Dental Implants in A Patient with History of Zoledronate Therapy: A Challenging Case

Implant placement in patient with history of bisphosphonate therapy is still controversial due to the risks of osteointegration failure and Biphosphonate related osteonecrosis of the jaws. Very few cases are reported. This paper aimed to report the success at 3 years follow up of 4 implants placed in a female patient with history of breast cancer and zoledronate infu-sions ( twice yearly for 2 years).

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Restorative dentistry 5: dental implants

Oxford Handbook of Clinical Dentistry ◽

10.1093/med/9780198832171.003.0009 ◽

2020 ◽

pp. 361-375

Keyword(s):

Dental Implants ◽

Dental Implant ◽

Surgical Techniques ◽

Gingival Recession ◽

Missing Teeth ◽

Implant Placement ◽

History Of ◽

Key Aspects ◽

Supporting Structures

Single or multiple dental implants have become a well-accepted method of replacement of missing teeth and their supporting structures. This chapter introduces implantology, with an explanation of the history of dental implants and a discussion regarding the need to replace missing teeth. The key aspects of treatment planning for implants are outlined including assessment of suitability for implant placement, indications, and contraindications. Available implant types are outlined and the risks of implant placement such as failure to osseointegrate, gingival recession, and nerve damage are considered. Basic surgical techniques for implant placement are described including an explanation of healing and integration times. The chapter includes provision, follow-up, and maintenance advice regarding restoration of the dental implant.

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Osseointegration of Dental Implants and Osteonecrosis of the Jaw in Patients Treated With Bisphosphonate Therapy: A Systematic Review

Journal of Oral Implantology ◽

10.1563/aaid-joi-d-11-00234 ◽

2013 ◽

Vol 39 (4) ◽

pp. 510-520 ◽

Cited By ~ 25

Author(s):

Gurpreet K. Chadha ◽

Azadeh Ahmadieh ◽

Satish Kumar ◽

Parish P. Sedghizadeh

Keyword(s):

Systematic Review ◽

Dental Implants ◽

Patient Population ◽

Osteonecrosis Of The Jaw ◽

Bisphosphonate Therapy ◽

Absolute Contraindication ◽

Strength Of Evidence ◽

Implant Placement ◽

Population Sizes ◽

History Of

Bisphosphonate (BP) drugs are a commonly prescribed group of medications used in the treatment of metabolic and oncologic bone disorders. The aim of this study was to conduct a systematic review in order to evaluate whether patients on BP therapy are appropriate candidates for dental implants as compared to patients not taking BP drugs with respect to successful implant osseointegration and the risk of developing bisphosphonate-related osteonecrosis of the jaw. Based on the current literature, a history of oral or intravenous BP use is not an absolute contraindication for dental implant placement, and dental implants can osseointegrate successfully in this patient population. Importantly, the studies currently available on this topic are of moderate to weak strength of evidence with inherent bias and limitations, and hence results must be interpreted in this context. Well-controlled studies with higher strength of evidence and larger population sizes are required to address this topic more accurately in the future.

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Ab interno 180-degree trabeculectomy with a dual blade in a patient with refractory primary congenital glaucoma

European Journal of Ophthalmology ◽

10.1177/11206721211010402 ◽

2021 ◽

pp. 112067212110104

Author(s):

Mehmet Talay Koylu ◽

Fatih Mehmet Mutlu ◽

Alper Can Yilmaz

Keyword(s):

Intraocular Pressure ◽

Female Patient ◽

Congenital Glaucoma ◽

Safe Procedure ◽

Primary Congenital Glaucoma ◽

History Of ◽

Kahook Dual Blade ◽

The Right ◽

Ab Interno

A 13-year-old female patient with refractory primary congenital glaucoma (PCG) in the right eye who had a history of multiple glaucoma operations underwent ab interno 180-degree trabeculectomy with the Kahook Dual Blade (KDB) targeting the nasal and inferior angles. On postoperative day 1, the intraocular pressure (IOP) of the right eye reduced from 43 to 15 mmHg while on medical therapy. The patient maintained this IOP level throughout the 6-month follow-up. Ab interno KDB trabeculectomy targeting both nasal and inferior angles may be an effective and safe procedure for the treatment of PCG even in eyes with a history of previously failed glaucoma procedures.

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Bone Remineralization around Dental Implants following Conservative Treatment after Peri-Implantitis

Case Reports in Dentistry ◽

10.1155/2019/7210837 ◽

2019 ◽

Vol 2019 ◽

pp. 1-6

Author(s):

Algirdas Puisys ◽

Viktorija Auzbikaviciute ◽

Renata Simkunaite-Rizgeliene ◽

Dainius Razukevicius ◽

Rokas Linkevicius ◽

...

Keyword(s):

Case Report ◽

Surgical Treatment ◽

Conservative Treatment ◽

Dental Implants ◽

Dental Implant ◽

Posterior Part ◽

Treatment Method ◽

Color Changes ◽

Implant Placement ◽

History Of

The aim of this case report is to show that bone remineralization around dental implants with a history of peri-implantitis is possible after irritant factors are removed and only conservative treatment is performed. Patient came to the clinic after three years of dental implant placement complaining about swelling, sensitivity and gingiva color changes at the posterior part of the maxilla. During radiographic and intraoral examinations peri-implantitis of the #24 implant site was diagnosed. The surgical treatment method was rejected and performed conservative treatment instead. The outcome is promising; periapical radiographs three months later showed bone remineralization as well as stable bone after 10 years. A key clinical message: Bone remineralization around dental implants with a history of peri-implantitis is possible after irritant factors are removed and conservative treatment performed.

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Immunohistochemical Study of Ten Cases of Argyrophilic Carcinoma (Carcinoid) of the Breast

Tumori Journal ◽

10.1177/030089168807400309 ◽

1988 ◽

Vol 74 (3) ◽

pp. 295-302 ◽

Cited By ~ 5

Author(s):

Salvatore Andreola ◽

Emanuela Di Re ◽

Mirella Merson ◽

Lorenza Maggiulli ◽

Patrizia De Palma

Keyword(s):

Breast Cancer ◽

Natural History ◽

Human Breast Cancer ◽

Immunohistochemical Study ◽

Secretory Activity ◽

Controversial Issue ◽

Breast Cancers ◽

Human Breast ◽

History Of

The significance of argyrophilia in human breast cancer is still a controversial issue. We tested immunohistochemically 10 cases of argyrophilic carcinomas of the breast and found evidence of immunoreactivity with neuroendocrine markers: chromogranin, NSE, gastrin, insulin and bombesin. Argyrophilia was demonstrated in breast cancers of the usual types and was found to be related to the secretory activity of neoplastic cells. Unfortunately, no adequate follow-up data are available to clarify the natural history of argyrophilic breast cancer. A clinical treatment different from that of conventional breast cancer is not at present justified.

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162 The influence of a family history of breast cancer on the risk of developing a contralateral primary: A longterm follow up study

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/s0360-3016(99)90180-3 ◽

1999 ◽

Vol 45 (3) ◽

pp. 231 ◽

Cited By ~ 2

Author(s):

I.H. Kunkler ◽

W.J.L. Jack ◽

G.R. Kerr

Keyword(s):

Breast Cancer ◽

Family History ◽

Follow Up Study ◽

History Of

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Race as a risk factor for developing osteonecrosis of the jaw after long term bisphosphonate therapy in patients with metastatic breast cancer

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.596 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 596-596

Author(s):

T. Aiti ◽

S. McDunn ◽

L. Hussein ◽

I. Ashkenazi ◽

A. Jajeh ◽

...

Keyword(s):

Breast Cancer ◽

Logistic Regression ◽

Risk Factor ◽

Bone Metastasis ◽

Statistical Significance ◽

Significant Proportion ◽

Metastatic Breast ◽

Osteonecrosis Of The Jaw ◽

Bisphosphonate Therapy ◽

History Of

596 Background: Association between osteonecrosis of the jaw (ONJ) and bisphosphonate treatment has been increasingly reported in the literature. Methods: This is a retrospective review of a single institution’s experience with patients diagnosed with bone metastasis secondary to breast cancer, who developed ONJ while treated with bisphosphonates (Zoledronic acid - Zometa; Pamidronate - Aredia), between 1.1.2001 and 10.30.2005. Presentation, age, race, and outcome were reviewed. Logistic Regression was used to test for statistical significance. Results: 161 patients with bone metastasis secondary to breast cancer treated with bisphosphonates were reviewed (82 African American, 29 Caucasians, 26 Hispanic, 15 Asian and 9 others.). ONJ developed in 6 (3.7%) patients, 5 of which were Caucasians. Logistic regression adjusting for dose shows that the odds ratio for developing ONJ comparing Caucasians with non-Caucasians is 45.7 (p=0.016). Age did not impact occurrence of ONJ. All 6 patients developed ONJ after a minimum of 31 months of treatment. Two patients had a history of previous tooth extraction. In four other patients, ONJ appeared spontaneously. One patient, who presented with an abscess, developed sepsis which resulted in the patient’s death. Two patients were treated with debridement and antibiotics and their lesions healed. Three other patients ended up suffering from a chronically exposed bone. Conclusion: ONJ is a serious complication of bisphosphonate therapy and it affected a significant proportion of our patients. Our data suggests that Caucasians may be more susceptible. Since sample size is small, determining if race is a risk factor for the development of ONJ, while on bisphosphonate therapy, will require further investigation. No significant financial relationships to disclose.

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The clinical impact and outcomes of immunohistochemistry-only metastases in breast cancer

Journal of Clinical Oncology ◽

10.1200/jco.2009.27.15_suppl.613 ◽

2009 ◽

Vol 27 (15_suppl) ◽

pp. 613-613

Author(s):

M. S. Pugliese ◽

M. M. Stempel ◽

S. M. Patil ◽

M. Hsu ◽

H. S. Cody ◽

...

Keyword(s):

Breast Cancer ◽

Cox Regression ◽

Rare Event ◽

Axillary Recurrence ◽

Unilateral Breast Cancer ◽

Prognostic Features ◽

Regression Methods ◽

Kaplan Meier ◽

History Of

613 Background: Modern surgical and pathologic techniques can detect small volume axillary metastases in breast cancer. The clinical significance of these metastases was evaluated in comparison to patients with negative sentinel lymph nodes (Neg-SN). Methods: Retrospective database review from 1997 through 2003 for eligible patients with unilateral breast cancer and no history of significant non-breast malignancy identified 232 patients with sentinel lymph node (SLN) metastases identified only by immunohistochemical stains (IHC-SN). They were compared to 252 Neg-SN controls selected at random from the same database population. Statistical analysis was performed with 2-sample tests, Kaplan-Meier, and Cox regression methods. Results: IHC-SN patients had worse prognostic features and received more systemic therapy than controls (Table). Age and ER status were similar. In 123 IHC-SN patients treated with axillary dissection (ALND), 16% had macrometastases in the non-SLNs. Only one axillary recurrence occurred in the group of IHC-SN patients without ANLD (n=109). With median follow up of 5 years (range 0.01–12.0), 28 recurrences and 25 deaths occurred. There were no differences between cases and controls for recurrence-free survival (RFS) or overall survival (OS) both by univariate and multivariate models that included variables such as age, tumor size, chemotherapy and hormone therapy [HR 0.99 (95%CI 0.43–2.28, p=0.99) for RFS, HR 2.06 (95%CI 0.79–5.35) p=0.14 for OS]. In IHC-SN patients treated with ALND, patients with positive non-SLNs (n=20) tended to have worse RFS than those with negative non-SLNs (n=103) [RFS 89% vs. 97% at 5 yrs (p=0.06)]. Conclusions: A significant number of IHC-SN patients had a macrometastasis identified at ALND. In patients not undergoing dissection, axillary recurrence was a rare event. However, failure to identify additional metastases by omitting ALND may result in understaging and inadequate systemic treatment in some patients. [Table: see text] No significant financial relationships to disclose.

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