Orofacial pain – a presenting symptom of bisphosphonate associated osteonecrosis of the jaws

Srinivasan, Dilip; Shetty, Suresh; Ashworth, D. R.; Grew, N.; Millar, B.G.

doi:10.1038/bdj.2007.635

Cited by 13 publications

(5 citation statements)

References 6 publications

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“…In particular, skeletal morbidity represents an important concern in pediatric acute lymphoblastic leukemia (ALL) patients [31][32][33]. Another painful skeletal complication, such as osteonecrosis of the jaw, may be induced by bisphosphonates [34][35][36]. The most important source of superficial somatic pain in HM patients under active treatment is represented by oral mucositis, induced by high-dose chemotherapeutic treatments, particularly if they include metotrexate or cytarabine, conditioning regimens for hematopoietic stem cell transplantation (HSCT) and, to a lesser extent, by standard chemotherapies [37,38].…”

Section: Nociceptive Painmentioning

confidence: 99%

“…Osteonecrosis of the jaw has been reported after administration of bisphosphonates in 8.5% of MM patients receiving these agents [35,36]; in 30-60% of MM patients, this complication is associated with pain as a presenting symptom [34]. Therapy-related visceral pains have been reported in association with acute pancreatitis.…”

Section: Epidemiology Of Pain In Malignant Hematologymentioning

confidence: 99%

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Pain in malignant hematology

Niscola

Tendas

Scaramucci

et al. 2011

Expert Review of Hematology

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Pain is frequently experienced by patients with hematological malignancies, although it often receives little attention. Different underlying causes and mechanisms may sustain several pain syndromes in hematological malignant patients. Pain may be due to disease itself, to disease-related complications, to iatrogenic causes or may be associated with unrelated medical conditions. The management of pain in this setting requires a multidisciplinary approach, integrating analgesics and causal interventions. An accurate diagnostic assessment and the identification of the underlying causes and pathogenetic mechanisms may dictate the treatment approach. For most pain patients, the WHO's three-step analgesic scale for cancer pain relief can provide adequate relief with oral options, although difficult-to-treat pain syndromes, requiring a more complex treatment approach, may also be observed.

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Section: Nociceptive Painmentioning

confidence: 99%

Section: Epidemiology Of Pain In Malignant Hematologymentioning

confidence: 99%

Pain in malignant hematology

Niscola

Tendas

Scaramucci

et al. 2011

Expert Review of Hematology

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“…Das Mooren-Ulkus ist durch das Fehlen einer Assoziation mit einer systemischen Erkrankung und sein klinisches Erscheinungsbild (fehlende Skleritis, überhängende Ränder und starke Schmerzen) charakterisiert. Es tritt häufiger bei Männern auf und das Durchschnittsalter variiert je nach Region [6].…”

Section: Transfer In Die Praxis Von Prof Dr Stephan J Linke (Hamburg)unclassified

Peripher ulzerative Keratitis – eine interdisziplinäre Herausforderung

Linke¹

2023

Kompass Autoimmun

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Purpose: of review: To discuss peripheral ulcerative keratitis, with a focus on the evaluation and management of associated systemic diseases. Recent findings: Peripheral ulcerative keratitis (PUK) is a sight-threatening condition that is often defined by the presence of a crescent-shaped area of peripheral corneal thinning, an epithelial defect, and an inflammatory corneal infiltrate. It is highly associated with rheumatoid arthritis, systemic necrotizing vasculitides like granulomatosis with polyangiitis, and collagen vascular diseases like systemic lupus erythematosus. Undertreated PUK carries a risk of vision loss and premature death. Summary: Multidisciplinary collaboration between the ophthalmologist, rheumatologist, and other consultants is required. Early and aggressive steroid-sparing therapy should be considered in cases due to noninfectious systemic disease.

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“…It has therefore been called bisphosphonate-related osteonecrosis of the jaws (BRONJ), and is described as an area of bone exposure in the maxillofacial and intraoral region which shows signs of delayed or slow healing. The lesion may be asymptomatic or sore with swelling, purulent discharge, tooth involvement or mobility and paresthesia [2][3][4]. This definition has undergone several alterations.…”

Section: Introductionmentioning

confidence: 99%

Medication-Related Osteonecrosis of the Jaw in Dental Practice: A Retrospective Analysis of Data from the Milan Cohort

et al. 2022

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A retrospective analysis was performed with the aim of understanding whether the risk factors showed in the literature for medication-related osteonecrosis of the jaws (MRONJ) in cancer patients are also relevant in osteoporotic patients taking antiresorptive drugs (ARDs). Data were retrospectively pooled from health records of patients on ARDs who requested a dental visit between January 2006 and April 2020 in the Dental Unit at Fondazione Ca’ Granda IRCCS Ospedale Maggiore Policlinico, University of Milan. A total of 434 patients were included. The following variables were collected: sex, age, smoking habit, type of ARD, duration of treatment, route of administration, therapeutic indication, concurrent systemic therapies and pathologies. Statistical analysis confirmed the relevance of chemotherapy, smoking, and immunosuppressive drugs as risk factors. In addition, a higher frequency of MRONJ in osteoporotic patients was reported in our cohort in association with an immunodeficiency disorder of variable origin. In conclusion, the identification of individual risk-profile before dental treatments is crucial for prevention. Anamnesis should include main risk factors, such as immunosuppression, dental extractions, smoking, trauma, and poor dental health. Nevertheless, our suggestion for dental professionals is to conduct a complete medical history of patients who mention long-term per oral therapies with ARDs for osteoporosis. Osteoporotic, as well as cancer patients, may also benefit from periodic monitoring of the ARDs therapy in order to prevent MRONJ.

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Orofacial pain – a presenting symptom of bisphosphonate associated osteonecrosis of the jaws

Cited by 13 publications

References 6 publications

Pain in malignant hematology

Pain in malignant hematology

Peripher ulzerative Keratitis – eine interdisziplinäre Herausforderung

Medication-Related Osteonecrosis of the Jaw in Dental Practice: A Retrospective Analysis of Data from the Milan Cohort

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