Intravenous Bisphosphonate–Associated Osteonecrosis of the Jaw

Statz, Thomas A.; Guthmiller, Janet M.; Humbert, Lewis A.; Johnson, Georgia K.

doi:10.1902/jop.2007.070104

Cited by 15 publications

(13 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Since 2003, when Marx (4) published a series of thirtysix cases of osteonecrosis associated with bisphosphonates, numerous studies have been carried out which relate the occurrence of osteonecrosis in maxillary structures, mainly the mandible, associated with intravenous bisphosphonates following oral surgery, mainly exodontias (1,(4)(5)(6)(7)(8)(9). However, the topic of the present review is the incidence of osteonecrosis related to dental implant placement in patients undergoing treatment with oral bisphosphonates; our findings are shown in table 2.…”

Section: Resultsmentioning

confidence: 99%

Dental implants in patients treated with oral Bisphosphonates: A bibliographic review

Montoya-Carralero¹,

Parra-Mino²,

Fernández³

et al. 2009

Med Oral

View full text Add to dashboard Cite

Bisphosphonates inhibit bone resorption and are used to treat a range of pathologies, including Paget disease, osteoporosis, multiple myeloma and metastases associated with breast or prostate cancer. At present, there is no effective treatment for bisphosphonate induced osteonecrosis, so prevention is extremely important. Since quality of life deteriorates for those suffering osteonecrosis, maximum precautions should be taken with patients at risk, and especially whenever oral surgery, including dental implant placement, is contemplated. Dentists and oral or maxillofacial surgeons must keep up to date with the latest approaches to prevention, particularly when treating patients who are presently taking, or who will be taking bisphosphonates and are also candidates for dental implants.

show abstract

Section: Resultsmentioning

confidence: 99%

Dental implants in patients treated with oral Bisphosphonates: A bibliographic review

Montoya-Carralero¹,

Parra-Mino²,

Fernández³

et al. 2009

Med Oral

View full text Add to dashboard Cite

show abstract

“…somministrati in congiunzione alla terapia del cancro, è una breve reazione di fase acuta, caratterizzata da sintomi simil-infl uenzali. Altre complicanze includono insuffi cienza renale, sindrome nefrosica, squilibrio elettrolitico, ipocalcemia e osteonecrosi dei mascellari (ONJ) [3,9] . La ONJ da bisfosfonati, descritta per la prima volta nel 2003 da Marx [10] , è defi nita come una patologia che si manifesta a carico delle ossa mascellari, originando dall'osso alveolare ed estendendosi successivamente all'osso basale o al ramo.…”

Section: Onj Is a Complicationunclassified

“…Tra i più importanti fattori predisponenti per la ONJ si considerano il tipo, la dose totale e la durata della terapia con bisfosfonati, nonché, anche se meno frequentemente, fattori che modifi cano la vascolarizzazione locale, come le emoglobinopatie, i disordini metabolici, il LES, fattori ambientali e sociali (tabacco e alcol), la gravidanza, un'età superiore a 60 anni e il sesso femminile [1] . Una storia di chirurgia dentale, trauma o infezione è stata ipotizzata essere un fattore precipitante [3,12] . Questo caso clinico descrive un'osteonecrosi dei mascellari spontanea, identifi cata in una paziente sottoposta ad avulsioni chirurgiche prima dell'inizio del trattamento con bisfosfonati.…”

Section: Onj Is a Complicationunclassified

“…La loro azione si esplica attraverso l'induzione dell'apoptosi osteoclastica e l'interruzione del riassorbimento osteoclastico di osso mineralizzato e di cartilagine. Essi si fi ssano ai cristalli di idrossiapatite e vengono incorporati defi nitivamente nella matrice ossea [3,4] . Gli aminobisfosfonati, grazie alle loro proprietà antiangiogeniche e alla loro capacità di bloccare l'invasione tumorale, hanno un effetto diretto sui tumori: inducono l'apoptosi cellulare e impediscono l'adesione delle cellule maligne alla matrice extracellulare dell'osso [5,6] .…”

unclassified

See 1 more Smart Citation

Osteonecrosi spontanea dei mascellari in relazione all’assunzione di bisfosfonati endovenosi: caso clinico

Carini

Pisapia

et al. 2012

Italian Oral Surgery

View full text Add to dashboard Cite

Caso clinicoITALIAN ORAL SURGERY 2012;11(5)(S1):S296-S302 | S296 RiassuntoObiettivi : L'osteonecrosi dei mascellari ( osteonecrosis of the jaw , ONJ) rappresenta un possibile effetto collaterale connesso all'assunzione dei bisfosfonati. L'incidenza di ONJ tra i pazienti che ricevono bisfosfonati per via endovenosa (e.v.) supera quella registrata nei pazienti trattati con bisfosfonati orali. L'obiettivo di questo studio è documentare la possibilità di sviluppo spontaneo di osteonecrosi dei mascellari in relazione all'assunzione di bisfosfonati endovenosi. Materiali e metodi : Si descrive un caso clinico di osteonecrosi mandibolare spontanea in una paziente sottoposta ad avulsioni chirurgiche prima dell'inizio del trattamento con bisfosfonati. Risultati : Nel presente caso clinico l'esposizione ossea si è risolta, mostrando così che i pazienti con ONJ, in terapia con bisfosfonati e.v. e in presenza di altri fattori di rischio possono guarire in modo adeguato con una terapia tempestiva e appropriata. Conclusioni : I pazienti che devono essere sottoposti a terapia con bisfosfonati e.v. devono essere informati dei potenziali rischi e inseriti AbstractObjectives : Osteonecrosis of the jaw (ONJ) is one of the multiple side effects of bisphosphonate therapy. The incidence of ONJ among patients receiving intravenous (IV) bisphosphonates exceeds that recorded in patients treated with oral bisphosphonates. We report a case of spontaneous ONJ related to intravenous administration of bisphosphonates. Materials and methods : We describe a case of spontaneous mandibular osteonecrosis in a female patient who underwent dental surgery before beginning therapy with bisphosphonates.

show abstract

“…They are difficult to heal with a dramatic impact on quality of life. Progressive bone necrosis increases the risk of spontaneous jaw fractures [Statz et al, 2007] and the continuous infections could be a threat to the life of immune-suppressed cancer patients. Clearly, a means to identify those with a predisposition or with early preclinical lesions is required.…”

mentioning

confidence: 99%

Bisphosphonate-Related Osteonecrosis of the Jaw: Model and Diagnosis with Cone Beam Computerized Tomography

Barragan-Adjemian

Lausten

Ang

et al. 2008

Cells Tissues Organs

View full text Add to dashboard Cite

Intravenous bisphosphonate (BP) therapy has become the standard of care for the treatment of cancers that metastasize to bone. BPs are associated with osteonecrosis of alveolar bones, a condition known as osteonecrosis of the jaw (ONJ). The incidence or pathogenesis of ONJ is largely unknown. The lesions are characterized by areas of exposed necrotic bone that do not heal after 8 weeks in the absence of radiation to the head and neck. ONJ lesions have been recalcitrant to conventional therapies. Lesions in cancer patients treated with BPs develop in association with periodontal disease, tooth extraction and/or in association with increased mechanical force due to partial/complete dentures. We hypothesized that intravenous BPs in cancer patients impair normal bone remodeling, thereby increasing the incidence of osteonecrotic lesions and that these lesions can be detected using cone beam computerized tomography (CBCT). From CBCTs taken at the University of Missouri at Kansas City School of Dentistry, 26 subjects had a cancer diagnosis and were on BP therapy. From these 26 subjects, 18 presented visible, exposed necrotic bone. We observed both sclerotic and radiolucent lesions. Lesions could be detected and measured in reconstructed images where most were found to expand to large areas of the bone. We were able to identify necrotic bodies or ‘involucrums’ within the ONJ lesions, suggesting that this could be the mechanism for the formation of a clinically visible sequestrum. We propose that CBCT can potentially identify and follow the progression of both pre- and postclinical lesions in ONJ patients, allowing better diagnosis and assessment of disease status.

show abstract

Intravenous Bisphosphonate–Associated Osteonecrosis of the Jaw

Cited by 15 publications

References 19 publications

Dental implants in patients treated with oral Bisphosphonates: A bibliographic review

Dental implants in patients treated with oral Bisphosphonates: A bibliographic review

Osteonecrosi spontanea dei mascellari in relazione all’assunzione di bisfosfonati endovenosi: caso clinico

Bisphosphonate-Related Osteonecrosis of the Jaw: Model and Diagnosis with Cone Beam Computerized Tomography

Contact Info

Product

Resources

About