Platelet-rich therapies in the treatment of intravenous bisphosphonate-related osteonecrosis of the jaw: A report of 32 cases

Oral Oncology ◽  
2012 ◽  
Vol 48 (5) ◽  
pp. 469-474 ◽  
Author(s):  
Marco Mozzati ◽  
Giorgia Gallesio ◽  
Valentina Arata ◽  
Renato Pol ◽  
Matteo Scoletta
Keyword(s):  
Osteonecrosis Of The Jaw ◽  
Intravenous Bisphosphonate

scholarly journals Characteristics of patients with osteonecrosis of the jaw with oral versus intravenous bisphosphonate treatment

2021 ◽  
Vol 43 (1) ◽  
Author(s):  
Seung-Hun Lee ◽  
So-Young Choi ◽  
Min-Su Bae ◽  
Tae-Geon Kwon
Keyword(s):  
Retrospective Study ◽  
Clinical Characteristics ◽  
Demographic Data ◽  
Osteonecrosis Of The Jaw ◽  
Group Differences ◽  
Bisphosphonate Treatment ◽  
Administration Route ◽  
Lesion Number ◽  
Different Characteristics ◽  
Intravenous Bisphosphonate

Abstract Purpose This retrospective study was aimed to evaluate the clinical characteristics and treatment outcomes in patients with osteonecrosis of the jaw who were receiving oral versus intravenous (IV) bisphosphonate (BP). Materials and methods This retrospective study enrolled subjects who had been diagnosed with medication-related osteonecrosis of the jaw (MRONJ) during the period from July 2010 to June 2014. Information regarding the following demographic and clinical characteristics was collected: demographic data, administration route and type of BP, duration of BP medication, primary disease, number of involved sites, location of the lesion, number of surgeries, outcome of treatments, and laboratory test. All the patients were divided into oral and IV BP groups; and the between-group differences were compared. Results Total 278 patients were divided into two groups as per the route of BP administration. The proportion of oral BP-related MRONJ group were more dominant over IV BP group (oral BP, n = 251; IV BP, n = 27). In the IV BP group, the average dosing duration (31.4 months) was significantly shorter than that in the oral BP group (53.1 months) (P < 0.001). The average number of involved sites in the oral BP group (1.21 ± 0.48) was smaller than that in the IV BP group (1.63 ± 0.84) (P < 0.001). The average number of surgeries was higher in the IV BP group (1.65 ± 0.95) as compared to that in the oral BP group (0.98 ± 0.73) (P < 0.001). Outcome after the surgery for MRONJ after IV BP was poor than oral BP group. Conclusion IV administration of BP causes greater inhibition of bone remodeling and could lead more severe inflammation. Therefore, even if the duration of IV administration of BP is shorter than that of oral BP, the extent of the lesion could be more extensive. Therefore, the result suggests that the MRONJ after IV BP for cancer patients needs to be considered as different characteristics to oral BP group for osteoporosis patents.

scholarly journals An unusual case of bone regeneration of a necrotic mandible with pathologic fracture in an elderly hemodialysis patient with medication-related osteonecrosis of the jaw: a case report and review of the literature

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Kunio Yoshizawa ◽  
Akinori Moroi ◽  
Ran Iguchi ◽  
Akihiro Takayama ◽  
Junko Goto ◽  
...  
Keyword(s):  
Bone Regeneration ◽  
Unusual Case ◽  
Pathologic Fracture ◽  
Osteonecrosis Of The Jaw ◽  
Intraoperative Bleeding ◽  
Case Presentation ◽  
Old Japanese ◽  
Systemic Condition ◽  
Intravenous Bisphosphonate ◽  
Rare Report

Abstract Background Bisphosphonates are frequently used for osteoporosis. Medication-related osteonecrosis of the jaw, a complication of bone-modifying agents, including bisphosphonates or angiogenic inhibitors, can be challenging to treat in elderly patients with numerous preexisting conditions. Achieving good treatment outcomes is especially difficult in patients with pathological fractures accompanied with extraoral fistulae. Case presentation We report an unusual case of prominent bone regeneration following palliative surgical treatment in a 72-year-old Japanese female patient undergoing hemodialysis. She previously had severe osteoporosis due to renal osteodystrophy and was receiving antiresorptive intravenous bisphosphonate. Computed tomography revealed a discontinuous left lower mandibular margin with a pathologic fracture and extensive, morphologically irregular sequestrum formation (80 × 35 × 20 mm). The patient was diagnosed with stage III medication-related osteonecrosis of the jaw and pathologic mandibular fracture. Immediately before the surgery, the anticoagulant used for dialysis was changed from heparin to nafamostat mesylate to reduce the risk of intraoperative bleeding. Sequestrectomy was performed under general anesthesia. Postoperative infection was not observed, the intraoral and submandibular fistula disappeared, and, surprisingly, prominent spontaneous bone regeneration was observed postoperatively at 6 months. Despite the severe systemic condition of the patient, the conservative surgical approach with sequestrectomy has yielded desirable results for more than 6 years since the surgery. Conclusions This rare report of spontaneous bone regeneration in a patient of advanced age and poor general condition is the oldest case of mandibular regeneration ever reported.

Intravenous Bisphosphonate-Related Osteonecrosis of the Jaw: Bone Scintigraphy as an Early Indicator

2009 ◽  
Vol 67 (7) ◽  
pp. 1363-1372 ◽  
Author(s):  
Felice S. O'Ryan ◽  
Sam Khoury ◽  
Wendy Liao ◽  
Myo M. Han ◽  
Rita L. Hui ◽  
...  
Keyword(s):  
Bone Scintigraphy ◽  
Osteonecrosis Of The Jaw ◽  
Early Indicator ◽  
Jaw Bone ◽  
Intravenous Bisphosphonate

scholarly journals The effect of pamidronate delivery in bisphosphonate-naïve patients on neutrophil chemotaxis and oxidative burst

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Jeffrey W. Chadwick ◽  
Howard C. Tenenbaum ◽  
Chun-Xiang Sun ◽  
Robert E. Wood ◽  
Michael Glogauer
Keyword(s):  
Neutrophil Function ◽  
Osteonecrosis Of The Jaw ◽  
Innate Immune ◽  
Neutrophil Chemotaxis ◽  
Oral Rinse ◽  
Non Invasive ◽  
Potential Biomarker ◽  
Baseline Values ◽  
Neutrophil Superoxide ◽  
Intravenous Bisphosphonate

Abstract The pathogenesis of medication-related osteonecrosis of the jaw (MRONJ), a morbid condition associated with bisphosphonate administration, has not been fully elucidated. Recent research utilizing a murine model has revealed that the neutrophil becomes dysfunctional following exposure to bisphosphonates. Accordingly, the impairment of neutrophil function could play an important role in the pathogenesis of MRONJ via an infectious mechanism mediated by the suppression of the innate immune system. Currently, the existing human data are insufficient to substantiate this theory. To investigate, we isolated neutrophils from blood and oral rinse samples from bisphosphonate-naïve patients who were recently diagnosed with multiple myeloma both prior to and one month following their initial infusion of pamidronate, an intravenous bisphosphonate agent. Stimulated blood and oral neutrophil superoxide production and chemotactic capabilities were found to be impaired relative to baseline values. These results suggest that impaired neutrophil function may partially contribute to the aetiology underlying the pathophysiological processes linked to the development of MRONJ. Further, as the functional status of circulating neutrophils was reflected in the oral cavity where sampling can be accomplished in a non-invasive fashion, it is conceivable that neutrophil function could serve as a potential biomarker for MRONJ prognostication.

Characteristics of the early stages of intravenous bisphosphonate-related osteonecrosis of the jaw in patients with breast cancer

2014 ◽  
Vol 72 (8) ◽  
pp. 656-663 ◽  
Author(s):  
Akira Matsuo ◽  
Hayato Hamada ◽  
Hiroshi Kaise ◽  
Daichi Chikazu ◽  
Kimito Yamada ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Osteonecrosis Of The Jaw ◽  
Early Stages ◽  
Intravenous Bisphosphonate

Intravenous bisphosphonate–related osteonecrosis of the jaw: Long-term follow-up of 109 patients

2013 ◽  
Vol 115 (2) ◽  
pp. 192-200 ◽  
Author(s):  
Amber L. Watters ◽  
Heidi J. Hansen ◽  
Tijaana Williams ◽  
Joanne F. Chou ◽  
Elyn Riedel ◽  
...  
Keyword(s):  
Osteonecrosis Of The Jaw ◽  
Long Term Follow Up ◽  
Intravenous Bisphosphonate

scholarly journals Comparison of the Effect of Oral Versus Intravenous Bisphosphonate Administration on Osteoclastogenesis in Advanced-Stage Medication-Related Osteonecrosis of the Jaw Patients

2021 ◽  
Vol 10 (13) ◽  
pp. 2988
Author(s):  
Hye-Won Kim ◽  
Min-Woo Lee ◽  
Jung-Hwan Lee ◽  
Moon-Young Kim
Keyword(s):  
Prognostic Factor ◽  
Osteonecrosis Of The Jaw ◽  
Independent Prognostic Factor ◽  
Stage Iii ◽  
Tartrate Resistant Acid Phosphatase ◽  
Advanced Stage ◽  
Administration Route ◽  
History Of ◽  
Intravenous Bisphosphonate

It is yet unknown whether the intravenous administration route alone can fully account for the exacerbation of medication-related osteonecrosis of the jaw (MRONJ). The purpose of this retrospective study was to identify the potential role of the bisphosphonate (BP) administration route as an independent prognostic factor for non-cancerous, stage III MRONJ patients. Bone samples were retrospectively obtained from two groups of osteoporosis patients who underwent surgery for the treatment of stage III MRONJ. Among the subjects, 10 had a history of only oral BP consumption and 10 of intravenous (IV) BP administration. The samples were assessed for osteoclast morphology and immunohistochemical expression of the receptor activator of NF-κB ligand (RANKL), osteoprotegerin (OPG), and potassium calcium-activated channel subfamily N member 4 (Kcnn4). Although the osteoclasts derived from both groups exhibited no significant differences in the mean quantity, diameter, and nuclearity, significantly attenuated tartrate-resistant acid phosphatase activity was noted among the IV BP-induced MRONJ bones compared to those of the oral BP group. Significant suppression of the RANKL/OPG ratio and Kcnn4 expression among the retrieved bones of IV BP group patients was also noted. Our results indicate the potential of the BP administration route as an independent prognostic factor for advanced-stage MRONJ, regardless of the dosage or indication for which the BP was prescribed.

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