Search results for "osteonecrosi"

Unusual presentation of a solitary plasmocytoma of the jaw: a case report

2013

Introduction. Plasma cell malignancies include two localized forms (e.g. Solitary Plasmocytoma of the Bone-SPB- and Extramedullary Plasmocytoma-EMP) and one more severe disseminated form (e.g. Multiple Myeloma-MM). SPB usually affected male during 6th decades, it occurs as a single uni- or multilocular osteolytic lesion, histopathological- ly characterized by an abnormal proliferation of plasma cell. In some patients SPB may progress to MM, character-ized by multiple osteolytic lesion in several bones, presence of abnormal plasma cells in the bone marrow biopsy, detection of amyloid deposit and abnormalities of immunoglobulin production. In both clinical forms, the maxillofacial area is rar…

Can radium 223 be a conservative non-surgical management of medication-related osteonecrosis of the jaw?

2019

AbstractOsteonecrosis of the jaw (ONJ) is a rare and severe necrotic bone disease reflecting a compromise in the body's osseous healing mechanisms and unique to the craniofacial region. Radium 223 dichloride (Ra223) is the only targeted alpha therapy able to extend survival in patients with bone metastases from prostate cancer. Mechanism of action and data currently available focused mainly on osteoblastic metastases from prostate cancer. In 2018, a Caucasian 54-year-old woman presented to our institution for a breast cancer with bone metastases. Since the patient refused any treatment and taking into account the bone disease, our multidisciplinary team evaluated a supplementary strategy wi…

Histological findings of osteonecrosis spotted prior to tooth extractions. Should we consider tooth extraction still the main trigger event?

2021

Osteonecrosis of the jaw (ONJ) is an adverse drug reaction described as the progressive destruction and death of bone that affects the mandible and maxilla of patients exposed to the treatment with medications known to increase the risk of disease, in the absence of a previous radiation treatment. Tooth extraction often precedes the manifestation of ONJ; indeed, it is sometimes called trigger event and it have also been considered as risk factors for the onset of ONJ. As a consequence, some of the guidelines recommend avoiding tooth extractions in patients at risk of ONJ; however, a growing body of evidence indicates that dental/periodontal infection prior to extraction, rather than dental …

CD34 and CD105 Microvessels in Resected Bone Specimen May Implicate Wound Healing in MRONJ

2021

Clinical treatment outcome of MRONJ (medication-related osteonecrosis of the jaw) surgery despite radical osseous removal and primary closure healing still shows differences in terms of outcome and disease recurrence. The study aims to assess the rate of angiogenesis of MRONJ lesions in order to understand the impact of angiogenesis and neoangiogenesis status on MRONJ surgical treatment outcome. This is the first study correlating microvessel density with prognosis in MRONJ surgically-treated patients. The immunohistochemical expression of CD34 and CD105 in MRONJ specimens obtained from surgically-treated patients was evaluated. The most vascularized areas detected by CD34 and CD105 were se…

Conservative Surgical Management of Stage I Bisphosphonate-Related Osteonecrosis of the Jaw

2014

Purpose. To report the efficacy of conservative surgical treatment for stage I bisphosphonate-related osteonecrosis of the jaw (BRONJ).Materials and Methods. This study reports the clinical outcomes of 63 patients treated for BRONJ stage I (according to Ruggiero's staging system) at the Oral Pathology and Laser-Assisted Surgery Unit of the University of Parma between January 2004 and January 2011. Surgical interventions were performed, under local analgesia, in patients unresponsive for a period of six months to noninvasive treatments such as cycles of local or systemic antibacterial therapy combined or not to low level laser therapy, ozone therapy, or Hyperbaric Oxygen Therapy. All interve…

Review and update on drugs related to the development of osteonecrosis of the jaw

2019

Conflict of interest Conclusions of the working group on “New drugs related to the de-velopment of osteonecrosis of the jaw”. Spanish Society of Cranio-mandibular Dysfunction and Orofacial Pain and Spanish Society of Oral Medicine SEDCYDO-SEMO joint International Meeting: 30th SEDCYDO annual meeting & 15th SEMO Congress. Bilbao (Spain); June, 2019. [EN] Background: Medication-related osteonecrosis of the jaw (MRONJ) is a rare, but serious adverse effect of cer-tain drugs, of which bisphosphonates are the most widely known. This pathology is also associated with other medications such as the biologic antiresorptive agent, denosumab and some antiangiogenics such as sunitinib, bevacizumab or a…

New paradigms for dental prevention of medication related osteonecrosis of jaws (MRONJ)

2018

ONJ-Prevention of local osteonecrosis risk factors should be planned before and during the intake of associated drugs, according to new schedules. Secondary prevention requires a careful clinical oral examination, but also first level X-ray examinations and, when necessary, second level (CT) too. Three main risk factors of ostonecrosis of the jaws (ONJ) are recognised: (i) the type of ONJ-related medications: antiresorptive (e.g., Bisphosphonates, Denosumab) and antiangiogenic drugs (e.g., Bevacizumab, Sunitinib); (ii) the category of patient at MRONJ risk: cancer versus non-cancer patient; (iii) the typologies and timing of dental treatments (e.g., before, during, or after the drug adminis…

Current Controversies in Classification, Management, and Prevention of Bisphosphonate-Related Osteonecrosis of the Jaw

2014

Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a serious complication associated with oral and intravenous bisphosphonate therapy that adversely affects the quality of life, producing significant morbidity. Since the first description of bone necrosis in patients receiving bisphosphonate therapy in 2003 [1], hundreds of studies were published about this topic and various national and international medical societies have published protocols and guidelines. Nevertheless, there are still many controversies regarding the classification, management, and prevention of BRONJ. Even the definition of BRONJ is still debated and changed with the progress of knowledge and experience. Accord…

Comment on Medication-Related Osteonecrosis of the Jaw: MASCC/ISOO/ASCO Clinical Practice Guideline Summary

2020

Bisphosphonate-related osteonecrosis of the jaw (BRONJ): run dental management designs and issues in diagnosis

2007

Recently, jawbone osteonecrosis has been largely reported as a potential adverse effect of bisphosphonate (BP) administration. Because of the peculiar pharmacokinetic and pharmacodynamic features of the BF (mainly for i.v. administration), their efficacy and large use, some major issues have to be taken into account extendedly both by oncologists and by dentists: 1) therapeutic dental protocol for patients with diagnosis of bisphosphonate-related osteonecrosis of the jaw (BRONJ); 2) dental strategies for patients in former or current i.v. BF treatment and in absence of BRONJ signs; 3) strategies for patients before i.v. BF treatment. Clinical features and guidelines for the management of th…