Search results for "Jaw"

Legal liability in bisphosphonate-related osteonecrosis of the jaw

2014

Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is an adverse reaction that may occur in patients administered with bisphosphonates (BP). This condition can cause high morbidity and hinder quality of life. Its treatment is complex and often unsatisfactory, and prevention strategies may have limited effectiveness, if any. Thus, managing patients treated with BP may result in exposure of the practitioner to legal liability or malpractice claims: legal actions pursuant to BRONJ are reported to be underway on three continents. Nonetheless, the attribution of liability, if any, is a complex process requiring, on the basis of current knowledge, a robust and pragmatic approach to the facts…

Demographic and behavioural profiles of patients with common oral mucosal lesions by a homogeneity analysis

2012

Oral Diseases (2012) 18, 396–401 Objective:  The aim of this study is to assess the main oral mucosal lesions (OMLs) within a hospital base and to provide an anamnestic, diagnostic model based on homogeneity analysis of some variables. Methods:  The demographic and behavioural data (i.e. gender, age, smoking status, alcohol consumption and therapeutic drug usage) of 1753 patients with at least one OML were considered. Multiple correspondence analysis (MCA) and multivariate tests of the simultaneous marginal homogeneity hypothesis (SMH) were used to analyse the evidence of any differences between the demographic and behavioural profiles relating to OMLs diagnoses. Statistical significance of…

Review of: "Teriparatide Promotes Bone Healing in Medication-Related Osteonecrosis of the Jaw: A Placebo-Controlled, Randomized Trial"

2020

The pathophysiology of aging bone jaw: primary and secondary prevention

2010

The skeleton is composed of approximately 200 bones, and it is the backbone of our body along with ligaments and joints. The bone is not a static but a dynamic structure, constantly reshuffling, that may suffer fractures due to trauma, despite their particular hardness and strength. Complex physiologic mechanisms, sometimes with the help of surgery, can lead to bone repairing. In the elderly, often, the skeletal system can be affected by osteoporosis, a "silent disease" that causes fragile bones especially of the vertebrae and femur; its contributing factors are menopause (in women), smoking, nutritional deficiencies, systemic diseases or prolonged use of drugs. The masticatory apparatus an…

The impact of medication-related osteonecrosis of the jaws on the quality of life in cancer patients

2020

Background To evaluate the impact of oral health on the quality of life (QOL) of individuals undergoing cancer treatment at the time of diagnosis of medication-related osteonecrosis of the jaw (MRONJ). Material and Methods The present cross-sectional study analyzed patients with MRONJ from 2013 to 2019. The collected data included demographic data, base disease, medications associated with MRONJ, route of administration and time of use, signs, symptoms, and tomographic features of acute MRONJ, staging according to American Association of Oral and maxillofacial Surgeons position paper 2014 (AAOMS), type of dental treatment performed, outcome, and the responses to the Oral Health Impact Profi…

Medication-related osteonecrosis of the jaws (MRONJ) in cancer patients treated with denosumab VS. zoledronic acid : a systematic review and meta-ana…

2020

Background The aim of the present study was to analyse the incidence, risk ratio (RR) and prognoses of two types of medication-related osteonecrosis of the jaws (MRONJ): denosumab-related osteonecrosis of the jaws (DRONJ) and Bisphosphonate-Related Osteonecrosis of the Jaws (BRONJ) in cancer patients under treatment with denosumab or zoledronic acid (ZA). Material and Methods An electronic and manual search was conducted for randomized controlled trials (RCTs) until May 2019. Assessment of the identified studies, risk of bias and data extraction were performed independently by two reviewers. The incidence of DRONJ and BRONJ and the RR to develop MRONJ were calculated at 1 year, 2 years and …

2014

Management of osteonecrosis of the jaw associated with antiresorptive agents is challenging, and outcomes are unpredictable. The severity of disease is the main guide to management, and can help to predict prognosis. Most available staging systems for osteonecrosis, including the widely-used American Association of Oral and Maxillofacial Surgeons (AAOMS) system, classify severity on the basis of clinical and radiographic findings. However, clinical inspection and radiography are limited in their ability to identify the extent of necrotic bone disease compared with computed tomography (CT). We have organised a large multicentre retrospective study (known as MISSION) to investigate the agreem…

Oral squamous cell carcinoma mimicking osteonecrosis of the jaw: a case report

2021

Osteonecrosis of the jaw (ONJ) is a well-known adverse drug reaction to bisphosphonate (BP) treatment. ONJ diagnosis is usually based on the patient’s medical/medication histories and on the clinical/radiological features of necrotic bone (frequently exposed). Furthermore, in case of mandibular involvement, patients may present pain and/or hypesthesia of the inferior alveolar nerve. There are no pathognomonic clinical and radiological signs of ONJ, and in doubtful cases, the histologic examination is recommended. We report a case of a woman attending to our sector of Oral Medicine (AOUP “P. Giaccone” Palermo, Italy) with a mandibular bone exposure after implants loss and a medical history o…

Cerebrovascular Brainstem Diseases with Isolated Cranial Nerve Palsies

2002

There is a significant number of individual patients with cranial nerve palsies as the sole manifestation of MRI- and, less frequently, CT-documented small brainstem infarctions or hemorrhages. The 3rd and 6th nerves are most commonly involved and, less frequently, the 4th, 5th, 7th, and 8th nerves. An intra-axial basis for such lesions may be underestimated if the diagnosis is based solely on MRI. The electrophysiologic abnormalities indicating brainstem lesions may be independent of MRI-documented morphological lesions. This paper reviews the literature on cerebrovascular brainstem diseases manifesting as isolated cranial nerve palsies. It supports the concept that small pontine and mesen…

Third nerve palsy as the sole manifestation of midbrain ischemia

1995

Thirty-seven patients with risk factors for the development of cerebrovascular diseases had sudden onset isolated third nerve palsy and abnormal masseter reflex and/or electro-oculographic findings indicating a causative midbrain lesion. Improvement or recovery of the third nerve palsies was accompanied by improvement or recovery of the abnormal electrophysiologic findings pointing to their functional significance. Magnetic resonance imaging (MRI) in 29 of these patients demonstrated corresponding ischemic midbrain lesions in eight, ipsilateral in five patients, bilateral in three. In another three patients with MRI proven midbrain lesions (ipsilateral in two, bilateral in one) electrophysi…