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Biphosphonates-related osteonecrosis of the jaw: Clinical and physiopathological considerations.

Borgioli A, Viviani C, Duvina M, Brancato L, Spinelli G, Brandi ML, Tonelli P - Ther Clin Risk Manag (2009)

Bottom Line: Nitrogen-containing biphosphonates are widely used for the management of metastatic cancer, for prevention and treatment of osteoporosis, for the treatment of Paget's disease, and for the management of acute hypercalcemia.According to our experience, the treatment of BRON-J's lesions is difficult and prolonged.For this reason, in order to avoid these complications it is mandatory to perform a risk staging in patients who must undergo biphosphonate administration.

View Article: PubMed Central - PubMed

Affiliation: Department of Odontostomatology, Dental School;

ABSTRACT
Since osteonecrosis of the jaw was related to biphosphonate administration by Marx, studies showing clinical symptoms, drug and surgical therapies overwhelmed the literature. Furthermore, the literature demonstrated the correlation between chronic biphosphonate adsumption and osteonecrosis of the jaw onset. Nitrogen-containing biphosphonates are widely used for the management of metastatic cancer, for prevention and treatment of osteoporosis, for the treatment of Paget's disease, and for the management of acute hypercalcemia. According to our experience, the treatment of BRON-J's lesions is difficult and prolonged. For this reason, in order to avoid these complications it is mandatory to perform a risk staging in patients who must undergo biphosphonate administration. When pharmacologic treatments with antibiotics and local antiseptics are not able to control the development of BRON-J's complications, the clinicians should perform radical surgical treatments such as the resection of the bone involved.

No MeSH data available.


Related in: MedlinePlus

Worsening of the lesion after sequestrectomy in patient treated with Zometa® for 12 months (59 years old, female, breast cancer).
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getmorefigures.php?uid=PMC2697532&req=5

f2-tcrm-5-0217: Worsening of the lesion after sequestrectomy in patient treated with Zometa® for 12 months (59 years old, female, breast cancer).

Mentions: The different thickness of the cortexes justifies the earlier externalization if the pathologic process is located in the upper jaw. In the lower jaw the osteolytic damage tend to became deeper sometimes reaching the inner edge of the mandibula (Figures 1, 2). The involved bone can fracture spontaneously because of its reduced elasticity. Furtheremore the purulent material can compress nerve endings, causing local paresthesia.19,20 This phase, often following the relapse of the oncologic disease and/or the antiblastic treatment associated to corticosteroid therapy is defined as “complicated phase.”


Biphosphonates-related osteonecrosis of the jaw: Clinical and physiopathological considerations.

Borgioli A, Viviani C, Duvina M, Brancato L, Spinelli G, Brandi ML, Tonelli P - Ther Clin Risk Manag (2009)

Worsening of the lesion after sequestrectomy in patient treated with Zometa® for 12 months (59 years old, female, breast cancer).
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2697532&req=5

f2-tcrm-5-0217: Worsening of the lesion after sequestrectomy in patient treated with Zometa® for 12 months (59 years old, female, breast cancer).
Mentions: The different thickness of the cortexes justifies the earlier externalization if the pathologic process is located in the upper jaw. In the lower jaw the osteolytic damage tend to became deeper sometimes reaching the inner edge of the mandibula (Figures 1, 2). The involved bone can fracture spontaneously because of its reduced elasticity. Furtheremore the purulent material can compress nerve endings, causing local paresthesia.19,20 This phase, often following the relapse of the oncologic disease and/or the antiblastic treatment associated to corticosteroid therapy is defined as “complicated phase.”

Bottom Line: Nitrogen-containing biphosphonates are widely used for the management of metastatic cancer, for prevention and treatment of osteoporosis, for the treatment of Paget's disease, and for the management of acute hypercalcemia.According to our experience, the treatment of BRON-J's lesions is difficult and prolonged.For this reason, in order to avoid these complications it is mandatory to perform a risk staging in patients who must undergo biphosphonate administration.

View Article: PubMed Central - PubMed

Affiliation: Department of Odontostomatology, Dental School;

ABSTRACT
Since osteonecrosis of the jaw was related to biphosphonate administration by Marx, studies showing clinical symptoms, drug and surgical therapies overwhelmed the literature. Furthermore, the literature demonstrated the correlation between chronic biphosphonate adsumption and osteonecrosis of the jaw onset. Nitrogen-containing biphosphonates are widely used for the management of metastatic cancer, for prevention and treatment of osteoporosis, for the treatment of Paget's disease, and for the management of acute hypercalcemia. According to our experience, the treatment of BRON-J's lesions is difficult and prolonged. For this reason, in order to avoid these complications it is mandatory to perform a risk staging in patients who must undergo biphosphonate administration. When pharmacologic treatments with antibiotics and local antiseptics are not able to control the development of BRON-J's complications, the clinicians should perform radical surgical treatments such as the resection of the bone involved.

No MeSH data available.


Related in: MedlinePlus