A microorganism not to be overlooked in studies focusing on osteonecrosis of the jaws: Comment on “Kim SM, et al. Histochemical observation of bony reversal lines in bisphosphonate-related osteonecrosis of the jaw”

2017 ◽  
Vol 123 (6) ◽  
pp. 738-739 ◽  
Author(s):  
Aydin Gülses ◽  
Mustafa Ayna ◽  
Yahya Açil
Keyword(s):  
Osteonecrosis Of The Jaw ◽  
Osteonecrosis Of The Jaws ◽  
Histochemical Observation

scholarly journals ASSESSMENT OF BONE METABOLISM IN PATIENTS WITH BISPHOSPHONATE OSTEONECROSIS OF THE JAWS

2017 ◽  
Vol 21 (4) ◽  
pp. 197-199
Author(s):  
Elena Mikhaylovna Spevak ◽  
D. Yu Khristoforando ◽  
A. B Davydov
Keyword(s):  
Bone Metabolism ◽  
Cancer Patients ◽  
Osteonecrosis Of The Jaw ◽  
Main Group ◽  
Control Group ◽  
Tartrate Resistant Acid Phosphatase ◽  
Type I ◽  
Bone Specific Alkaline Phosphatase ◽  
Osteonecrosis Of The Jaws ◽  
Bisphosphonate Osteonecrosis

The aim of the study was to evaluate bone metabolism in cancer patients with bisphosphonate osteonecrosis of the jaws. The study included 45 people of the main group (patients with cancer with osteonecrosis of the jaw in patients receiving bisphosphonates) and 25 in the control group (cancer patients treated with bisphosphonates, but did not have osteonecrosis of the jaw), which had a stabilization of the underlying disease. Bone metabolism was evaluated by the level of osteocalcin (OC), bone-specific alkaline phosphatase (bALP), aminoterminal of propeptide of procollagen type I (P1NP), tartrate-resistant acid phosphatase (TRAP5b), calcium (Cа), phosphorus (P) in blood serum before treatment and after 6 months. Compared to the average levels of marker patients of the main and control groups using the Mann-Whitney test for p < 0,05. A baseline level of СТХ (0,23±0,02 ng/ml) and OС (11,58±0,54 ng/ml) in the treatment group was significantly (p < 0.05) lower than control group (0,43±0,01 ng/ml and 17,94±0,83 ng/ml), and the level of osteocalcin in the main group (11,58±0,54 ng/ml) was on average below normal 2,59 times. Recorded significantly higher (p < 0,05) levels bALP (133,24±14,03 U/l) and TRAP5b (3,54±0,38 U/l) in patients with osteonecrosis compared with a control group (73,32±3,41 U/l and 3,12±0,12 U/l). Reliably detected differences in the levels of P1NP, Ca and P were not detected (p > 0,05). In the main group after 6 months of treatment was observed a tendency of growth of СТХ, TRAP5b, OK, bALP, P1NP, Ca, but only for the markers of resorption and СТХ, TRAP5b these differences were significant. Indicators of patients in the control group were stable and did not differ in the dynamics. The development of bisphosphonate osteonecrosis of the jaws is directly related to bone metabolism and occurs with predominance of the processes of bone resorption and inhibition of bone formation processes.

scholarly journals Medication-Related Osteonecrosis of the Jaws Initiated by Zoledronic Acid and Potential Pathophysiology

2021 ◽  
Vol 9 (8) ◽  
pp. 85
Author(s):  
Aya Alsalih ◽  
Annica Dam ◽  
Pia Lindberg ◽  
Anna Truedsson
Keyword(s):  
Zoledronic Acid ◽  
Dental Pulp ◽  
Bone Remodelling ◽  
Osteonecrosis Of The Jaw ◽  
Inclusion Criteria ◽  
Cellular Mechanisms ◽  
Osteonecrosis Of The Jaws ◽  
Current Review ◽  
Dose Dependent

The aim of this systematic review is to present an up-to-date review of available publications investigating the cellular mechanisms initiating the development of medication-related osteonecrosis of the jaw caused by zoledronic acid. Electronic searches of MEDLINE/PubMed and Scopus were conducted on the 3 June, 2019. A total of 804 publications were identified, of which 11 met the inclusion criteria and were, therefore, included in this study. All the included studies were in vitro studies investigating various human cells. The current review found that zoledronic acid in various concentrations increased apoptosis and decreased migration and proliferation of epithelial cells, fibroblasts, osteoblasts, endothelial cells and dental pulp stem cells, which can affect local tissue homeostasis. The consequences of zoledronic acid were found to be both time- and dose-dependent. The pathophysiology of medication-related osteonecrosis of the jaw is likely a multifactorial process involving prolonged wound healing, chronic inflammation and altered bone remodelling following the administration of zoledronic acid. Further research is needed to identify the exact pathophysiology to optimise management and treatment.

scholarly journals Dental management of patients treated with intravenous bisphosphonates. A case report

2017 ◽  
Vol 25 (3) ◽  
pp. 248
Author(s):  
Keico Graciela Sano Trauth ◽  
Marilena Chinali Komesu ◽  
Claudia Helena Lovato Silva ◽  
Valéria Oliveira Pagnano ◽  
Leandro Dorigan De Macedo ◽  
...  
Keyword(s):  
Dental Treatment ◽  
Treatment Plan ◽  
Osteonecrosis Of The Jaw ◽  
Periodontal Therapy ◽  
Dental School ◽  
Invasive Procedures ◽  
Osteonecrosis Of The Jaws ◽  
Dental Management ◽  
Supportive Periodontal Therapy ◽  
Intravenous Bisphosphonates

Bisphosphonates are drugs used for the inhibition of osteoclastic bone resorption. Their therapeutic use is indicated for Paget’s disease, hypercalcemia of cancer, bone metastases, and osteoporosis. The main side effect of these drugs is osteonecrosis of the jaw, which is difficult to control. The aim of the present study was to report a patient, who was referred to the Special Needs Clinics of the Ribeirão Preto Dental School, University of São Paulo, for dental treatment. His medical history revealed a diagnosis of multiple myeloma with bone marrow transplantation in November 2007. Since then, he has been using zometa every 3 months. After physical examination and complementary exams, a diagnosis of angular cheilitis, erythematous candidiasis, caries, localized chronic periodontitis, pulp necrosis and partial edentulousness was established. The treatment plan was based on control of angular cheilitis candidiasis, basic periodontal therapy, supportive periodontal therapy, endodontic treatment, and partial mandibular and maxillary dentures. All invasive procedures were performed with antibiotic prophylaxis. The patient is under treatment and care is being taken to avoid osteonecrosis of the jaws. The authors highlight the need for knowledge of the side effects of bisphosphonates to prevent such effects and to maintain the oral health of the patients.

scholarly journals Decayed, Missing, and Filled Teeth Index and Periodontal Health in Osteoporotic Patients Affected by BRONJ: An Observational Study

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Giacomo Oteri ◽  
Ennio Bramanti ◽  
Valentina Nigrone ◽  
Marco Cicciù
Keyword(s):  
Oral Health ◽  
Periodontal Disease ◽  
Dental Hygiene ◽  
Case Reports ◽  
Rare Complication ◽  
Osteonecrosis Of The Jaw ◽  
Periodontal Health ◽  
Necrotic Bone ◽  
Osteonecrosis Of The Jaws ◽  
The Poor

The aim of this paper is to describe the incidence of decayed, missing, and filled teeth (DMFT) and periodontal disease in 32 osteoporotic patients affected by bisphosphonate-related osteonecrosis of the jaw (BRONJ). Moreover, an investigation between the obtained data and 20 patients treated with bisphosphonate drugs and with no evidence of ONJ has been performed. Osteonecrosis of the jaws is a rare complication in a subset of patients receiving bisphosphonate drugs. Based on a growing number of case reports and institutional reviews, this kind of therapy can cause exposed and necrotic bone specifically in the jawbones. From April 2009 to June 2012, 32 osteoporotic patients treated with oral or intravenous (I.V.) bisphosphonates have been recorded. The patients’ oral health has been compared with 20 bisphosphonates patients with no ONJ. The incidence of decayed, missing, and filled teeth (DMFT) and periodontal disease was recorded in all patients and student’st-test was applied for comparing the two investigated groups data. Data demonstrated how the poor dental hygiene and periodontal disease of the BRONJ patients’ are connected with the occurrence of jawbone necrosis.

scholarly journals Curious Case of Rodent Poison: A Case Report

2021 ◽  
Vol 5 (9) ◽  
pp. CR1-CR4
Author(s):  
Sam Ponraj Davidson. S ◽  
Somasundaram Elangovan ◽  
Suman Jhansi Lakshmi ◽  
B. Senthil Kumar
Keyword(s):  
Case Report ◽  
Ionizing Radiation ◽  
Malignant Tumors ◽  
Osteonecrosis Of The Jaw ◽  
Osteonecrosis Of The Jaws ◽  
Radiation Induced ◽  
Bisphosphonate Osteonecrosis

Osteonecrosis was first described as a consequence of ionizing radiation used in the treatment of malignant tumors but later a variety of causes for osteonecrosis were found which include, Medication induced, radiation induced, chemical induced and infection induced. Terms such as: bisphosphonate osteonecrosis (BON), Bisphosphonate Associated Osteonecrosis of the Jaws (BONJ), Bisphosphonate Related Osteonecrosis of the Jaws (BRONJ), Antiresorptive Osteonecrosis of the Jaw (ARONJ) and Medication Related Osteonecrosis of the Jaw (MRONJ) have all had proponents and all continue to be utilized. However, Migliorati  first proposed a designation of the disease as osteochemonecrosis. This case report is about a chemical induced osteonecrosis patient who placed rat poison inside the mouth. 

scholarly journals Impact of Antiresorptive Agents on Maxillary Bones: a Narrative Literature Review

2021 ◽  
Vol 23 (4) ◽  
pp. 268-276
Author(s):  
Maria Luiza da Silva Matos ◽  
Pedro Henrique Bastos de OIiveira ◽  
Ana Carla Barletta Sanches ◽  
Tila Fortuna Costa Freire ◽  
Juliana Borges de Lima Dantas ◽  
...  
Keyword(s):  
Literature Review ◽  
Adverse Effects ◽  
Osteonecrosis Of The Jaw ◽  
Drug Holiday ◽  
Osteonecrosis Of The Jaws ◽  
Antiresorptive Agents ◽  
Antiresorptive Drugs ◽  
Bibliographic Search ◽  
Narrative Literature ◽  
Narrative Literature Review

AbstractAntiresorptive drugs operate in the bone metabolism modulation and are widely used in the treatment of bone metastases and bone losses related to hormonal deficiency. Although this therapy shows satisfactory results, there are adverse effects associated with its use, such as osteonecrosis of the jaws. Medication-related osteonecrosis of the jaws (MRONJ) is, therefore, a serious and challenging condition with important implications in dentistry. The aim was to conduct a narrative literature review on anti-resorptive drugs and their latest repercussions on the maxillary bones. The review was carried out through a bibliographic search using Decs/Mesh descriptors of interest, in Portuguese and English, in the PubMed, Virtual Health Library (VHL) and Scielo databases. After applying the inclusion and exclusion criteria, a total of 33 studies were selected for analysis. It can be noticed that therapy with anti-resorptive agents is complex, especially in dental practice, since MRONJ is a complication that is difficult to manage. Regarding the therapeutic options, these are divided into conservative, surgical or adjuvant therapy, however, there are no protocols in the literature, and there is no consistency regarding the indication of the suspension of the drug administration - "Drug Holiday". Thus, it is important that the multidisciplinary team seeks strategies that minimize complications and promote control over the use of these drugs. In addition, there is a need for investigations that contribute with guidelines for the management and control of adverse effects resulting from therapy with antiresorptive drugs. Keywords: Bone Density Conservation Agents. Diphosphonates. Denosumab. Bisphosphonate-Associated Osteonecrosis of the Jaw. ResumoAs drogas antirreabsortivas atuam na modulação do metabolismo ósseo e são indicadas para o tratamento de metástases ósseas e perdas ósseas relacionadas à deficiência hormonal. Ainda que esta terapia apresente resultados satisfatórios, observam-se efeitos adversos associados ao seu uso, como a osteonecrose dos maxilares. A osteonecrose dos maxilares associada ao uso de medicamentos (OMAM) é, portanto, uma condição séria e desafiadora com implicações importantes na Odontologia. O objetivo foi realizar uma revisão narrativa de literatura sobre as drogas antirreabsortivas e suas respectivas repercussões nos ossos maxilares. A revisão foi realizada através de busca bibliográfica utilizando descritores Decs/Mesh de interesse, em português e inglês, nas bases de dados PubMed, Biblioteca Virtual de Saúde (BVS) e Scielo. Após aplicação dos critérios de inclusão e exclusão, um total de 33 trabalhos foram selecionados para análise. Pode-se constatar que a terapia com agentes antirreabsortivos é complexa, sobretudo na prática odontológica, visto que a OMAM é uma complicação de difícil manejo. Em relação às condutas terapêuticas para esta condição, divide-se em terapia conservadora, cirúrgica ou adjuvante, todavia, não existem protocolos validados na literatura, bem como não há consistência quanto à indicação do intervalo de suspensão da administração da droga - “Drug Holiday”. Desse modo, é importante que a equipe multidisciplinar busque estratégias que minimizem as complicações e promovam o controle no uso dessas drogas. Além disso, nota-se a necessidade de realizar investigações que contribuam com diretrizes para o manejo e controle dos efeitos adversos decorrentes da terapia com medicamentos antirreabsortivos. Palavras-chave: Conservadores da Densidade Óssea. Bisfosfonatos. Denosumabe. Osteonecrose Associada a Bisfosfonatos.  

scholarly journals The Use of Photodynamic Therapy on Medication-Related Osteonecrosis of the Jaws: An Animal Study

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Gökay Karapınar ◽  
Özge Özdal Zincir ◽  
Meral Ünür ◽  
Necat Vakur Olgaç
Keyword(s):  
Photodynamic Therapy ◽  
Osteonecrosis Of The Jaw ◽  
Male Rats ◽  
Sprague Dawley ◽  
Tissue Samples ◽  
Osteonecrosis Of The Jaws ◽  
Tracp 5B ◽  
Valuable Marker ◽  
Group 3 ◽  
Group 2

SummaryBackground/Aim: Bisphosphonate-related osteonecrosis of the jaw (BRONJ) was first introduced in 2003 and its scope was expanded by the name medication-related osteonecrosis of the jaw (MRONJ), since 2014. This study aimed to evaluate the effects of photodynamic therapy (FDT) on tissue samples by histopathological and histomorphometric examination and serum TRACP-5b (Tartrateresistant acid phosphatase-5b) measurement in rats.Material and Methods: 24 Sprague-Dawley male rats were divided into 3 groups comprising 8 animals. Zoledronic acid was administered to groups 1 and 2 and 0.9% sodium chloride was administered to group 3 intraperitoneally. After the injections were completed, dental extractions were performed. Photodynamic therapy was applied to group 2, three times a weekfor the two weeks after the extraction. In the 16th week, sacrification was performed. Rats were undergone histopathologic and histomorphometric evaluations.Results: Photodynamic therapy has led to a decrease in epithelial opening and inflammation and an increase in the formation of new bone. Serum TRACP-5b values were shown to decrease significantly in the presence of osteonecrosis.Conclusions: PDT was shown to be useful in reducing MRONJ risk in rats. As a serum biomarker, Serum TRACP-5b could be a valuable marker. Additional studies should confirm the findings.

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