Application of pamidronate disodium for the treatment of diffuse sclerosing osteomyelitis of the mandible: A clinical study

Li, Xiaoli; Jia, Kuankuan; An, Jingang; Zhang, Yi

doi:10.1016/j.oooo.2020.06.023

Cited by 11 publications

(14 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In our two cases, we observed a local reduction in bone turnover on scintigraphy in both, with persistent sclerosis in the first, and, remarkably, resolution of sclerosis in the second. For CRMO, full resolution of lesions on MRI in children after both NSAID and pamidronate therapy has been described earlier ( 35 – 37 ), just like for DSO an improvement of structural bone changes after pamidronate therapy has been reported ( 38 , 39 ). A recent randomized study on the effect of pamidronate in CNO patients in general did report significant improvement on radiological disease activity, but not on chronic inflammatory changes ( 40 ).…”

Section: Discussionmentioning

confidence: 74%

Sternocostoclavicular Hyperostosis: Positive Clinical and Radiological Response on Pamidronate

et al. 2021

View full text Add to dashboard Cite

BackgroundSternocostoclavicular hyperostosis (SCCH) is a rare disease, constituting a chronic sterile osteomyelitis with elevated bone turnover in the axial skeleton, causing pain and shoulder dysfunction. SCCH severely interferes with daily activities, work, and quality of life. SCCH has a relapse-remitting disease course, but inflammatory-induced sclerotic transformation in the affected area is slowly progressive. Here we present two patients with clinical and radiological diagnosis of SCCH treated with intravenous pamidronate, leading to clinical remission in both, but complete resolution of sclerosis in one of them, which is a novel finding in our experience.Case PresentationTwo adult female SCCH-patients presented with longstanding pain, swelling of the anterior chest wall, and compromised shoulder function. Subsequent single photon emission computed tomography-computed tomography (SPECT/CT) illustrated elevated bone activity and sclerosis in the SC region, with hyperostosis, confirming the diagnosis of SCCH. As symptoms in both patients were eventually refractory to standard painkillers such as non-steroidal anti-inflammatory drugs (NSAIDs), intravenous pamidronate treatment in 3-month cycles was started. Pamidronate was effective in reducing pain and improving shoulder function and also led to decreased bone turnover on skeletal scintigraphy. Sclerosis in the first patient persisted. In the second patient, however, a complete resolution of sclerosis was observed.ConclusionsSCCH remains a rare bone disorder for which no evidence-based therapies are yet available. While disease burden is high, SCCH lacks recognition and is often diagnosed long after symptomatic presentation. As for the cases in this report, pamidronate was successful in reducing symptoms, and in the second case even led to regression of sclerotic changes on CT-imaging.

show abstract

Section: Discussionmentioning

confidence: 74%

Sternocostoclavicular Hyperostosis: Positive Clinical and Radiological Response on Pamidronate

et al. 2021

View full text Add to dashboard Cite

show abstract

“…In an observational clinical study that included 43 patients who underwent an infusion of 60mg of Pamidronate for 3 consecutive days, it was concluded that the treatment is effective and safe, and the patients evolved with reduced edema, pain and trismus. Among the 43 treated patients, only 2 cases repeated the cycle and another 4 cases presented recurrence of symptoms within the contemplated period, no side effects were reported, but is important to hightlight that the follow up lasted 18 months 14 .…”

Section: Discussionmentioning

confidence: 91%

Pharmacological Treatment of Primary Chronic Osteomyelitis

Oliveira¹,

Migliolo²,

Lemos³

et al. 2023

J Oral Diag

View full text Add to dashboard Cite

Introduction: Chronic primary osteomyelitis (CPO) is a rare disease, defined as a chronic inflammatory process involving cortical and medullary bone. In the maxillofacial region, it mainly affects the mandible, with a predilection for females in a wide age range, with unknown etiology or defined treatment protocol. Objective: The objective of this article is to report a case of the rare disease Chronic Primary Osteomyelitis, focusing on its clinical, radiographic, and histopathological characteristics, and to discuss the nomenclature for differential diagnosis while comparing with other osteomyelitis. Case Report: MLP patient, 53 years old, female, leukoderma, was admitted at the Maxillofacial Surgery and Traumatology Service of the University Hospital of USP referred from another service and reported of severe pain and swelling in the face for approximately 1 .5 year. On clinical examination, he presented edema 1+/4+ in the lower third of the right hemiface, sensitive to palpation, trismus, lower lip paresthesia, no evidence of infectious odontogenic focus, increased volume or intraoral secretion. The patient was submitted to an incisional biopsy, computed tomography and scintigraphy, which showed an sclerotic pattern and increased uptake in the mandible, respectively. After months of antibiotic therapy with no results, the patient was initially submitted to 20mg of Prednisone with regression up to 5mg and two doses of 60mg of Pamidronate which resulted in remission of pain, edema and trismus. Until the publication of this article, the patient had no recurrence of the symptoms, totalizing 6 years of follow up. Conclusion: CPO is a rare and challenging diagnosis disease. Prednisone was effective to edema and trismus decreasement and Pamidronate for pain control, however more studies are necessary to determine a definitive treatment for this condition.

show abstract

“…These articles were filtered for relevance and duplication, resulting in 58 articles. A subsequent full-text assessment reduced the number of articles suitable for inclusion to ten 14 , 28 – 36 . No additional articles were identified through searching bibliographies.…”

Section: Resultsmentioning

confidence: 99%

“…The study by Li et al . 28 also utilised VAS to measure pain severity within their patient cohort. Thirty-three percent of their patient cohort reported moderate to severe pain prior to undergoing bisphosphonate therapy.…”

Section: Resultsmentioning

confidence: 99%

Bisphosphonate therapy in the management of diffuse sclerosing osteomyelitis of the mandible: a systematic review and narrative synthesis

Abukhder,

Nasri Elmi,

Van Der Lith

et al. 2023

Annals of Medicine &Amp; Surgery

View full text Add to dashboard Cite

Background: Diffuse Sclerosing Osteomyelitis (DSO) affecting the mandible is an uncommon condition characterized by recurrent pain and functional disturbances. Traditional treatments involving antibiotics, steroids, and analgesics have generally yielded unsatisfactory results. Numerous articles have proposed the utilization of bisphosphonate therapy as an alternative approach to achieve sustained symptom relief. This study aims to consolidate the available evidence on the effectiveness of bisphosphonate therapy in managing DSO. Methods: A systematic review protocol was registered with PROSPERO and reported in accordance with the Preferred Reporting for Items for Systematic Reviews and Meta-Analyses. Comprehensive electronic search strategies were devised, and studies were screened based on predefined inclusion and exclusion criteria. Results: Ten articles met the eligibility criteria, encompassing a total of 135 patients diagnosed with DSO who received bisphosphonate treatment. All included studies consistently reported a reduction in pain levels and swelling, along with a decrease in the cumulative use of analgesics. The majority of patients reported long-lasting symptom improvement with bisphosphonate therapy. Notably, four studies documented improvements in maximal mouth opening, with one study reporting a mean increase of 9.6mm. Furthermore, six studies observed improvements in panoramic radiographs and cone beam CT scans, with one publication describing two patients exhibiting near-normal bone architecture. Importantly, all studies reported the absence of long-term complications. Conclusions: Bisphosphonate therapy emerges as a promising treatment modality for DSO, exhibiting efficacy in symptom alleviation and radiological enhancement while conferring lasting benefits. Nevertheless, further prospective studies are warranted to refine treatment protocols and substantiate these findings.

show abstract

Application of pamidronate disodium for the treatment of diffuse sclerosing osteomyelitis of the mandible: A clinical study

Cited by 11 publications

References 20 publications

Sternocostoclavicular Hyperostosis: Positive Clinical and Radiological Response on Pamidronate

Sternocostoclavicular Hyperostosis: Positive Clinical and Radiological Response on Pamidronate

Pharmacological Treatment of Primary Chronic Osteomyelitis

Bisphosphonate therapy in the management of diffuse sclerosing osteomyelitis of the mandible: a systematic review and narrative synthesis

Contact Info

Product

Resources

About