosis of this destructive side effect is crucial in preventing excessive bone loss, pain and infection.Objective To aid dental practitioners in the early identification of bisphosphonate-related osteonecrosis of the jaw.Method A scoping review was carried out.Data sources We searched MEDLINE via OVID, EMBASE via OVID, Dentistry and Oral Sciences Source (DOSS), Proquest Dissertation and Theses Search, to identify references that described clinical and radiological findings in medication-related osteonecrosis of the jaw (MRONJ)...
January 2018: British Dental Journal
Amerigo Giudice, Francesco Bennardo, Selene Barone, Alessandro Antonelli, Michele Mario Figliuzzi, Leonzio Fortunato
PURPOSE: The main limitation of surgical treatment of medication-related osteonecrosis of the jaw (MRONJ) is difficulty in defining resection margins. The aim of this study was to compare the efficacy of the surgeon's experience and autofluorescence-guided bone surgery to delimit resection margins for necrotic bone. MATERIALS AND METHODS: MRONJ requiring surgical treatment was classified according to American Association of Oral and Maxillofacial Surgeons staging...
November 23, 2017: Journal of Oral and Maxillofacial Surgery
Hiroaki Shimamoto, Tristan R Grogan, Tomomi Tsujimoto, Naoya Kakimoto, Shumei Murakami, David Elashoff, Tara L Aghaloo, Sotirios Tetradis
OBJECTIVES: To evaluate the impact of CBCT in the diagnostic thinking efficacy, management and prognosis of patients with suspected stage 0 medication-related osteonecrosis of the jaw (MRONJ). METHODS: For 15 patients with suspected stage 0 MRONJ, clinical photographs, a panoramic radiograph and selected CBCT sections were identified. 13 oral surgeons reviewed the material and answered 10 questions in two different sessions. First session included clinical photographs and panoramic radiographs, while second session also included CBCT images...
November 23, 2017: Dento Maxillo Facial Radiology
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