scholarly journals Medication‐related osteonecrosis of the jaw after long‐term bisphosphonate treatment in a cat

2019 ◽  
Vol 33 (2) ◽  
pp. 862-867 ◽  
Author(s):  
Melinda J. Larson ◽  
Ashley B. Oakes ◽  
Ember Epperson ◽  
Dennis J. Chew
Keyword(s):  
Osteonecrosis Of The Jaw ◽  
Bisphosphonate Treatment

Bisphosphonate-induced osteonecrosis of the ear canal: our experience and a review of the literature

2018 ◽  
Vol 132 (4) ◽  
pp. 372-374 ◽  
Author(s):  
L McCadden ◽  
C G Leonard ◽  
W J Primrose
Keyword(s):  
Side Effects ◽  
Acid Treatment ◽  
Osteonecrosis Of The Jaw ◽  
Term Treatment ◽  
External Ear ◽  
Bisphosphonate Treatment ◽  
Review Of The Literature ◽  
Ear Canal ◽  
Long Term Treatment

AbstractBackground:Oesophageal disorders and osteonecrosis of the jaw are recognised complications of the commonly prescribed medication bisphosphonate. Despite these diagnoses being seen comparatively frequently within the ENT clinic, osteonecrosis of the external ear is a less well reported complication.Methods:The current literature is reviewed and our experience with six cases of bisphosphonate-related ear canal osteonecrosis is presented.Results:Six cases were identified as suffering from ear canal osteonecrosis as a result of bisphosphonate treatment. One of our cases suffered bilateral ear canal osteonecrosis after only 20 months of oral alendronic acid treatment. Management ranged from bisphosphonate cessation and topical treatment, to surgical debridement in the operating theatre.Conclusion:Bisphosphonate-related ear canal osteonecrosis is undoubtedly under-diagnosed. For such a commonly prescribed medication, the risks and side effects of bisphosphonate should be better known and long-term treatment should be avoided if possible.

scholarly journals Bisphosphonate Associated Osteonecrosis of the Jaw: An Update on Pathophysiology, Risk Factors, and Treatment

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Lars Rasmusson ◽  
Jahan Abtahi
Keyword(s):  
Risk Factors ◽  
Chronic Osteomyelitis ◽  
Osteonecrosis Of The Jaw ◽  
Bisphosphonate Treatment ◽  
Review Of The Literature ◽  
Implant Placement ◽  
The World ◽  
Incidence Risk ◽  
Tooth Extractions

Osteonecrosis of the jaw in patients treated with bisphosphonates is a relatively rare but well known complication at maxillofacial units around the world. It has been speculated that the medication, especially long-term i.v. bisphosphonate treatment, could cause sterile necrosis of the jaws. The aim of this narrative review of the literature was to elaborate on the pathological mechanisms behind the condition and also to gather an update on incidence, risk factors, and treatment of bisphosphonate associated osteonecrosis of the jaw. In total, ninety-one articles were reviewed. All were published in internationally recognized journals with referee systems. We can conclude that necrotic lesions in the jaw seem to be following upon exposure of bone, for example, after tooth extractions, while other interventions like implant placement do not increase the risk of osteonecrosis. Since exposure to the bacterial environment in the oral cavity seems essential for the development of necrotic lesions, we believe that the condition is in fact chronic osteomyelitis and should be treated accordingly.

Osteonecrosis of the Jaw in a Patient With Bone Metastatic Prostate Cancer After Long-term Bisphosphonate Treatment With Severe Deterioration Following Radium-223

2018 ◽  
Vol 16 (5) ◽  
pp. 328-331 ◽  
Author(s):  
Bente Brokstad Herlofson ◽  
Gry Karina Kjølle ◽  
Kristine Løken Westgaard ◽  
Ayca M. Løndalen ◽  
Øyvind S. Bruland
Keyword(s):  
Prostate Cancer ◽  
Metastatic Prostate Cancer ◽  
Osteonecrosis Of The Jaw ◽  
Bisphosphonate Treatment ◽  
Radium 223 ◽  
Severe Deterioration

scholarly journals Duration of Bisphosphonate Drug Holidays in Osteoporosis Patients: A Narrative Review of the Evidence and Considerations for Decision-Making

2021 ◽  
Vol 10 (5) ◽  
pp. 1140
Author(s):  
Kaleen N. Hayes ◽  
Elizabeth M. Winter ◽  
Suzanne M. Cadarette ◽  
Andrea M. Burden
Keyword(s):  
Surrogate Marker ◽  
Femoral Fractures ◽  
Osteonecrosis Of The Jaw ◽  
Bisphosphonate Therapy ◽  
Narrative Review ◽  
Drug Holiday ◽  
Future Research ◽  
Mineral Density ◽  
First Line Therapy

Bisphosphonates are first-line therapy for osteoporosis, with alendronate, risedronate, and zoledronate as the main treatments used globally. After one year of therapy, bisphosphonates are retained in bone for extended periods with extended anti-fracture effects after discontinuation. Due to this continued fracture protection and the potential for rare adverse events associated with long-term use (atypical femoral fractures and osteonecrosis of the jaw), a drug holiday of two to three years is recommended for most patients after long-term bisphosphonate therapy. The recommendation for a drug holiday up to three years is derived primarily from extensions of pivotal trials with alendronate and zoledronate and select surrogate marker studies. However, certain factors may modify the duration of bisphosphonate effects on a drug holiday and warrant consideration when determining an appropriate time off-therapy. In this narrative review, we recall what is currently known about drug holidays and discuss what we believe to be the primary considerations and areas for future research regarding drug holiday duration: total bisphosphonate exposure, type of bisphosphonate used, bone mineral density and falls risk, and patient sex and body weight.

Oral bisphosphonate treatment in patients with Duchenne muscular dystrophy on long term glucocorticoid therapy

2020 ◽  
Vol 30 (7) ◽  
pp. 599-610
Author(s):  
Cuixia Tian ◽  
Brenda L. Wong ◽  
Lindsey Hornung ◽  
Jane C. Khoury ◽  
Irina Rybalsky ◽  
...  
Keyword(s):  
Duchenne Muscular Dystrophy ◽  
Muscular Dystrophy ◽  
Glucocorticoid Therapy ◽  
Bisphosphonate Treatment ◽  
Oral Bisphosphonate

scholarly journals Characteristics of patients with osteonecrosis of the jaw with oral versus intravenous bisphosphonate treatment

2021 ◽  
Vol 43 (1) ◽  
Author(s):  
Seung-Hun Lee ◽  
So-Young Choi ◽  
Min-Su Bae ◽  
Tae-Geon Kwon
Keyword(s):  
Retrospective Study ◽  
Clinical Characteristics ◽  
Demographic Data ◽  
Osteonecrosis Of The Jaw ◽  
Group Differences ◽  
Bisphosphonate Treatment ◽  
Administration Route ◽  
Lesion Number ◽  
Different Characteristics ◽  
Intravenous Bisphosphonate

Abstract Purpose This retrospective study was aimed to evaluate the clinical characteristics and treatment outcomes in patients with osteonecrosis of the jaw who were receiving oral versus intravenous (IV) bisphosphonate (BP). Materials and methods This retrospective study enrolled subjects who had been diagnosed with medication-related osteonecrosis of the jaw (MRONJ) during the period from July 2010 to June 2014. Information regarding the following demographic and clinical characteristics was collected: demographic data, administration route and type of BP, duration of BP medication, primary disease, number of involved sites, location of the lesion, number of surgeries, outcome of treatments, and laboratory test. All the patients were divided into oral and IV BP groups; and the between-group differences were compared. Results Total 278 patients were divided into two groups as per the route of BP administration. The proportion of oral BP-related MRONJ group were more dominant over IV BP group (oral BP, n = 251; IV BP, n = 27). In the IV BP group, the average dosing duration (31.4 months) was significantly shorter than that in the oral BP group (53.1 months) (P < 0.001). The average number of involved sites in the oral BP group (1.21 ± 0.48) was smaller than that in the IV BP group (1.63 ± 0.84) (P < 0.001). The average number of surgeries was higher in the IV BP group (1.65 ± 0.95) as compared to that in the oral BP group (0.98 ± 0.73) (P < 0.001). Outcome after the surgery for MRONJ after IV BP was poor than oral BP group. Conclusion IV administration of BP causes greater inhibition of bone remodeling and could lead more severe inflammation. Therefore, even if the duration of IV administration of BP is shorter than that of oral BP, the extent of the lesion could be more extensive. Therefore, the result suggests that the MRONJ after IV BP for cancer patients needs to be considered as different characteristics to oral BP group for osteoporosis patents.

scholarly journals Dental management in Oncology patient: osteonecrosis related osteonecrosis of the Jaw (MRONJ)

2020 ◽  
Vol 4 (1) ◽  
pp. 01-02
Author(s):  
Picardo Noemi
Keyword(s):  
Task Force ◽  
Health Assessment ◽  
Osteonecrosis Of The Jaw ◽  
Oncology Patient ◽  
Stomatognathic System ◽  
Oncological Patients ◽  
Dental Management ◽  
Antiresorptive Drugs ◽  
Antiangiogenic Drugs

It is essential that oncological patients treated with antiresorptives or antiangiogenic drugs diagnosed Medication Related Osteonecrosis of the Jaw (MRONJ) must be treated in an interdisciplinary fashion. The patient’s stomatognathic system should be examined preventatively prior to the initiation of antiresorptive drugs in order to avoid pathological buccal manifestations, following the same healthcare clinical protocols used for patients receiving head and neck radiotherapy. Additionally, patients should be informed of the precautions to be taken, including regular dental appointments for oral health assessment. The risk of developing MRONJ should be evaluated according to the type of antiresorptives or antiangiogenic drugs administered and treatment duration. In the case of MRONJ, its fundamental characteristic is positioned in the biochemical particularity of the pharmacokinetic expression of antiresorptive drugs, reversibly (DS) or irreversibly (BPs) inhibiting the functionality of the osteoclast. Therefore, the consideration of invading bone tissue as little as possible and performing resective therapies in cases of systemic infectious spread follows, since its long-term resolution would not be effective because the drug (BPs) has frank accumulation at a distance, a characteristic used by treating doctors and it would not have clinical relevance to suggest its suspension. According to the recommendations of AAOMS; Task Force and AOCMF coincide with the sharing of consensus on minimally invasive manipulations once the necrotic foci have been installed and the preventive attitude prevails of eliminating all septic foci prophylactically before starting therapy with antiresorptive drugs. There are positions with a trend more committed to frank bone manipulation with the aim of evacuating the infectious problem and other more conservative positions in order not to expand drug necrosis volumetrically due to bone accumulation of BPs or DS.

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