Thirteen cases of jaw osteonecrosis in patients on bisphosphonate therapy

Vieillard, Marie-Hélène; Maes, Jean-Michel; Penel, Guillaume; Facon, Thierry; Magro, Léonardo; Bonneterre, J.; Cortet, Bernard

doi:10.1016/j.jbspin.2007.05.003

Cited by 38 publications

(17 citation statements)

References 38 publications

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“…Cases with BRONJ may exhibit osteolytic lesions, sclerosis of cortical bone, reactive changes in the periosteal aspect, sequester formation as well as no radiographic signs. [19][20][21][22][23][24] BRONJ usually occurs more frequently in patients receiving nitrogen-containing bisphosphonates via parenteral route than oral administration. [24][25][26][27] Researchers reported the incidence of BRONJ after oral surgery (like tooth extraction) with cancer patients receiving intravenous bisphosphonates between 6.5% and 51.8%.…”

Section: Discussionmentioning

confidence: 99%

Malnutrition due to bisphosphonate-related osteonecrosis of the jaw in a chronic dialysis patient: case report

Akar

Efeoğlu

Alp³

et al. 2013

Renal Failure

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Adequate nutrition is imperative for a successful outcome in dialysis patients. Excellent oral hygiene and an efficient mastication can help to correct several metabolic and endocrine disturbances as well as delay initiation of dialysis in patients with chronic renal failure. However, concerns exist about the risk of malnutrition and protein depletion. On the other hand, intravenous bisphosphonates are the current standard of care for the treatment of hypercalcemia of malignancy and for the prevention of skeletal complications associated with bone metastases. Recently, retrospective case studies have reported an association between long-term bisphosphonate therapy and osteonecrosis of the jaws. This complication occurs either spontaneously or after minor dento-alveolar surgery including extraction of teeth. A malnourished dialysis patient who showed the typical clinical features of bisphosphonaterelated osteonecrosis of the jaw (BRONJ) without any obvious radiological changes in his panoramic radiograph is reported. To minimize the risk of BRONJ, patients initiated on bisphosphonates should optimize routine dental care and have their baseline oral health evaluated by both clinical and radiographic examinations before initiation of bisphosphonate therapy.

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Section: Discussionmentioning

confidence: 99%

Malnutrition due to bisphosphonate-related osteonecrosis of the jaw in a chronic dialysis patient: case report

Akar

Efeoğlu

Alp³

et al. 2013

Renal Failure

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“…Most of BSNs with amine group cause nausea, dyspepsia, vomiting, gastric pain, and diarrhea. Because of growing concerns about side effects related to long term use of bisphosphonates, the indication and need for therapy should be reviewed at least annually based on results of DEXA scans and therapy discontinued if treatment objectives are met [101].…”

Section: Bisphosphonatesmentioning

confidence: 99%

Low Testosterone—An Important Predictor of Low Mineral Bone Density in Young Men—Our Own Experience and a Review of Literature

Funaro¹,

Bolyakov²,

Gimenez³

et al. 2013

ASM

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Urologists and reproductive endocrinologists have become the first contact physicians for young men of reproductive age and have the unique opportunity to positively affect men's health and quality of life. Growing evidence indicates that a significant proportion of men presenting with infertility or sexual dysfunction are hypogonadal. One hundred ninety nine men were enrolled in our center, and mean total testosterone was <300 ng/dl. Patients were divided into three groups based on their DEXA scan results; normal bone density (n = 122, 57%), osteopenia (n = 69, 39%) and osteoporosis (n = 8, 4%). There were no differences in the mean age (p < 0.64), height (p < 0.99) and weight (p < 0.06) among the three groups (ANOVA), but men with osteopenia had statistically significant lower weights (p < 0.02). Our results indicate that hypogonadism is one of the main risk factors for osteopenia and osteoporosis which can be found in 8% of hypogonadal men younger than 50 years of age. Testosterone replacement therapy may be indicated in most men with hypogonadism and low bone mineral density (BMD); however the benefits of testosterone treatment in eugonadal men are unproven. Selective estradiol and androgen receptor modulators expand our treatment modalities in men of reproductive age when suppression of gonadotropins may interfere with reproductive plans. Early detection of hypogonadism and osteoporosis may lower the risk of hip and vertebral fractures in some men. Further prospective RCTs are needed to prove cost-effectiveness of detection and the best treatment of osteoporosis in hypogonadal men of reproductive age. Urologists have the opportunity to be at the forefront of greater awareness of this clinical problem due to their frequent contact with this population of patients.

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“…3 Analysis of data retrieved from clinical studies indicates a strong association between tooth extractions and BRONJ. 4,5 Thus, the effects of Bps therapy on the healing of alveolar sockets have been the focus of several in vivo studies. 6,7,8 Recently, we demonstrated the development of BRONJ-like lesions in rodents by associating tooth extractions with daily high dosages of alendronate (ALN) in a long-term study.…”

Section: Introductionmentioning

confidence: 99%

“…9,16,17,18,19,20,21,24,25,26 The last is undoubtedly the most relevant, since most patients develop BRONJ lesions after tooth extractions, as described in clinical studies. 4,5 This finding could be related to an urgent requirement for wound healing after this surgical procedure, especially during initial phases, and, in the field of Bps, this is worsened since these drugs impair the angiogenesis and resorption process after tooth extractions. 11,32 Indeed, these features are in agreement with our findings of lower CTX levels and degrees of vascularization in animals treated with ALN.…”

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confidence: 99%

Experimental osteonecrosis: development of a model in rodents administered alendronate

et al. 2016

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Abstract:The main objective of this study was to cause bisphosphonate-related osteonecrosis of the jaws to develop in a rodent model. Adult male Holtzman rats were assigned to one of two experimental groups to receive alendronate (AL; 1 mg/kg/week; n = 6) or saline solution (CTL; n = 6). After 60 days of drug therapy, all animals were subjected to first lower molar extraction, and 28 days later, animals were euthanized. All rats treated with alendronate developed osteonecrosis, presenting as ulcers and necrotic bone, associated with a significant infection process, especially at the inter-alveolar septum area and crestal regions. The degree of vascularization, the levels of C-telopeptide cross-linked collagen type I and bone-specific alkaline phosphatase, as well as the bone volume were significantly reduced in these animals. Furthermore, on radiographic analysis, animals treated with alendronate presented evident sclerosis of the lamina dura of the lower first molar alveolar socket associated with decreased radiographic density in this area. These findings indicate that the protocol developed in the present study opens new perspectives and could be a good starting model for future property design.

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Thirteen cases of jaw osteonecrosis in patients on bisphosphonate therapy

Cited by 38 publications

References 38 publications

Malnutrition due to bisphosphonate-related osteonecrosis of the jaw in a chronic dialysis patient: case report

Malnutrition due to bisphosphonate-related osteonecrosis of the jaw in a chronic dialysis patient: case report

Low Testosterone—An Important Predictor of Low Mineral Bone Density in Young Men—Our Own Experience and a Review of Literature

Experimental osteonecrosis: development of a model in rodents administered alendronate

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