Clinical profile of individuals with bisphosphonate-related osteonecrosis of the jaw: an integrative review

Maciel, Aloizio Premoli; Quispe, Reyna Aguilar; Martins, Lázara Joyce Oliveira; Caldas, Rogério Jardim; Santos, Paulo Sérgio da Silva

doi:10.1590/1516-3180.2019.0352.r2.15052020

Cited by 8 publications

(4 citation statements)

References 52 publications

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“…Os bisfosfonatos representam uma classe de medicamentos amplamente empregados desde 1960 em pacientes com doenças ósseas, como osteoporose e doença de Paget, ou neoplasias malignas, como câncer de mama ou próstata (Sales & Conceição, 2020). Sendo estes, indicados com o objetivo de prevenir metástases ósseas, neoplasias ósseas ou como tratamento de osteoporose (Oliveira et al, 2021;Eguia et al, 2020;Maciel et al, 2020).…”

Section: Resultados Discussãounclassified

Uma alternativa de exodontia minimamente traumática em pacientes que fazem uso de bisfosfonatos

Ribeiro

Alencar

2022

RSD

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Majoritariamente empregados na terapêutica de indivíduos portadores de neoplasias malignas, ou doenças ósseas, o grupo dos bisfosfonatos, cujo mecanismo está relacionado às propriedades antiosteoclásticas, promovem alterações na capacidade de remodelação óssea, gerando a ocorrência de um quadro de manejo desafiador: a osteonecrose dos maxilares. O presente estudo tem como objetivo de expor uma alternativa de manejo minimamente traumático de exodontia, com o fim de evitar a osteonecrose dos maxilares associada ao uso desta classe de medicamentos. Trata-se de uma revisão de literatura realizada através da seleção de artigos disponíveis nas bases de dados PubMed, LILACS e Google Acadêmico, publicados entre 2008 e 2021 nas línguas inglesa e portuguesa. A literatura aponta que a ocorrência da osteonecrose dos maxilares está relacionada com a via de administração, tempo do tratamento e a dosagem do bisfosfonato, sendo a via endovenosa a mais associada com esta condição devido a sua rápida absorção pela estrutura óssea, que é uma via amplamente utilizada em pacientes submetidos ao tratamento quimioterápico, destacando procedimentos de extração dentária como o principal desencadeador desta condição. Tomando por base que este quadro ocorre principalmente devido à manipulação óssea em procedimentos de cirurgias bucais, ressalta-se a importância de um manejo conservador para que a osteonecrose dos maxilares seja evitada, sendo a esfoliação dentária com elásticos ortodônticos uma opção viável e com resultados satisfatórios descritos pela literatura.

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Section: Resultados Discussãounclassified

Uma alternativa de exodontia minimamente traumática em pacientes que fazem uso de bisfosfonatos

Ribeiro

Alencar

2022

RSD

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“…The patients' features are also important: immunodeficiency, comorbidities such as diabetes as well as the presence of autoimmune diseases have been suggested as risk factors for ONJ [15]. The local triggering factors were examined in a recent review: tooth extraction was reckoned in 46% of individuals, implant placement in 14%, prosthetic trauma in 14% [16].…”

Section: Clinical and Genetic Risk Factors For Onjmentioning

confidence: 99%

Medication-Related Osteonecrosis of the Jaw (MRONJ): Are Antiresorptive Drugs the Main Culprits or Only Accomplices? The Triggering Role of Vitamin D Deficiency

2021

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Osteonecrosis of the jaw (ONJ) is a severe clinical condition characterized mostly but not exclusively by an area of exposed bone in the mandible and/or maxilla that typically does not heal over a period of 6–8 weeks. The diagnosis is first of all clinical, but an imaging feedback such as Magnetic Resonance is essential to confirm clinical suspicions. In the last few decades, medication-related osteonecrosis of the jaw (MRONJ) has been widely discussed. From the first case reported in 2003, many case series and reviews have appeared in the scientific literature. Almost all papers concerning this topic conclude that bisphosphonates (BPs) can induce this severe clinical condition, particularly in cancer patients. Nevertheless, the exact mechanism by which amino-BPs would be responsible for ONJ is still debatable. Recent findings suggest a possible alternative explanation for BPs role in this pattern. In the present work we discuss how a condition of osteomalacia and low vitamin D levels might be determinant factors.

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“…Currently, the first‐line prescription treatment for osteoporosis is bisphosphonates, which act by binding the mineral component of bone and inhibit the action of osteoclasts (Khosla & Hofbauer, 2017). Despite their remarkable effects on bone volume improvement, side effects such as osteonecrosis of jaw and atypical femur fractures limit bisphosphonates application in clinic (Maciel et al., 2020). Therefore, effective treatment of mandible osteoporosis is still an important clinic need.…”

Section: Introductionmentioning

confidence: 99%

Amniotic membrane mesenchymal stem cells‐based therapy improves Bmi‐1‐deficient mandible osteoporosis through stimulating osteoblastic bone formation and inhibiting osteoclastic bone resorption

Yin

Wang

Xie

et al. 2022

J Tissue Eng Regen Med

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Mandible osteoporosis with age is characterized by greater fragility and accompanied with abnormal oral function. Mesenchymal stem cell transplantation can ameliorate osteoporosis. Bmi‐1 is a transcriptional repressor which is an important regulator of cell cycle, stem cells self‐renewal, and cell senescence. Here, we use a new kind of membrane mesenchymal stem cells (MSCs), amniotic membrane mesenchymal stem cells (AMSCs), to explore therapeutic effects on Bmi‐1‐deficient caused mandible osteoporosis. Phenotypes of mandibles from 5‐week‐old Bmi‐1‐deficient mice with AMSCs‐based therapy were compared with age‐matched Bmi‐1‐deficient mandibles without AMSCs‐based therapy and wild‐type mice. Bmi‐1‐deficient mice without AMSCs‐based therapy displayed mandible osteoporosis accompanied with the rising senescence‐associated molecules and imbalance redox homeostasis. Results showed that the alveolar bone volume, cortical thickness, type I collagen and osteocalcin immunopositive areas, mRNA expression levels of alkaline phosphatase, superoxide dismutase, gluathione reductase, and protein expression level of Runx2 were all reduced significantly in Bmi‐1−/− mandibles. Protein levels of PPARγ, p16, p21, p53, and redox gene levels of Bnip3l, Cdo1, Duox1, and Duox2 were up‐regulated in mandibles from vehicle‐transplanted Bmi‐1−/− mice. Also, osteoclasts were activated in Bmi‐1−/− alveolar bone. Transplanted AMSCs migrated into mandibles and improved all the parameters in Bmi‐1−/− mandibles with AMSCs‐based therapy. These findings indicate that AMSCs‐based therapy could rescue mandible osteoporosis induced by Bmi‐1 deficiency through stimulating osteoblastic bone formation and inhibiting osteoclastic bone resorption. Our findings implied that AMSCs‐based therapy had preventative and therapeutic potential for mandible osteoporosis.

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Clinical profile of individuals with bisphosphonate-related osteonecrosis of the jaw: an integrative review

Abstract: Osteonecrosis of the jaw. Medication-related osteonecrosis of the jaw. Neoplasm metastasis therapy. Diagnosis and management of osteonecrosis of the jaw. Drug-induced osteonecrosis of the jaw.

Cited by 8 publications

References 52 publications

Uma alternativa de exodontia minimamente traumática em pacientes que fazem uso de bisfosfonatos

Uma alternativa de exodontia minimamente traumática em pacientes que fazem uso de bisfosfonatos

Medication-Related Osteonecrosis of the Jaw (MRONJ): Are Antiresorptive Drugs the Main Culprits or Only Accomplices? The Triggering Role of Vitamin D Deficiency

Amniotic membrane mesenchymal stem cells‐based therapy improves Bmi‐1‐deficient mandible osteoporosis through stimulating osteoblastic bone formation and inhibiting osteoclastic bone resorption

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