Important aspects regarding the role of microorganisms in bisphosphonate-related osteonecrosis of the jaws

Boff, Renata Chiapinotto; Salum, Fernanda Gonçalves; Figueiredo, Maria Antonia Zancanaro de; Cherubini, Karen

doi:10.1016/j.archoralbio.2014.05.002

Cited by 44 publications

(68 citation statements)

References 73 publications

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“…Additional osteotomy after surgical tooth extraction furthers increase the risk for ONJ, even combined with perioperative adjuvant treatment . (Boff, Salum, Figueiredo, & Cherubini, 2014;De Ceulaer, Tacconelli, & Vandecasteele, 2014;Hinson, Smith, Siegel, & Stack, 2014;Lumerman, 2013;Russmueller et al, 2016). The presence of jaw infection associated with oral microbial biofilm also significantly increases the risk of ONJ in cancer patients taking antiresorptive drugs like bisphosphonates and denosumab.…”

Section: Local Risk Factorsmentioning

confidence: 99%

“…Jaw infection may also delay exposed bone re-coverage by mucosal layer and subsequent ONJ healing. (Boff, Salum, Figueiredo, & Cherubini, 2014;De Ceulaer, Tacconelli, & Vandecasteele, 2014;Hinson, Smith, Siegel, & Stack, 2014;Lumerman, 2013;Russmueller et al, 2016). Therefore, poor oral hygiene and dental implants may also confer to the risk of ONJ, requiring appropriate preventing measures.…”

Section: Local Risk Factorsmentioning

confidence: 99%

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Antiresorptive treatment-associated ONJ

Eleutherakis‐Papaiakovou

Bamias

2017

Eur J Cancer Care

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Osteonecrosis of the jaw (ONJ) is a severe complication of therapy with antiresorptive agents (e.g. bisphosphonates and denosumab), which are used to manage bone metastases from cancer, to reduce the incidence of skeletal-related events. Available data indicate that 0-27, 5% of patients exposed to antiresorptive agents may develop ONJ, depending on the number of infusions and the duration of therapy. Besides antiresorptive therapy, a number of risk factors for osteonecrosis have been identified. Oral surgical procedures, tooth extractions and infection to the jawbones are considered the main risk factors for developing ONJ, when receiving antiresorptive therapy. However, a growing number of patients develop ONJ without apparent risk factors, raising concern for other predisposing factors. Jaw bone necrosis may be irreversible, resulting in a chronic disease with negative impact on the quality of patients' lives. The role of risk reduction strategies like meticulous dental screening and optimal oral hygiene is fundamental for preventing development of ONJ. ONJ is usually treated conservatively to relieve the symptoms and manage jaw bone necrosis. In certain cases, surgical intervention is required. Future research should emphasize individual predisposition to ONJ, more effective preventive measures and more efficient therapeutic procedures.

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Section: Local Risk Factorsmentioning

confidence: 99%

Section: Local Risk Factorsmentioning

confidence: 99%

Antiresorptive treatment-associated ONJ

Eleutherakis‐Papaiakovou

Bamias

2017

Eur J Cancer Care

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“…They believe that removal of the necrotic tissue can reduce the amount of microorganisms, 18 which play an important role in the disease aetiopathogenesis. 60 Patients who do not have any symptoms should be kept under follow-up. Surgical treatment of the lesions before bone exposure was also adopted by Schiodt et al, 20 who believe that surgical intervention performed as soon as possible provides better response to treatment.…”

Section: Management Of Patientsmentioning

confidence: 99%

Bisphosphonate-related osteonecrosis of the jaw: from the sine qua non condition of bone exposure to a non-exposed BRONJ entity

Koth¹,

Figueiredo²,

Salum³

et al. 2016

Dentomaxillofacial Radiology

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“…As a result, proper healing of alveolar tissues does not take place, as well as exposure and osteonecrosis. 7 The clinical picture often notes the exposure of the bone over a large area. The visible tissue may have a characteristic gray color, there is pain caused by palpation and spontaneous pain, swelling of the surrounding soft tissues, and sometimes pathological fractures can be observed.…”

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confidence: 99%

“…6 This is followed by incorporation into osteoclasts, leading to their inactivation and finally to their apoptosis. 2,7 These drugs probably reduce the amount of VEGF protein (a strong proangiogenic factor), lead to a handicap in the formation of new blood vessels and indirectly have a negative impact on bone remodeling. The beneficial impact on the primary disease (by inhibiting the proliferation of tumor cells) and stimulation of their apoptosis were demonstrated among oncological patients.…”

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confidence: 99%

Bone necrosis associated with the use of bisphosphonates: Case report

Jachewicz¹,

Jakiel²

2017

Dent. Med. Probl.

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The aim of this study was to present the case of a 68-year-old female patient with jaw bone necrosis associated with the use of bisphosphonates. The case was qualified for the second degree of severity (BRONJ). The study demonstrates a multi-month observation of the patient and describes the sequestrectomy procedure performed, which was supplemented by covering the bone tissue with a collagen sponge. The treatment applied was slightly different from the accepted algorithms of proceedings. The difference was connected with the use of a collagen sponge containing gentamicin (used to cover the bone's surface) after the sequestrectomy. The collagen material, in contrast to the exposed dead bone, is a surface which may be susceptible to epithelization. This gives a possibility to the secondary closing of the wound as a result of granulation and epithelization without the bone's re-exposure. Moreover, the study characterizes indications for the use of bisphosphonates, their chemical structure and mechanism of action. It shows the definition of BRONJ (bisphosphonate-related osteonecrosis of the jaw) and risk factors for its occurrence, as well as prevention and treatment methods.

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Important aspects regarding the role of microorganisms in bisphosphonate-related osteonecrosis of the jaws

Cited by 44 publications

References 73 publications

Antiresorptive treatment-associated ONJ

Antiresorptive treatment-associated ONJ

Bisphosphonate-related osteonecrosis of the jaw: from the sine qua non condition of bone exposure to a non-exposed BRONJ entity

Bone necrosis associated with the use of bisphosphonates: Case report

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