Medication-Related Osteonecrosis of The Jaw treatment Modalities, A review Article

2020 ◽  
Author(s):  
Amir Ali Asadi
Keyword(s):  
Maxillofacial Surgery ◽  
Osteonecrosis Of The Jaw ◽  
Treatment Modalities ◽  
Oral And Maxillofacial Surgery ◽  
Antiangiogenic Agents ◽  
Bone Surgery ◽  
Guided Surgery ◽  
Level Laser ◽  
Controversial Topic ◽  
Super Infection

Introduction: Medication-related osteonecrosis of the jaw (MRONJ) is a serious adverse reaction of antiresorptive and antiangiogenic agents. Management of MRONJ has remained a controversial topic within the oral and maxillofacial surgery community. Methods: Articles from 2010 to 2020 were selected. We determined that all review studies evaluated the effectiveness of various MRONJ therapies to resolve the condition were eligible for this study. We determined that all review studies evaluated the effectiveness of various MRONJ therapies to resolve the condition were eligible for this study. Results: Antibiotic therapy such as penicillin-based antibiotics plus β-lactamase inhibitor or metronidazole could decrease disease progression and may prevent super infection of the bone. Surgery should be considered in all stages of MRONJ as it confirms the histology. fluorescence-guided surgery is helpful for MRONJ cases under Denosumab and it is recommended to use Low Level Laser and PDT as adjuvant treatment of MRONJ. Conclusion: It seems that conservative treatment, minimally traumatic extraction technique, removal of bone edges and mucosal wound closure may prevent the occurrence of MRONJ  

scholarly journals Piezo electric bone surgery – Review

2019 ◽  
Author(s):  
CHELSEA JEGADISH ◽  
JACOB RAJA ◽  
JOHNSON RAJA JAMES ◽  
MOHAN RAJ JP ◽  
DIVYA LAL.S
Keyword(s):  
Soft Tissues ◽  
Maxillofacial Surgery ◽  
Bone Architecture ◽  
Patient Comfort ◽  
Treatment Modalities ◽  
Autogenous Bone ◽  
Oral And Maxillofacial Surgery ◽  
Bone Surgery ◽  
Piezoelectric Surgery ◽  
Implant Dentistry

Piezoelectric surgery was first explained by French Jacques and Pierre Curie in 1880. Piezoelectric bone surgery is a novel osteotomy and osteoplasty technique invented by Professor Vercellotti in 1988 to overcome the limitations of traditional instrumentation in oral bone surgery by modifying and improving conventional ultrasound technology. The cutting action is the result of linear microvibrations, in amplitude between 30 and 200 μm that allow to obtain a micrometer precision in the range of 25-29 KHz modulated ultrasonic resonant frequency. Nerves, vessels, and soft tissue are preserved by the microvibrations (60 to 200 mm/sec), which are optimally adjusted to target only mineralized tissue. It is a minimally invasive osteotomy device to achieve unparallel precision, patient comfort, intra-operative sensitivity, intra-operative visibility, blood free surgical site and reduced damage to the surrounding soft tissues, osteocytes and important structures like nerves, muscles and mucosa. Also Piezosurgery is very useful in harvesting autogenous bone for regenerating periodontal defects. Various treatment modalities are based on removal of etiologic factors and preserving bone architecture. Recently this novel surgical approach has gained popularity in various fields of dental implantology, oral and maxillofacial surgery, endodontics, and orthopedics. This article aims to review the clinical calibre of piezosurgery in the field of periodontology and implant dentistry. Key Words : LESS INVASIVE, PRECISION CUTTING, MICRO VIBRATIONS, FASTER RECOVERY, PIEZO TECHNIQUE

scholarly journals Various Therapeutic Methods for the Treatment of Medication-Related Osteonecrosis of the Jaw (MRONJ) and Their Limitations: A Narrative Review on New Molecular and Cellular Therapeutic Approaches

Antioxidants ◽  
2021 ◽  
Vol 10 (5) ◽  
pp. 680
Author(s):  
Sung-Woon On ◽  
Seoung-Won Cho ◽  
Soo-Hwan Byun ◽  
Byoung-Eun Yang
Keyword(s):  
Bone Morphogenetic Proteins ◽  
Maxillofacial Surgery ◽  
Treatment Protocol ◽  
Osteonecrosis Of The Jaw ◽  
Therapeutic Modality ◽  
Definitive Treatment ◽  
Antiangiogenic Agents ◽  
Platelet Concentrates ◽  
Therapeutic Approaches ◽  
Positive Effect

Medication-related osteonecrosis of the jaw (MRONJ) is one of the most interesting diseases in the field of maxillofacial surgery. In addition to bisphosphonates, the use of antiresorptive and antiangiogenic agents is known to be the leading cause. However, the exact pathogenesis of MRONJ has not been established, and various hypotheses have been proposed, such as oxidative stress-related theory. As a result, a definitive treatment protocol for MRONJ has not been identified, while various therapeutic approaches are applied to manage patients with MRONJ. Although the surgical approach to treat osteomyelitis of the jaw has been proven to be most effective, there are limitations, such as recurrence and delayed healing. Many studies and clinical trials are being conducted to develop another effective therapeutic modality. The use of some materials, including platelet concentrates and bone morphogenetic proteins, showed a positive effect on MRONJ. Among them, teriparatide is currently the most promising material, and it has shown encouraging results when applied to patients with MRONJ. Furthermore, cell therapy using mesenchymal stem cells showed promising results, and it can be the new therapeutic approach for the treatment of MRONJ. This review presents various treatment methods for MRONJ and their limitations while investigating newly developed and researched molecular and cellular therapeutic approaches along with a literature review.

scholarly journals Treatment of Stage 2 Medication-Induced Osteonecrosis of the Jaw: A Case Series

2021 ◽  
Vol 18 (3) ◽  
pp. 1018
Author(s):  
Guillermo Pardo-Zamora ◽  
Yanet Martínez ◽  
Jose Antonio Moreno ◽  
Antonio J. Ortiz-Ruíz
Keyword(s):  
Bone Structure ◽  
Negative Impact ◽  
Maxillofacial Surgery ◽  
Case Series ◽  
Osteonecrosis Of The Jaw ◽  
Oral And Maxillofacial Surgery ◽  
Minimally Invasive Surgical ◽  
Therapeutic Protocols ◽  
Serious Disease ◽  
The University

Medication-induced jaw osteonecrosis (MRONJ) is a rare and serious disease with a negative impact on patients’ quality of life, whose exact cause remains unclear and which may have a multifactorial origin. Although there are different therapeutic protocols, there is still no consensus. This case series evaluated three patients diagnosed with staged 2 MRONJ treated at the University of Murcia dental clinic according to the protocols described by the Spanish Society of Oral and Maxillofacial Surgery and the American Association of Oral and Maxillofacial Surgeons. Within 12 months of the application of therapeutic protocols, the lesions were completely healed in all cases. Radiography showed slow but progressive healing with normal bone structure. Conservative treatment with antibiotics, chlorhexidine rinses and minimally invasive surgical intervention with necrotic bone resection is effective in treating stage 2 of MRONJ. In cases of refractory osteonecrosis, the application of platelet and leukocyte-rich fibrin (PRF-L) in the surgical approach improves the outcome in soft tissue healing and bone regeneration but further research is needed to confirm its effectiveness.

scholarly journals Surgical Treatment of Medication-Related Osteonecrosis of the Jaw: A Retrospective Study

2020 ◽  
Vol 17 (23) ◽  
pp. 8801
Author(s):  
Na Rae Choi ◽  
Jung Han Lee ◽  
Jin Young Park ◽  
Dae Seok Hwang
Keyword(s):  
Retrospective Study ◽  
Surgical Treatment ◽  
Treatment Outcomes ◽  
Maxillofacial Surgery ◽  
Osteonecrosis Of The Jaw ◽  
Oral And Maxillofacial Surgery ◽  
Single Institution ◽  
Patient Factors ◽  
Surgical Success ◽  
Negative Impacts

The purpose of this study was to confirm the success rate of surgical treatment of medication-related osteonecrosis of the jaw (MRONJ) in patients at a single institution (Association of Oral and Maxillofacial Surgery (AAOMS) stages 1, 2, or 3), and to identify the factors that influence treatment outcomes. As a result of analyzing the outcomes of treatment, surgical “success” was achieved in 93.97% (109) of cases, and “failure” was observed at 6.03% (7) cases. Analysis of patient factors that potentially affect treatment outcomes showed that zoledronate dose (p = 0.005) and the IV (intravenous) injection of drugs (p = 0.044) had significant negative impacts.

Evolution of Aesthetic Dentistry

2019 ◽  
Vol 98 (12) ◽  
pp. 1294-1304 ◽  
Author(s):  
M.B. Blatz ◽  
G. Chiche ◽  
O. Bahat ◽  
R. Roblee ◽  
C. Coachman ◽  
...  
Keyword(s):  
Dental Treatment ◽  
Maxillofacial Surgery ◽  
Dental Materials ◽  
Specific Treatment ◽  
Point Of View ◽  
Treatment Modalities ◽  
Oral And Maxillofacial Surgery ◽  
The Past ◽  
Science And Art ◽  
Aesthetic Dentistry

One of the main goals of dental treatment is to mimic teeth and design smiles in a most natural and aesthetic manner, based on the individual and specific needs of the patient. Possibilities to reach that goal have significantly improved over the last decade through new and specific treatment modalities, steadily enhanced and more aesthetic dental materials, and novel techniques and technologies. This article gives an overview of the evolution of aesthetic dentistry over the past 100 y from a historical point of view and highlights advances in the development of dental research and clinical interventions that have contributed the science and art of aesthetic dentistry. Among the most noteworthy advancements over the past decade are the establishment of universal aesthetic rules and guidelines based on the assessment of natural aesthetic parameters, anatomy, and physiognomy; the development of tooth whitening and advanced restorative as well as prosthetic materials and techniques, supported by the pioneering discovery of dental adhesion; the significant progress in orthodontics and periodontal as well as oral and maxillofacial surgery; and, most recently, the implementation of digital technologies in the 3-dimensional planning and realization of truly natural, individual, and aesthetic smiles. In the future, artificial intelligence and machine learning will likely lead to automation of aesthetic evaluation, smile design, and treatment-planning processes.

scholarly journals Utility of Photodynamic Therapy in Dentistry: Current Concepts

2020 ◽  
Vol 8 (2) ◽  
pp. 43
Author(s):  
Anette Stájer ◽  
Szilvia Kajári ◽  
Márió Gajdács ◽  
Aima Musah-Eroje ◽  
Zoltán Baráth
Keyword(s):  
Photodynamic Therapy ◽  
Clinical Success ◽  
Maxillofacial Surgery ◽  
Treatment Method ◽  
Treatment Modalities ◽  
Oral And Maxillofacial Surgery ◽  
Invasive Treatment ◽  
Advantages And Disadvantages ◽  
Non Invasive ◽  
Wide Range

The significant growth in scientific and technological advancements within the field of dentistry has resulted in a wide range of novel treatment modalities for dentists to use. Photodynamic therapy (PDT) is an emerging, non-invasive treatment method, involving photosensitizers, light of a specific wavelength and the generation of singlet oxygen and reactive oxygen species (ROS) to eliminate unwanted eukaryotic cells (e.g., malignancies in the oral cavity) or pathogenic microorganisms. The aim of this review article is to summarize the history, general concepts, advantages and disadvantages of PDT and to provide examples for current indications of PDT in various subspecialties of dentistry (oral and maxillofacial surgery, oral medicine, endodontics, preventive dentistry, periodontology and implantology), in addition to presenting some images from our own experiences about the clinical success with PDT.

scholarly journals Observational Study of the Bisphosphonate-Related Osteonecrosis of Jaws

2018 ◽  
Vol 91 (2) ◽  
pp. 209-215 ◽  
Author(s):  
Andreea Elena Lungu ◽  
Madalina Anca Lazar ◽  
Andrada Tonea ◽  
Horatiu Rotaru ◽  
Rares Calin Roman ◽  
...  
Keyword(s):  
Oral Treatment ◽  
Maxillofacial Surgery ◽  
Osteonecrosis Of The Jaw ◽  
Postoperative Recovery ◽  
Oral And Maxillofacial Surgery ◽  
Necrotic Bone ◽  
Functional Rehabilitation ◽  
Maxillary Bone ◽  
Medical Background ◽  
Radiological Image

Introduction. The bisphosphonate-related osteonecrosis of the jaw was first referred to in 2003. Bisphosphonates action is focused on the osteoclasts. The drastic inhibition of the osteoclastic function is harmful for the jaws which are the only bones of the human skeleton in relative contact with the external environment. The adverse effects of the bisphosphonate-related therapy include the pathology for which they are prescribed, the atypical fractures in pathological bone.Method. The aim of this research was to analyze the risk factors and the treatment methods in case of osteonecrosis of the jaws. To achieve these goals, the author analyzed the observation sheets of the patients admitted to the Oral and Maxillofacial Surgery Clinic during the period 2010-2015. The inclusion criteria were as follows: treatment with bisphosphonates, current or previous; the lesions of the mucous gingiva of the maxillaries followed by exposed necrotic bone, older than 8 weeks, with no tendency of healing; specific radiological image showing extended osteolysis with diffuse outline or radiopacity surrounded by radio-transparence, representing the necrotic bone sequestered; no metastasis in the necrotic maxillary bone; patient with no medical background of cervical-facial radiations. The patients who met these criteria were admitted in the study after signing the informed consent. Afterwards, the information found in the notes of the observational sheet (anamnesis, general examination and the imagistic investigation, treatment, postoperative recovery, prescription, postoperative recommendations) were gathered and submitted for statistic analysisResults. Of the 20 patients in total, 13 were women and 7 men, of ages ranging from 43 to 83. The most numerous cases were registered in the seventh age decade. All patients included in the study had lesions of the gingival maxillary mucosal areas with exposure of the subjacent necrotic bone. 60% of them were under intravenous treatment with zoledronic acid (Zometa®). A single patient was under oral treatment with bisphosphonates. 19 of these 20 patients developed osteonecrosis following a dental extraction while one case was due to the instability of the mandibular mobile prosthesis. 61% of the patients included in the study developed a necrotic process in the mandibular bone, 80% of the localizations were in the posterior area. As first intention, the choice of treatment was represented by local lavages with antiseptic solutions, general antibiotics and sequestrectomy. Of these patients, a third had relapsed and needed radical surgery treatment.Conclusions. Prevention of the bisphosphonate-related osteonecrosis of the jaw represents the best method of treatment. The development of bone sequesters damages the volume of the maxillary bone as such, reducing the chances for prosthetic functional rehabilitation of the dento-maxillary system. An increase in the quality of life by oral restoration of these patients may represent a challenge.

scholarly journals Comparison of functional outcome after open and closed reduction of mandibular subcondylar fracture

2020 ◽  
pp. 1-12
Author(s):  
Samira Shabbir Balouch ◽  
Rana Sohail ◽  
Sadia Awais ◽  
Riaz Ahmad Warraich ◽  
Mir Ibrahim Sajid
Keyword(s):  
Internal Fixation ◽  
Closed Reduction ◽  
Open Reduction ◽  
Maxillofacial Surgery ◽  
Mouth Opening ◽  
Treatment Modalities ◽  
Oral And Maxillofacial Surgery ◽  
Subcondylar Fracture ◽  
Group A ◽  
Group B

Abstract Objective: To compare open reduction with internal fixation of mandibular subcondylar fracture with closed reduction in terms of adequate mouth opening. Method: The randomised clinical trial was conducted from March 2014 to February 2015 at the Oral and Maxillofacial Surgery Department, King Edward Medical University and Allied Hospitals, Lahore, Pakistan, and comprised patients who presented with unilateral subcondylar fractures. The patients were randomly divided into 2 groups. Group-A patients were treated with closed reduction and immobilisation and were discharged the same day, while Group-B patients were treated by open reduction with internal fixation and retained in ward for 1 day. Both were recalled for periodic follow-ups, and were compared in terms of achieving adequate mouth opening. Data was analysed using SPSS 20. Results: Of the 70 patients, 35(50%) were in each of the two groups. The mean age in Group-A was 28.88±11.86 years compared to 28.22±10.80 years in Group-B (p>0.05). Mean mouth opening in  the two groups were consistently positive, and significant at the last two follow-ups(p<0.001). Conclusion: The difference in results of both treatment modalities was significant, indicating that open reduction and internal fixation should be the preferred treatment. Key Words: Mandibular sub-condylar fracture, Open reduction, Closed reduction, Internal fixation, Mouth opening.

Prevalence and pattern of oral and maxillofacial trauma in Chhattisgarh- A retrospective study

2021 ◽  
Vol 7 (3) ◽  
pp. 131-134
Author(s):  
Sushmita Batra ◽  
Surabhi Singhai ◽  
Pramod Krishna B ◽  
Rajdeep Singh ◽  
Sushant Soni
Keyword(s):  
Maxillofacial Surgery ◽  
The Body ◽  
Maxillofacial Trauma ◽  
Treatment Modalities ◽  
Oral And Maxillofacial Surgery ◽  
Mandibular Fractures ◽  
High Morbidity ◽  
Maxillofacial Injuries ◽  
Facial Region ◽  
Clinical Records

Maxillofacial trauma is any physical trauma to the facial region, commonly encountered by maxillofacial surgeons, and is often associated with high morbidity and so constitute quite a significant portion of the workload of the oral and maxillofacial surgeon. Maxillofacial injuries can occur as an isolated injury or may be associated with multiple injuries in other parts of the body. To assess the patterns, etiology, and treatment modalities of maxillofacial trauma in a teaching hospital in central India, over a 12-year period. Patients with maxillofacial trauma were identified using the department database and clinical records. 264 patients were identified with maxillofacial trauma in the department of oral and maxillofacial surgery between January 2006 and December 2018. The study showed that there was a male preponderance in all age groups over female. Of the 264 patients with maxillofacial injuries, 83,33% had isolated lower face (mandibular) fractures, followed by midface fractures (10.60%) and panfacial fractures (6.06%). Road traffic accidents (87.12%) were the most common form of etiology for trauma followed by assaults (10.98%). Most trauma were treated with open reduction internal fixation (89%) than closed reduction (11%). The etiology and pattern of maxillofacial injuries reflect the trauma patterns within the community and can thus provide a guide to help design programs toward prevention and treatment.

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