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Jaw osteonecrosis

Yasuhiro Takeuchi, Junko Hashimoto, Yosuke Nishida, Chiemi Yamagiwa, Takashi Tamura, Akihide Atsumi
Objectives: This postmarketing, observational study evaluated the safety and effectiveness of monthly intravenous (IV) ibandronate in Japanese patients with osteoporosis. Methods: Eligible patients received monthly IV ibandronate 1 mg for 12 months. Adverse drug reactions (ADRs) were evaluated. Changes in bone mineral density (BMD) and bone turnover markers (BTMs) were assessed using matched t -test analysis. Cumulative fracture rates were analyzed by Kaplan-Meier methodology...
March 2018: Osteoporosis and Sarcopenia
A W Sklavos, S N Delpachitra, A M Thomas, A Nastri
Medication-related osteonecrosis of the jaw is a well-described, yet poorly understood disease of bone that is commonly associated with antiresorptive and antiangiogenic drugs. We report a case of spontaneous bilateral osteonecrosis of the mandible in a patient with no previous exposure to either.
February 14, 2019: British Journal of Oral & Maxillofacial Surgery
Min-Tser Liao, Wu-Chien Chien, Jen-Chun Wang, Chi-Hsiang Chung, Shi-Jye Chu, Shih-Hung Tsai
OBJECTIVE: The aim of this study was to explore whether patients with Sjögren's syndrome (SS) were susceptible to bisphosphonate (BP)-related osteonecrosis of the jaw (BRONJ) after tooth extraction in the entire population of Taiwan. DESIGN: A nationwide population-based retrospective cohort study. SETTING: Data were extracted from Taiwan's National Health Insurance Research Database (NHIRD). METHODOLOGY: Medical conditions for both the study and control group were categorised using the International Classification of Diseases, 9th Revision...
February 13, 2019: BMJ Open
Nelson B Watts, John T Grbic, Neil Binkley, Socrates Papapoulos, Peter W Butler, Xiang Yin, Antoniette Tierney, Rachel B Wagman, Michael McClung
Context: Antiresorptive therapy has been associated with osteonecrosis of the jaw (ONJ), an infrequent but potentially serious adverse event. Objective: To assess information on invasive oral procedures and events (OPEs) - dental implants, tooth extraction, natural tooth loss, scaling/root planing, jaw surgery - during the 7-year FREEDOM Extension and to present details of positively adjudicated ONJ cases. Design: Randomized, double-blind, placebo-controlled 3-year trial (FREEDOM) followed by 7 years of open-label denosumab (FREEDOM Extension)...
February 13, 2019: Journal of Clinical Endocrinology and Metabolism
Kelly McGowan, Robert S Ware, Caroline Acton, Saso Ivanovski, Newell W Johnson
OBJECTIVES: Medication-related osteonecrosis of the jaws (MRONJ) is a serious condition whose risk factors remain unclear. The aim of this study is to investigate the role of oral health and of dental treatment in the development of MRONJ. MATERIALS AND METHODS: A case-control study was conducted in Brisbane, Australia. Hospital records were used to identify incident cases of MRONJ between January 2010 and March 2017. Cases were individually matched to up to 3 controls according to age, sex, primary disease, and type of antiresorptive therapy...
February 12, 2019: Clinical Oral Investigations
Marco Vinícius de Sales Lima, Jaqueline Rizzato, Daniella Varzea Gracindo Marques, Dárcio Kitakawa, Felipe da Silva Peralta, Alexandre Prado Scherma, Luis Felipe C S Carvalho
Background: This case report shows an affected postmenopausal patient with medicaments related osteonecrosis of the jaw injury associated with increased use of bisphosphonates and Prolia® (denosumab) for the treatment of osteoporosis. The mechanism of action of the receptor activates the denosumab of the nuclear-kB factor binding and makes nuclear-kB Factor, reducing bone volume and reabsorption in the trabecular and cortical bones and, consequently, decreasing an incidence of fractures and maintaining a bone formation...
October 2018: Journal of Oral & Maxillofacial Research
Anna Zurányi, Enikő Vasziné Szabó, Zsuzsanna Tóth
Medication-related osteonecrosis of the jaw may appear as adverse effect in antiresorptive therapy. Its successful treatment is challenging. We aimed to gather the systemic and local factors playing a role in etiology, published after its recognition. Risk factors were collected from the PubMed database 1998-2018. The three main groups of risk patients are: patients starting, patients having antiresorptive therapy, osteonecrosis diagnosed patients. The dentist must recognize risk factors, determine appropriate treatment plan and frequency of check-ups...
February 2019: Orvosi Hetilap
Jin-Woo Kim, Angenine Marie D Alfafara, Hye-Yeon Kim, Seon-Yeong Kim, Sun-Jong Kim
INTRODUCTION: An acidic environment has been recognized to increase catabolic activities and inhibit osteoblastic deposition, and also exhibited in the pathogenesis of various bone diseases. The aim of the study was to investigate the role of systemic and local pH alteration in the pathogenesis of medication-related osteonecrosis of the jaw (MRONJ). MATERIAL AND METHODS: Initially, MRONJ was induced in 54 Sprague-Dawley rats via subcutaneous bisphosphonate injections, once a week for 8 weeks...
February 7, 2019: Bone
Mitsuhiko Imada, Takahiro Yagyuu, Yoshihiro Ueyama, Masahiko Maeda, Kazuhiko Yamamoto, Satoshi Kurokawa, Jun-Ichiro Jo, Yasuhiko Tabata, Yasuhito Tanaka, Tadaaki Kirita
Osteonecrosis of the jaw induced by administration of bisphosphonates (BPs), BP-related osteonecrosis (BRONJ), typically develops after tooth extraction and is medically challenging. As BPs inhibit oral mucosal cell growth, we hypothesized that suppression of the wound healing-inhibiting effects could prevent BRONJ onset after tooth extraction. Since basic fibroblast growth factor (bFGF) promotes wound healing, but has a short half-life, we examined whether the initiation of BRONJ could be prevented by applying a bFGF-containing gelatin hydrogel over the extraction sockets of BRONJ model rats...
2019: PloS One
Pit Jacob Voss, Akihiko Matsumoto, Esteban Alvarado, Rainer Schmelzeisen, Fabian Duttenhoefer, Philipp Poxleitner
In the Original publication of the article, the co-author has been misspelled as Fabian Duttenhöfer in the article "Treatment of stage II medication-related osteonecrosis of the jaw with necrosectomy and autologous bone marrow mesenchymal stem cells" published in October 2017, Volume 105, Issue 4 of Odontology. The correct name is "Fabian Duttenhoefer".
February 5, 2019: Odontology
Akira Taguchi, Yukari Uemura, Takumi Imai, Shiro Tanaka, Hiroaki Ohta, Toshitaka Nakamura, Hajime Orimo, Toshitsugu Sugimoto, Satoshi Soen, Masataka Shiraki
Osteonecrosis of the jaw (ONJ) associated with bisphosphonate therapy is a rare but severe side effect in osteoporosis patients. Recently, the number of osteoporosis patients with ONJ has dramatically increased in Japan. This has contributed to an increase in the number of patients avoiding extractions. However, there has been no prospective study providing definitive incidence data for ONJ in Japanese patients. The purpose of this study was to elucidate the true as well as suspected incidence of ONJ. A total of 3229 subjects (1612 subjects in the minodronic acid group and 1617 subjects in the raloxifene group) in the Japanese Osteoporosis Intervention Trial protocol number 4 participated in this study...
February 4, 2019: Journal of Bone and Mineral Metabolism
Mohammad Zandi, Arash Dehghan, Payam Amini, Shideh Doulati, Leila Rezaeian
OBJECTIVE: The aim of this study was to evaluate the effect of teriparatide therapy on mandibular fracture healing in rats with medication-related osteonecrosis of the jaw (MRONJ). MATERIALS AND METHODS: To induce MRONJ, a total of 120 rats received intravenous zoledronate 0.06 mg/kg once a week for 6 weeks and their right mandibular first molar was extracted. Eighty of 94 rats with MRONJ were randomly selected and underwent unilateral mandibular osteotomy to replicate a fracture...
February 4, 2019: Clinical Oral Investigations
Takahiko Shibahara
Bisphosphonates (BPs) have been used as antiresorptive agents to treat patients with osteoporosis or metastatic bone cancer, each of which is characterized by bone loss due to the increased bone resorption. However, BPs could cause osteonecrosis of the jaw (ONJ), known as bisphosphonate-related osteonecrosis of the jaw (BRONJ). ONJ is associated with severe pain and deteriorated quality of life. ONJ is also caused by administration of denosumab, a monoclonal antibody against receptor activator of NFκB ligand (RANKL), that functions as a powerful antiresorptive agent...
2019: Tohoku Journal of Experimental Medicine
Rebecca King, Nikki Tanna, Vinod Patel
The link between medication-related osteonecrosis of the jaw (MRONJ) and bone modulating drugs, such as bisphosphonates and denosumab, is well established, and the number of reported cases is increasing. The development of novel medications used in the treatment of cancer, as well as autoimmune and bone conditions, has led to more cases of MRONJ being reported. However, in addition to this group of medications, increasing numbers of new agents in cancer therapy, such as antiangiogenic agents, have also been implicated in the development of MRONJ...
December 3, 2018: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
J G Messer, J M Jiron, J L Mendieta Calle, E J Castillo, R Israel, E G Phillips, J F Yarrow, C Van Poznak, L Kesavalu, D B Kimmel, J I Aguirre
OBJECTIVES: To determine the extent that zoledronate (ZOL) dose and duration is associated with bisphosphonate-related osteonecrosis of the jaw (BRONJ) prevalence in rice rats with generalized periodontitis (PD); characterize structural and tissue-level features of BRONJ-like lesions in this model; and examine the specific anti-resorptive role of ZOL in BRONJ. MATERIALS AND METHODS: Rice rats (n=228) consumed high-sucrose-casein diet to enhance generalized PD. Groups of rats received 0, 8, 20, 50 or 125μg/kg IV ZOL/4wks encompassing osteoporosis and oncology ZOL doses...
February 3, 2019: Oral Diseases
Makoto Tsuchimochi, Tohru Kurabayashi
MRONJ/ARONJ is a serious adverse effect of medication, although the incidence of the disease is rare, and there are still controversial issues regarding the pathogenesis of MRONJ/ARONJ. Medications that can lead to MRONJ/ARONJ are commonly used to treat osteoporosis and to prevent bone fractures caused by bone metastasis of malignancies. The long-standing disease state of ONJ deteriorates the quality of life of affected patients. Early detection and prevention of the disease are key to alleviating pain and discomfort...
November 2019: Japanese Dental Science Review
José-Darío Sánchez-López, Paolo Cariati, Jacobo Cambil-Martin, Mercedes Villegas-Calvo, María-Luisa Moreno-Martin
The main aim of the present report is to show the potential utility of bone scintigraphy for the diagnosis of jaw osteonecrosis. We report the history of a 62-year-old woman underwent breast cancer surgery in 2010. Moreover, patient received postoperative radiotherapy and chemotherapy. Intravenous bisphosphonates were also added to the treatment strategy to reduce the risk of bone metastasis. However, a hypermetabolic focus on left hemimandible was evidenced with a bone scintigraphy during follow up. After a careful study, the diagnosis of Bisphosphonate Related Ostneonecrosis of the Jaw (BRONJ) was carried out...
December 2018: Journal of Clinical and Experimental Dentistry
Martín Castro, Pedro Torres, Luis Solano, Luis A Córdova, Vicente A Torres
OBJECTIVES: Zoledronic acid, the most frequent agent associated with bisphosphonate-related osteonecrosis of the jaw (BRONJ), has been reported as cytotoxic for bone and vascular cells. Hence, identification of novel approaches aiming to counteract its cytotoxic effects will be desirable to develop preventive therapies for BRONJ. The salivary peptide Histatin-1 was recently shown to promote oral wound healing, by acting in epithelial and endothelial cells; however, its effects on cells exposed to zoledronic acid have not been explored...
January 28, 2019: Journal of Periodontology
Joji Tamaoka, Kazuki Takaoka, Hirokazu Hattori, Miho Ueta, Hanako Maeda, Michiyo Yamamura, Koji Yamanegi, Kazuma Noguchi, Hiromitsu Kishimoto
Aging is a significant risk factor for the development of bisphosphonate-related osteonecrosis of the jaws (BRONJ). Accumulating evidence suggests that bone aging is associated with oxidative stress (OS), and OS is associated with osteonecrosis. To elucidate the mechanisms of the onset of BRONJ, the present study focused on OS and the effects of treatment with the pro-oxidant DL-buthionine-(S,R)-sulfoximine (BSO), an oxidative stressor, on healing of a surgically induced penetrating injury of the palate. Six-week-old C57BL/6J mice were randomly divided into four groups (n=5 each) and treated with or without zoledronic acid (ZOL) and with or without BSO (experimental groups: ZOL, BSO, and ZOL+BSO; control group: saline solution)...
February 2019: Experimental and Therapeutic Medicine
Qizhang Wang, Jiyuan Liu, Ting Guo, Dazhong Liu, Jian Pan
BACKGROUND Medication-related osteonecrosis of the jaw (MRONJ) is due to the direct effects of drug toxicity and the effects on angiogenesis. The aims of this study were to evaluate the effects of treatment with the bisphosphonate, zoledronic acid, on human oral keratinocytes (HOKs) and human umbilical vein endothelial cells (HUVECs) in vitro, and whether epidermal growth factor (EGF) could alter these effects. MATERIAL AND METHODS HOKs and HUVECs were incubated with zoledronic acid or EGF. Cell viability was assessed by the cell counting kit-8 (CCK-8), cell apoptosis was studied using Annexin-V conjugated to fluorescein isothiocyanate (FITC)...
January 24, 2019: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
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