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Thomas Mücke, Christian R Krestan, David A Mitchell, Jan S Kirschke, Arno Wutzl
For patients with malignant disease taking bisphosphonates and denosumab, the incidence of medication-related osteonecrosis of the jaw (MRONJ) is up to 15% in contrast to 0.01% in patients with osteoporosis. Clinical presentation of MRONJ extends from asymptomatic exposure of bone in 94% of patients to severe cases of mandibular fractures in a minority of 4.5%. The strongest risk factors for MRONJ are invasive dental procedures and dental infections. Advances in imaging provide more preoperation information compared with panoramic radiograph...
July 2016: Seminars in Musculoskeletal Radiology
Thomas Lombard, Virginie Neirinckx, Bernard Rogister, Yves Gilon, Sabine Wislet
In recent years, medication-related osteonecrosis of the jaw (MRONJ) became an arising disease due to the important antiresorptive drug prescriptions to treat oncologic and osteoporotic patients, as well as the use of new antiangiogenic drugs such as VEGF antagonist. So far, MRONJ physiopathogenesis still remains unclear. Aiming to better understand MRONJ physiopathology, the first objective of this review would be to highlight major molecular mechanisms that are known to be involved in bone formation and remodeling...
2016: Stem Cells International
Alexandru Movila, Hani Mawardi, Kazuaki Nishimura, Tomomi Kiyama, Kenji Egashira, Jae-Young Kim, Alessandro Villa, Hajime Sasaki, Sook-Bin Woo, Toshihisa Kawai
Prior consensus held that medication-related osteonecrosis of the jaw (MRONJ) lesion was composed of necrotic bone; however, more recent studies have identified inflammatory infiltrates in the lesion. Herein, we report that remarkably elevated infiltrating γδT cells (90% of lymphocytes) express Semaphorin 4D (Sema4D) in human patient with MRONJ lesion, whereas γδT cells only account for 2-5% of lymphocytes in blood. Importantly, Sema4D is implicated in the pathogenesis of T cell-mediated inflammatory diseases, such as rheumatoid arthritis and multiple sclerosis...
October 5, 2016: Biochemical and Biophysical Research Communications
Mariana Comparotto Minamisako, Guilherme Henrique Ribeiro, Mariáh Luz Lisboa, Mabel Mariela Rodríguez Cordeiro, Liliane Janete Grando
Medication-related osteonecrosis of the jaws (MRONJ) can be considered an inability of the alveolar bone to respond to an injury, which frequently leads to severe local and systemic complications. Once the problem is installed, dentist must use all therapeutic approaches recommended. This manuscript reports a successful management of MRONJ handled with antibiotics, conservative debridement, low-level laser therapy (LLLT), and photodynamic therapy (PDT) up to 12 months. As healing of MRONJ may be very slow, combined therapeutic approaches are required...
2016: Case Reports in Dentistry
H Crane, V Toedtling
No abstract text is available yet for this article.
September 23, 2016: British Dental Journal
Adepitan A Owosho, Cherry L Estilo, Joseph M Huryn, SaeHee K Yom
OBJECTIVE: Very few studies have evaluated the efficacy of pentoxifylline and tocopherol (PENT-E) in the management of medication-related osteonecrosis of the jaw (MRONJ), although some studies have shown the therapeutic and prophylactic benefit of PENT-E in the management of osteoradionecrosis. We report the outcomes of MRONJ managed with PENT-E in patients with metastatic bone disease or multiple myeloma. STUDY DESIGN: Seven patients diagnosed with established cases of refractory MRONJ caused by antiresorptive medications for the management of metastatic bone tumors or multiple myeloma were administered PENT-E for a mean period of 16...
October 2016: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Christoph Klingelhöffer, Florian Zeman, Johannes Meier, Torsten Eugen Reichert, Tobias Ettl
PURPOSE: Surgical treatment of the medication-related osteonecrosis of the jaw (MRONJ) is still challenging. We examined the outcome of the resection of osteonecrotic lesions and the influence of potential risk factors on the operative success. METHODS: Seventy six surgical interventions on 40 patients were evaluated in a prospective design with a mean follow-up of 55 weeks. Primary endpoints were: (i) maintenance of the mucosal closure and (ii) decrease of MRONJ stage...
August 9, 2016: Journal of Cranio-maxillo-facial Surgery
Tara L Aghaloo, Sotirios Tetradis
Medication-related osteonecrosis of the jaws (MRONJ) is a well-described complication of antiresorptive and antiangiogenic medications. Although osteonecrosis can be associated with other inciting events and medications, such as trauma, infection, steroids, chemotherapy, and coagulation disorders, these are rarely reported in the literature. With the continued development and clinical use of new biologic medications for diseases such as cancer and rheumatoid arthritis, it is important to continue to evaluate their effects on the oral cavity...
July 30, 2016: Journal of Oral and Maxillofacial Surgery
Tohru Taniguchi, Yoshiko Ariji, Michihito Nozawa, Munetaka Naitoh, Yuichiro Kuroiwa, Kenichi Kurita, Eiichiro Ariji
OBJECTIVES: To compare the computed tomography (CT) features of mandibular cancellous and cortical bones between patients with bisphosphonate (BP) administration and those without and to assess the early changes of the mandible in BP-treated patients. STUDY DESIGN: Twenty-four BP-treated patients suffering from medication-related osteonecrosis of the jaw (MRONJ) were enrolled in this study. For comparison, 20 patients suffering from osteomyelitis and 20 patients without pathology in the jaw were also enrolled, all of whom did not receive BP treatment...
September 2016: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Guenter Russmueller, Rudolf Seemann, Kathrin Weiss, Victoria Stadler, Manuel Speiss, Christos Perisanidis, Thorsten Fuereder, Birgit Willinger, Irene Sulzbacher, Christoph Steininger
Medication-related osteonecrosis of the jaw (MRONJ) represents a complication of bisphosphonate treatment that responds poorly to standard treatment. In a retrospective cohort study we investigated a possible role of Actinomyces spp. in the pathogenesis of MRONJ. Deep biopsies of necrotic bone were collected during surgical treatment of MRONJ and evaluated by histology and microbiology for the presence of Actinomyces spp. Microbiological, demographic and clinicpathological data were analyzed for risk of Actinomyces-associated MRONJ...
2016: Scientific Reports
Yuri Matsuura, Ikiru Atsuta, Yasunori Ayukawa, Takayoshi Yamaza, Ryosuke Kondo, Akira Takahashi, Nobuyuki Ueda, Wakana Oshiro, Yoshihiro Tsukiyama, Kiyoshi Koyano
BACKGROUND: Mesenchymal stem cells (MSCs) have been isolated from a variety of tissues, including bone marrow, adipose, and mucosa. MSCs have the capacity for self-renewal and differentiation. Reports have been published on the systemic administration of MSCs leading to functional improvements by engraftment and differentiation, thus providing a new strategy to regenerate damaged tissues. Recently, it has become clear that MSCs possess immunomodulatory properties and can therefore be used to treat diseases...
2016: Stem Cell Research & Therapy
Bruce Turner, Lawrence Drudge-Coates, Sacha Ali, Jhumur Pati, Vinod Nargund, Enamul Ali, Leo Cheng, Paula Wells
Urologic patients receiving bone-targeted therapies are at risk of developing osteonecrosis of the jaw (ONJ). ONJ has historically been associated with bisphosphonate therapy. More recently, RANK-Ligand inhibitors (denosumab) have also been used to reduce the risk of skeletal-related events in patients who have advanced cancers with bone metastases. More than 65% of men with metastatic prostate cancer and nearly 75% of women with metastatic breast cancer are affected by bone metastases. The literature has described ONJ associated with bisphosphonate therapy as bisphosphonate-related osteonecrosis of the jaw (BRONJ)...
May 2016: Urologic Nursing
Larry Weeda
No abstract text is available yet for this article.
September 2016: Cranio: the Journal of Craniomandibular Practice
F-J Rodriguez-Lozano, R-E Oñate-Sánchez
BACKGROUND: The clinical management of medication-related osteonecrosis of the jaw (MRONJ) in patients treated with bisphosphonates and other antiresorptive agents is subject to controversy. The American Association of Oral and Maxillofacial Surgeons (AAOMS) has developed guidelines for the correct management of the disorder which are revised and updated by a panel of experts. MATERIAL AND METHODS: The present systematic review analyzes the different treatments currently used to treat this clinical condition, based on the PRISMA® (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement published in 2009...
2016: Medicina Oral, Patología Oral y Cirugía Bucal
K Grisar, M Schol, J Schoenaers, T Dormaar, R Coropciuc, V Vander Poorten, C Politis
The purpose of this study was to compare medication-related osteonecrosis of the jaw (MRONJ) with osteoradionecrosis (ORN). Group 1 comprised 74 MRONJ patients (93 lesions) and group 2 comprised 59 ORN patients (69 lesions). Patient characteristics, clinical presentation of the lesions, the presence of complications, and the relationship with previous dental extractions were analyzed for both groups. Significant differences were found between the groups with regard to the characteristics of the patient populations, extraction as the precipitating event, the type of initial complaint, the prevalence of pain, and the location of the lesions...
July 14, 2016: International Journal of Oral and Maxillofacial Surgery
Yuxing Guo, Diancan Wang, Yang Wang, Xin Peng, Chuanbin Guo
OBJECTIVE: The current staging system of medicine-related osteonecrosis of the jaws (MRONJ) assigns patients to different stages based on clinical manifestations. The extent of bone disease cannot be fully determined without radiologic evaluation. Missing radiologic information may lead to incorrect classification of MRONJ, resulting in poor outcomes of treatment. The objective of this study was to compare computed tomography (CT) and panoramic radiography (PR) features of MRONJ in different stages to achieve accurate staging on the basis of combined findings from clinical staging and imaging...
August 2016: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Lindsay L Graves, Susan V Bukata, Nona Aghazadehsanai, Tina I Chang, Neal Garrett, Arthur H Friedlander
PURPOSE: The risk of developing concomitant medication-related osteonecrosis of the jaw (MRONJ) in patients who have sustained an atypical femoral fracture (AFF) in association with parental administration of a bisphosphonate osteoclastic inhibitor medication for malignant disease is unclear. Published data were searched to determine the prevalence of these concomitant adverse medication events, if any. MATERIALS AND METHODS: A systematic review of published case series in the PubMed database was undertaken to ascertain the prevalence of patients having a concomitant history of AFF and MRONJ...
June 12, 2016: Journal of Oral and Maxillofacial Surgery
Hiromitsu Morita, Yuko Imai, Masahiro Yoneda, Takao Hirofuji
Bisphosphonates and irradiation are useful medical treatments, but can often cause oral complications such as medication-related oral necrosis of the jaw (MRONJ) and osteoradionecrosis (ORN) during oral surgery, including tooth extraction. Therefore, we should take all risks into consideration carefully before choosing dental treatment for patients with a medical history of such therapies. A 55-year-old woman who underwent cord blood transplantation to treat extranodal natural killer T (NK/T) cell lymphoma (nasal type IVB) had a medical history of bisphosphonate and irradiation treatments...
June 30, 2016: Special Care in Dentistry
C V Lyttle, H Paterson
A patient was referred by a clinical oncologist regarding a non-healing area of bone in the lower jaw. The patient was taking denosumab (Prolia(®), Xgeva(®)) when they had a tooth extracted and the area failed to heal. Following suspension of the drug, the area healed with mucosal coverage. This new class of drugs are being increasingly used as an alternative antiresorptive drug to bisphosphonates and are licenced in the UK for prevention of osteoporotic fractures and prevention of skeletal-related events (SREs) in patients with metastatic cancer...
June 24, 2016: British Dental Journal
Pia Lopez-Jornet, Arturo Sanchez Perez, Rui Amaral Mendes, Aurelio Tobias
PURPOSE: To date, no ideal strategy has been established for treating or preventing medication-related osteonecrosis of the jaw (MRONJ). The aim of the present work was to perform a systematic literature review to determine the efficacy of autologous platelet concentrate (APC) application, for prevention or treatment of MRONJ, together with surgical debridement. MATERIAL AND METHODS: An electronic search was performed using MEDLINE (PubMed), EMBASE, and Cochrane databases until January 2015 using the following search terms: osteonecrosis, bisphosphonates, antiresorptive, antiangiogenic therapy, BRONJ, platelet concentrate, PRP, PRF, and PRGF...
August 2016: Journal of Cranio-maxillo-facial Surgery
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