Bisphosphonate-associated osteonecrosis can hide jaw metastases

Bedogni, Alberto; Saia, Giorgia; Ragazzo, M.; Bettini, Giordana; Capelli, Paola; D’Alessandro, Emiliano; Nocini, Pier Francesco; Russo, Lucio Lo; Muzio, Lorenzo Lo; Blandamura, Stella

doi:10.1016/j.bone.2007.08.025

Cited by 47 publications

(41 citation statements)

References 21 publications

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“…45 No agreement on a surgical versus non-surgical approach to therapy has been reached in the treatment of BRONJ. [46][47][48][49] Some recommendations focus on prevention and a conservative approach. 19,25,27,50 Treatment strategies include the administration of antibiotics, oral antibacterial mouth rinse, cessation of BPs if possible, pain control, surgical debridement or resection for long-term palliation of infection and pain, 23,50 sequential removal of sequestrum (extensive involvement may necessitate a large area of debridement to include a segmental mandibulectomy and partial maxillectomy 23 ), mandibular reconstruction with the fibula flap, 51 and covering the exposed areas with tissue flaps.…”

mentioning

confidence: 99%

Treatment strategies and outcomes of bisphosphonate-related osteonecrosis of the jaw (BRONJ) with characterization of patients: a systematic review

Fliefel

Tröltzsch

Kühnisch

et al. 2015

International Journal of Oral and Maxillofacial Surgery

293

213

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mentioning

confidence: 99%

Treatment strategies and outcomes of bisphosphonate-related osteonecrosis of the jaw (BRONJ) with characterization of patients: a systematic review

Fliefel

Tröltzsch

Kühnisch

et al. 2015

International Journal of Oral and Maxillofacial Surgery

293

213

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“…3 However, the two pathologies can occur simultaneously within the same tissue and osteonecrosis can mask underlying cancerous involvement of bony tissue. 4 In our patient, the lack of pain, good response to systemic chemotherapy and characteristic radiological findings provide support for osteonecrotic rather than cancerous destruction of the infraorbital bone. Further, the patient subsequently developed osteonecrosis in the buccal area.…”

Section: Commentmentioning

confidence: 83%

Bisphosphonate-induced Osteonecrosis of the Maxilla Presenting as a Cicatricial Ectropion

Malik

Fernando

Laitt

et al. 2014

Orbit

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A 63-year-old gentleman, who was being treated with bisphosphonates for multiple myeloma, presented with a cicatricial ectropion of the lower eyelid, without exposure keratopathy. A CT scan demonstrated extensive destruction of bone with an infraorbital fracture surrounded by sclerotic bony changes. The patient was managed conservatively with discontinuation of bisphosphonate therapy and topical ocular lubricants. The patient's condition remained unchanged a year after this initial management.

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“…Tumor cells were found in noncontiguous areas of the tissue [Bedogni et al, 2007]. Solid tumor metastasis to the jaws is not frequent but does occur at an incidence of 1% [Keller and Gunderson, 1987].…”

Section: Metastasismentioning

confidence: 97%

Osteonecrosis of the Jaw: An Update and Review of Recommendations

Novince

Ward

McCauley

2008

Cells Tissues Organs

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Bisphosphonates have had a very positive impact as therapeutic agents for cancer and osteoporosis, but have also been associated with osteonecrosis of the jaw (ONJ) which has emerged as an idiosyncratic oral complication. Bisphosphonate-associated ONJ has generated wide attention despite its considerably rare occurrence. Many speculations exist as to why bisphosphonates may increase the incidence of ONJ. The American Society for Bone and Mineral Research established a task force on bisphosphonate-associated ONJ and recently released a summary report of their findings. A case definition delineated a confirmed case of ONJ as ‘an area of exposed bone in the maxillofacial region that did not heal within 8 weeks after identification by a health care provider, in a patient who was receiving or had been exposed to a bisphosphonate and had not had radiation therapy to the craniofacial region’. Treatment recommendations have been developed by the American Dental Association, the American Association of Oral and Maxillofacial Surgeons and the American Society for Bone and Mineral Research. Considering the scientific evidence, little is known about the true incidence and pathophysiology, and many questions persist. New epidemiologic studies are surfacing and attempts to ameliorate the condition may shed light on the likely complex etiology. The bones of the oral cavity provide a unique environment relative to blood flow, oral microbiota, bone structure and function. Although little is known of the mechanisms and course of ONJ, even less is known about the spectrum of issues of altered healing that could fall short of defined ONJ.

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Bisphosphonate-associated osteonecrosis can hide jaw metastases

Cited by 47 publications

References 21 publications

Treatment strategies and outcomes of bisphosphonate-related osteonecrosis of the jaw (BRONJ) with characterization of patients: a systematic review

Treatment strategies and outcomes of bisphosphonate-related osteonecrosis of the jaw (BRONJ) with characterization of patients: a systematic review

Bisphosphonate-induced Osteonecrosis of the Maxilla Presenting as a Cicatricial Ectropion

Osteonecrosis of the Jaw: An Update and Review of Recommendations

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