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Yumiko Ohbayashi, Fumi Nakai, Akinori Iwasaki, Takaaki Ogawa, Yuka Yamamoto, Yoshihiro Nishiyama, Minoru Miyake
The duration of antiresorptive therapy is an important risk factor for medication-related osteonecrosis of the jaw. We performed a pilot study using quantitative analysis by bone scintigraphy to test the hypothesis that mandibular metabolism is affected by long-term bisphosphonate (BP) therapy. Our primary objectives were to assess changes in bone metabolism of the mandible in response to long-term BP therapy and compare the bone metabolism changes of the mandible with other bone sites. We compared the metabolic difference at the site in the mandible unaffected by disease, the humerus and the femur between 14 osteoporosis patients who were being treated with BP (BP group) and 14 patients who were not being treated with BP (control group) using a quantitative analysis and bone scintigraphy...
October 21, 2016: Odontology
Shang-Chun Guo, Shi-Cong Tao, Wen-Jing Yin, Xin Qi, Jia-Gen Sheng, Chang-Qing Zhang
Osteonecrosis of the femoral head (ONFH) represents a debilitating complication following glucocorticoid (GC)-based therapy. Synovial-derived mesenchymal stem cells (SMSCs) can exert protective effect in the animal model of GC-induced ONFH by inducing cell proliferation and preventing cell apoptosis. Recent studies indicate the transplanted cells exert therapeutic effects primarily via a paracrine mechanism and exosomes are an important paracrine factor that can be directly used as therapeutic agents for tissue engineering...
2016: International Journal of Biological Sciences
Luis Schiper, Bluma Linkowski Faintuch, Roberto José da Silva Badaró, Erica Aparecida de Oliveira, Victor E Arana Chavez, Elisangela Chinen, Joel Faintuch
OBJECTIVES: Conventional imaging methods are excellent for the morphological characterization of the consequences of osteonecrosis; however, only specialized techniques have been considered useful for obtaining functional information. To explore the affinity of radiotracers for severely devascularized bone, a new mouse model of isolated femur implanted in a subcutaneous abdominal pocket was devised. To maintain animal mobility and longevity, the femur was harvested from syngeneic donors...
October 1, 2016: Clinics
Yohei Sotsuka, Toshihiro Fujiwara, Kenichiro Kawai, Soh Nishimoto, Masao Kakibuchi
Recent reports have shown successful transfer of vascularized fibular flap in bisphosphonate-induced mandibular osteonecrosis. We present a case of a 50-year-old patient who presented with bisphosphonate-related osteonecrosis of bilateral maxilla, which is reconstructed using a fibular flap.
September 2016: Plastic and Reconstructive Surgery. Global Open
S Sabharwal, N K Patel, D Griffiths, T Athanasiou, C M Gupte, P Reilly
OBJECTIVES: The objective of this study was to perform a meta-analysis of all randomised controlled trials (RCTs) comparing surgical and non-surgical management of fractures of the proximal humerus, and to determine whether further analyses based on complexity of fracture, or the type of surgical intervention, produced disparate findings on patient outcomes. METHODS: A systematic review of the literature was performed identifying all RCTs that compared surgical and non-surgical management of fractures of the proximal humerus...
October 2016: Bone & Joint Research
Axel Marx, Alexander Beier, Pouria Taheri, Martin Röpke, Thomas Kalinski, Andreas M Halder
BACKGROUND: Avascular necrosis after arthroscopic surgery of the knee has already been published. The purpose of this article is to report on the frequently misdiagnosed entity of osteonecrosis of the medial tibial plateau. CASE PRESENTATION: Charts and radiographs of a consecutive series with isolated medial tibial plateau osteonecrosis were analyzed. The criterion for inclusion was the absence of trauma. Six caucasian female patients with an average age of 76...
October 19, 2016: Journal of Medical Case Reports
Wataru Ando, Kengo Yamamoto, Tsuyoshi Koyama, Yoshichika Hashimoto, Takashi Tsujimoto, Kenji Ohzono
Idiopathic osteonecrosis of the femoral head (ONFH) can be correctly diagnosed in accordance with the established criteria. However, some general orthopedic physicians have misdiagnosed patients as having ONFH. The goal of this study was to clarify the radiologic and clinical features of misdiagnosed patients. This study included 50 patients who were referred to the authors' hospital by general physicians with a diagnosis of ONFH. The correct diagnosis was made based on the Japanese Investigation Committee diagnostic criteria for ONFH...
October 18, 2016: Orthopedics
Mansher Singh, Raquel Minasian, Matthew Jackson, E J Caterson
BACKGROUND: Surgical resection of ocular malignancies can result in complex craniofacial defects that can be difficult to reconstruct with conventional reconstruction techniques. Craniofacial prosthesis supported by bone-anchored implants has evolved as a reliable alternative in such scenarios. METHODS: The authors describe a patient who underwent extensive facial resection secondary to squamous cell carcinoma resulting in significant facial deformities. A bone-anchored osseointegrated implant was used to perform facial reconstruction...
October 14, 2016: Journal of Craniofacial Surgery
Yong Lu, Zhiyong Wang, Wei Han, Hao Li
Zoledronate has been reported to exhibit pro‑apoptotic and anti-angiogenic effects in endothelial cells, which partially contributes to bisphosphonate‑associated osteonecrosis of the jaw (BP‑ONJ). Zoledronate can also induce autophagic cell death. The present study hypothesized that Zoledronate may activate autophagy to exert pro‑apoptotic effects in endothelial cells and aimed to investigate the effect of Zoledronate on human umbilical vein endothelial cells (HUVECs) and explore the underlying mechanisms...
October 12, 2016: Molecular Medicine Reports
Christian Walter, Bilal Al-Nawas, Tim Wolff, Eik Schiegnitz, Knut A Grötz
OBJECTIVE: Bisphosphonate-associated osteonecrosis of the jaws (BP-ONJ) is triggered by inflammatory processes. Typical trigger factors are periodontal disease, denture pressure sores, and surgical interventions such as tooth extractions. Unfortunately there is only little data on how to proceed with implant therapy in patients with bisphosphonate treatment. This topic is not addressed in the German guidelines on medication-associated osteonecrosis. Therefore a systematic literature review was performed...
December 2016: Int J Implant Dent
N M Al-Namnam, P Nambiar, P Shanmuhasuntharam, M Harris
Dengue is a mosquito transmitted flaviviral infection which can give rise to severe haemorrhage (dengue haemorrhagic fever/DHF) and with capillary leakage induces hypovolemic shock (dengue shock syndrome/DSS). Although dengue symptoms and complications have been known for many decades there has only been one documented case of osteonecrosis of the maxilla which was treated by excision of the necrotic bone. In this case of dengue infection, extensive maxillary osteonecrosis and minimal root resorption appeared to follow factitious injury with a toothpick but resolved with nonsurgical management...
October 15, 2016: Australian Dental Journal
Kimona Issa, Todd P Pierce, Steven F Harwin, Anthony J Scillia, Anthony Festa, Michael A Mont
BACKGROUND: HIV is prevalent worldwide and numerous patients with this diagnosis ultimately may become candidates for TKA. Although some studies have suggested that complications are more common in patients with HIV who undergo TKA, these studies largely were done before the contemporary era of HIV management; moreover, it is unclear whether patients with HIV achieve lower patient-reported outcome scores or inferior implant survivorship. QUESTIONS/PURPOSES: We asked whether there were any differences in the outcomes of patients with HIV without hemophilia who undergo TKA compared with a matched control cohort in terms of: (1) patient-reported outcomes; (2) implant survivorship; and (3) complication rates...
October 14, 2016: Clinical Orthopaedics and related Research
Marina Kunstreich, Sebastian Kummer, Hans-Juergen Laws, Arndt Borkhardt, Michaela Kuhlen
The morbidity and toxicity associated with current intensive treatment protocols for acute lymphoblastic leukemia in childhood become even more important as the vast majority of children can be cured and become long-term survivors. Osteonecrosis is one of the most common therapy-related and debilitating side effects of anti-leukemic treatment and can adversely affect long-term quality of life. Incidence and risk factors vary substantially between study groups and therapeutic regimens. We therefore analyzed 22 clinical trials of childhood acute lymphoblastic leukemia in terms of osteonecrosis incidence and risk factors...
October 14, 2016: Haematologica
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
Mahdi Gholami, Reza Shahakbari, Somayeh Abdolahpour, Masoud Hatami, Azam Roshanmir
INTRODUCTION: Herpes zoster Infection (HZI) is a viral disease with painful skin rashes and blisters in a limited area on one side of the body, often in a strip. Osteonecrosis with spontaneous exfoliation of teeth in association with HZI of the mandibular nerve is a rare phenomenon. In this report, such an unusual complication of HZI is presented. CASE REPORT: The clinical course of a 53-year-old woman and a 54-year-old man with HZI associated with alveolar bone necrosis and tooth exfoliation were reviewed in order to develop a patient profile for this rare combination of physical findings...
September 2016: Iranian Journal of Otorhinolaryngology
Hye-Yeon Kim, Jin-Woo Kim, Sun-Jong Kim, Sang-Hwa Lee, Hong-Soo Lee
To assess the relevance of previous epidemiologic studies on bisphosphonate-related osteonecrosis of the jaw (BRONJ), we first conducted a systematic review of large population-based observational studies, and evaluated the validity of claims-based algorithms for the identification of BRONJ. Studies containing primary observational epidemiologic data regarding bisphosphonate exposure and outcomes of osteonecrosis of the jaw were systematically reviewed. Using surrogates for identifying potential BRONJ cases from a population-based hospital registry, validation was performed through medical chart review...
October 13, 2016: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
M Pedrazzoli, L Autelitano, F Biglioli
Mandibular fracture is usually the clinical end of bisphosphonate-related osteonecrosis of the jaw. This is a painful complication and patients cannot feed as usual, with a worsening of their quality of life. The goal of treatment in bisphosphonate related osteonecrosis of jaw (BRONJ) patients is to slow progression of bone necrosis. We present a novel technique for treatment of severe mandibular BRONJ in stage 3 patients that present with a high risk to develop fracture, since they have a residual unaffected mandibular bone height less than 6 mm...
August 2016: Acta Otorhinolaryngologica Italica
Diego H Díaz, Julieta A Rodas, Clarisa E Bozzini, Patricia M Mandalunis, Natalia D Escudero
Bisphosphonates are the first choice therapy for the pharmaco logical treatment of osteoporosis. Following reports of cases of bisphosphonaterelated osteonecrosis of the jaw and atypical femur fracture, the safety of longterm use of bisphosphonates has been evaluated, resulting in the proposal of strontium as an alternative drug. No experimental study using a sequential administration design has been reported to date. Hence, the aim of this study was to evaluate the effect on bone tissue of ovariectomized rats of administration of alendronate followed by strontium ranelate...
September 2016: Acta Odontológica Latinoamericana: AOL
Shin Saeng Lim, Beomseok Lee, In Sook Kim, Soon Jung Hwang
OBJECTIVES: Osteonecrosis of the jaw has been increasing after dentoalveolar surgery in patients treated with an antiresorptive bisphosphonate (BP), especially strong zoledronate (ZA). The pathophysiology underlying why osteonecrosis occurs exclusively in the jaw bone remains unclear. This study investigated skeletal site-specific bone healing during the use of BPs to explore the preferential incidence of osteonecrosis of the jaw bone. STUDY DESIGN: Extraction of mandibular molar and creation of a tibia defect were performed in rats 2 weeks after weekly intravenous injections with the potent ZA and the weaker BP etidronate...
August 18, 2016: Oral Surgery, Oral Medicine, Oral Pathology and Oral 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
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