A Case of SAPHO Syndrome with Endodontic Implications and Treatment with Biologic Drugs

Cotti, Elisabetta; Careddu, Roberto; Schirru, Elia; Marongiu, Silvia; Barca, Maria Pina; Manconi, Paolo Emilio; Mercuro, Giuseppe

doi:10.1016/j.joen.2015.04.005

Cited by 17 publications

(8 citation statements)

References 41 publications

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“…The only non‐randomized clinical study coherent with the question, showed that patients affected by RA, under anti‐TNF‐α therapy and non‐surgical periodontal treatment had a better improvement of periodontitis when compared with patients not taking BMs, or who had received periodontal treatment alone . In a documented case the synergism between an anti‐TNF‐α treatment and endodontic retreatment was associated with rapid clinical and radiological healing of an endodontic lesion refractory to the previous procedures, finding that was confirmed in a further study by the group employing an experimental animal model …”

Section: Discussionmentioning

confidence: 83%

“…Quality of information in the In vivo animal studies was considered moderate in five articles and high in seven studies . The assessment of the case reports classified one article as a low quality; two articles as moderate, and four articles as high‐quality of information . Considering the high to moderate overall quality of the studies and the scarcity of studies investigating this topic, all the studies meeting the inclusion criteria were included in the present review to provide the best and most comprehensive evidence available.…”

Section: Resultsmentioning

confidence: 99%

“…This specific topic has been addressed in three articles, thus the information available to date is limited. In one case report, anti‐TNF‐α therapy was administered for newly diagnosed rheumatic disease in a patient who, at the same time, received a secondary endodontic treatment in a tooth diagnosed with persistent AP. This contemporary management resulted in a positive response both to the general disease and to the endodontic retreatment, with a rapid healing of AP.…”

Section: Resultsmentioning

confidence: 99%

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Interaction of biologic therapy with apical periodontitis and periodontitis: a systematic review

Peddis

Musu

Ideo

et al. 2019

Australian Dental Journal

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Biologic medications (BMs) are increasingly used for the management of systemic chronic inflammatory diseases. These diseases are often associated with a higher prevalence of apical periodontitis (AP) and periodontitis (P). The purpose of this systematic review was to ascertain the interactions between AP and/or P and BMs. The review was registered in the PROSPERO database (CRD42017054756). Electronic searches were performed on Pubmed Medline, Scopus and The Web of Science from their inception through to 20 March 2018. The references of the articles selected were checked. The keywords were chosen based on a pilot search, which aimed to find the most frequently prescribed BMs. The included studies were appraised qualitatively using appropriate tools. Thirty-five articles met the inclusion criteria, comprising 16 non-randomized clinical studies, 12 in vivo animal studies and 7 case reports. Quality of information was assessed as high in 18 articles, moderate in 16 articles and low in 1 article. BMs in patients suffering from chronic inflammatory diseases seems to inhibit the progression of AP and P, and to enhance the healing response to periodontal and endodontic treatment. A healthier condition of the periodontal tissues seems to be associated with a better response of the patient to BMs therapy.Abbreviations and acronyms: AP = apical periodontitis; BM = biologic medications; P = periodontitis; RANKL = receptor activator of nuclear factor kappa-Β ligand (RANKL).

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Section: Discussionmentioning

confidence: 83%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Interaction of biologic therapy with apical periodontitis and periodontitis: a systematic review

Peddis

Musu

Ideo

et al. 2019

Australian Dental Journal

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“…In our cohort, over one-third of the patients had received a dental procedure within 1 month before the onset of oral symptoms, suggesting a possible role for transient bacteraemia and tissue damage. A previous study reported the case of a woman who developed SAPHO syndrome and had mandibular involvement in the area corresponding to a tooth with recurrent caries [ 15 ]. Prevotella , a mucous bacterial genus found in chronic inflammatory disease, including periodontitis and rheumatoid arthritis [ 22 ], was found to regulate the inflammatory process in a mouse model of chronic multifocal osteomyelitis (CMO) (Pstpip2 cmo mice) [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

Mandibular involvement in SAPHO syndrome: a retrospective study

Wang

Cao

et al. 2020

Orphanet J Rare Dis

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Background Mandible osteomyelitis can occur in synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome, a rare chronic inflammatory disease; however, few studies have explored its characteristics and management. Methods We reviewed the medical records of consecutive SAPHO patients with mandible involvement diagnosed in Peking Union Medical College Hospital from September 2014 to July 2019. Demographic, clinical, laboratory, and imaging data were collected at baseline. Prescription data and follow-up magnetic resonance imaging (MRI) and cone beam computed tomography (CBCT) images were collected from the hospital information system. An electronic questionnaire was distributed to all patients to obtain their latest symptoms. Results A total of 26 SAPHO patients with mandibular involvement were involved, all of whom responded to the questionnaire (38.5% male; median age, 28 years; median follow-up duration, 2.1 years). Ten patients (38.5%) had undergone an oral procedure 1 month before the onset of mandibular symptoms. All 14 of the patients who underwent a surgical intervention relapsed within a median duration of 2 months (range 0.25–4.0 months), and 24 patients (92.3%) achieved improvement with conservative treatment. Following bisphosphonate treatment, remission of bone marrow oedema and osteolysis was observed on MRI and CBCT, and 5 patients receiving bisphosphonates with follow-up CBCT after remission did not relapse in 5.4 months (mean 6.0, range 3.2–9.9 months). Conclusion Mandibular involvement of SAPHO syndrome predominantly occurs in young women. Dental procedures are a possible risk factor. Conservative treatment, especially intravenous bisphosphonates, can lead to oral improvement.

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“…Although it could be expected that SAPHO is infrequently encountered in dental practice, 28 the attending clinician should be familiar with management strategies for oral and perioral allergic reactions.…”

Section: Discussionmentioning

confidence: 99%

Oral care of a patient with a SAPHO syndrome and a nickel allergy

Campana

Canceill

Esclassan

2019

Special Care in Dentistry

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SAPHO is an acronym for Synovitis, Acne, Pustulosis, Hyperostosis and Osteitis. The syndrome is difficult to diagnose because it may present many different manifestations in adults and children. Its origin is still unknown, although some infectious, genetic and immune hypotheses have been put forward. We report the case of a 49‐year‐old woman with SAPHO syndrome, who developed a serious cutaneous allergy following the insertion of a removable partial denture (RPD). The oral care and treatment of this patient are described.

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A Case of SAPHO Syndrome with Endodontic Implications and Treatment with Biologic Drugs

Cited by 17 publications

References 41 publications

Interaction of biologic therapy with apical periodontitis and periodontitis: a systematic review

Interaction of biologic therapy with apical periodontitis and periodontitis: a systematic review

Mandibular involvement in SAPHO syndrome: a retrospective study

Oral care of a patient with a SAPHO syndrome and a nickel allergy

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