Maxilla Osteonecrosis: A Differential Diagnosis in Patients with Metastatic Cancer on Bisphosphonates

Smith, Joshua D.; Birkeland, Andrew C.; McHugh, Jonathan B.; Spector, Matthew E.

doi:10.4303/jcrm/235969

Cited by 4 publications

(5 citation statements)

References 11 publications

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“…Given high suspicion and repeatedly negative biopsies, or region of difficult access such as TMJ, positron emission topographies could help to discern in favour of metastasis, as long as osteonecrosis is not in the active infection phase ( Figure 5). In addition, the evolution and non-response to osteonecrosis treatment protocols will define the situation 24,25 . Management of head & neck metastatic tumours should be multidisciplinary and individualized to each patient.…”

Section: Resultsmentioning

confidence: 99%

Oral and Maxillary Metastases: Retrospective Clinical Analysis of 21 Cases

Prol¹,

Ruiz-Oslé²,

Malaetxebarría³

et al. 2019

j.maxilo

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Objective: Retrospective descriptive study of 21 oral soft tissue and/or maxillary bone metastatic cases.Materials and methods: Hospital records of our own department are reviewed for a 12-year period. Lymphoproliferative diseases, skin metastases, salivary glands, other craniofacial bones and cervical lymph-nodes are excluded. Epidemiologic, personal health, clinical, treatment and follow-up data are recollected and analysed in frequency statistics. Results: Male:Female ratio is 1.3:1, year-old range 52-82 and ethnic group 100 % white-caucasian. 19.0 % have carcinogenic occupational exposure, 52.4 % tobacco abuse, 61.9 % some kind of alcohol use, 57.1 % cardiovascular risk, 19.0 % cardiologic records, 28.6 % pulmonary, 19.0 % gastrointestinal, 19.0 % endocrine, 14.3 % genitourinary, 9.5 % other primary malignancy and 23.8% a first-degree relative with a neoplasm. 33.3 % patients have taken osteonecrosisrelated drugs or received craniofacial radiotherapy.Metastasis is the debut in 7 patients while it corresponds to infirmity progression in 14. The chief reason for consultation is a mass. 8 lesions affect soft tissue and 13 the bone. 81.0 % have epithelial neoplasm lineages. The organ of origin is: 23.8 % lung, 23.8 breast, 23.8 % kidney, 9.5 % skin, 9.5 % soft parts, 4.8 % prostate and 4.8 % thyroid. 100 % have other location metastases. 14.3 % patients undergo surgery, 38.1 % receive radiotherapy, 47.6 % chemo-or targeted therapy, and 28.6 % symptomatic treatment. After a 1-124 months range of followup, 17 patients die and 4 are alive. 1130-0558/

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Section: Resultsmentioning

confidence: 99%

Oral and Maxillary Metastases: Retrospective Clinical Analysis of 21 Cases

Prol¹,

Ruiz-Oslé²,

Malaetxebarría³

et al. 2019

j.maxilo

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“…Denosumab is a human monoclonal antibody used for its treatment, with bon suppression and turnover equal of greater than that of bisphosphonates. They also differ in their mechanisms of action [7,9].…”

Section: Discussionmentioning

confidence: 99%

“…Recently, bisphosphonate treatment has been reported to have serious adverse effects on bone structure, resulting in osteonecrosis, particularly of the jaw [6]. However, maxillary osteonecrosis remains a rare type, accounting for 25% of the reported cases of osteonecrosis induced by bisphosphonate [7].…”

Section: Introductionmentioning

confidence: 99%

Antiresorptive medication induced osteonecrosis of the maxilla with facial disfigurement: a case report

et al. 2021

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A 77-year-old male presented to our clinic with right cheek swelling, pain, and discharge for 1 month. Oral cavity examination revealed a draining fistula in the hard palate and a tender mass over the right cheek. An enhanced computed tomography scan of the paranasal sinuses showed an enhancing mass with maxillary bone destruction. Fine needle aspiration revealed the presence of pus cells and mucoid material with negative malignant cells. Debridement of loose necrotic tissue resulted in bone necrosis. Therefore, we diagnosed the patient with osteomyelitis induced by antiresorptive medications. A multicourse antibiotic regimen based on culture and sensitivity was initiated, and the patient showed a clinical and radiological response to healing. The patient later developed facial disfiguration due to soft tissue and bone defects with dysfunction of oral competence.

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“…Dentro do processo fisiológico, em razão dos bifosfonatos se aderirem na hidroxiapatita da matriz óssea na cavidade oral em regiões que acontecem o processo de remodelação óssea ocorre uma indução das células osteoclásticas a sofrerem uma morte celular programada a apoptose celular (SMITH JD et al, 2016). Segundo o estudo, a mandíbula é mais susceptível a osteonecrose em virtude de apresentarem índices de vascularização diferentes em relação à maxila, consequentemente favorecendo assim seu surgimento e proliferação (HENIEN M, et al, 2016).…”

Section: Revisão Bibliográficaunclassified

A relação entre os bifosfonatos e a osteonecrose

Silva¹,

Libarino²,

Santos³

et al. 2023

Acervo Odontológico

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Objetivo: Descrever a relação entre bifosfonatos e osteonecrose na Odontologia. Revisão bibliográfica: A osteonecrose induzida pelo uso contínuo dos bifosfonatos é uma enfermidade patológica que tem como característica principal o surgimento de uma área com exposição óssea exposta na cavidade bucal. American Association of Oral and Maxillofacial Surgeons orienta aos profissionais de saúde envolvidos no tratamento da osteonecrose mandibular em estágios iniciais (I) a terapêutica se consista na utilização de enxaguantes bucais antissépticos e antibióticos para controle da infecção. Em estágios avançados (II e III) o tratamento mais invasivo é recomendado. O diagnóstico em estágio inicial da osteonecrose mandibular com um plano de tratamento adequado para o caso em questão poderá ser mais benéfico para o paciente em comparação com um diagnóstico da enfermidade em estágios avançados. No entanto, cada circunstância necessita ser tratada de forma individualizada. Considerações finais: O diagnóstico na fase inicial da osteonecrose, juntamente com um plano de tratamento adequado será benéfico ao paciente, devido o tratamento se persistir de forma mais conservadora.

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Maxilla Osteonecrosis: A Differential Diagnosis in Patients with Metastatic Cancer on Bisphosphonates

Cited by 4 publications

References 11 publications

Oral and Maxillary Metastases: Retrospective Clinical Analysis of 21 Cases

Oral and Maxillary Metastases: Retrospective Clinical Analysis of 21 Cases

Antiresorptive medication induced osteonecrosis of the maxilla with facial disfigurement: a case report

A relação entre os bifosfonatos e a osteonecrose

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