Do measurements of inflammatory mediators in blood predict recurrence in patients with bisphosphonate-related osteonecrosis of the jaws?

Mücke, Thomas; Jung, Maximilian; Mitchell, David A.; Wolff, Klaus‐Dietrich; Wagenpfeil, Stefan; Stockmann, Philipp; Kesting, Marco; Deppe, Herbert

doi:10.1016/j.bjoms.2016.01.009

Cited by 4 publications

(2 citation statements)

References 23 publications

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“…12 Large and hypernucleated osteoclasts can be found in patients on long-term therapy with bisphosphonates, 11 and the intertrabecular spaces are infiltrated by inflammatory cells including neutrophils, lymphocytes, and plasma cells. [14][15][16] Vessels in the specimen are scarce in MRONJ cases due to the anti-angiogenetic effect. 17…”

Section: Definition Of Medication-related Osteonecrosis Of the Jawmentioning

confidence: 99%

“…20 Techniques using local tissue in conjunction with a standardized routine conservative treatment (antibiotics, mouth rinse, omit dentures, soft diet, or in some extensive cases nasogastric tube) are of value. 70 It is recognized that the risk of more extensive and refractory progression of BRONJ increases 13,14,18,20,23,62,71 when BRONJ recurs after initial conservative treatment or local debridement. Because recurrence has been shown to be of prognostic value in relation to the development of complications, 20,72 a more radical single treatment early on in a selected subset of patients should be considered rather than repeated unsuccessful debridements.…”

Section: Therapymentioning

confidence: 99%

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Bisphosphonate and Medication-Related Osteonecrosis of the Jaw: A Review

Mücke

Krestan

Mitchell

et al. 2016

Semin Musculoskelet Radiol

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For patients with malignant disease taking bisphosphonates and denosumab, the incidence of medication-related osteonecrosis of the jaw (MRONJ) is up to 15% in contrast to 0.01% in patients with osteoporosis. Clinical presentation of MRONJ extends from asymptomatic exposure of bone in 94% of patients to severe cases of mandibular fractures in a minority of 4.5%. The strongest risk factors for MRONJ are invasive dental procedures and dental infections. Advances in imaging provide more preoperation information compared with panoramic radiograph. Prevention strategies are the elimination of potential risk factors leading to invasive dental procedures and maintenance of good oral hygiene prior to the administration of antiresorptive agents. Management of MRONJ depends on the underlying disease, extent of the necrosis, and the presence of contributing therapy. Conservative therapies include topical anti-infective rinses and systemic antibiotic therapy. The most important part of surgical therapy is to remove the exposed and necrotic bone. Several options for defect closure are possible from local tissue flaps to microvascular free flap procedures. The development of MRONJ in conjunction with dental implants is a severe side effect and should be avoided if potentially harmful medication has already been administered.

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Section: Definition Of Medication-related Osteonecrosis Of the Jawmentioning

confidence: 99%

Section: Therapymentioning

confidence: 99%

Bisphosphonate and Medication-Related Osteonecrosis of the Jaw: A Review

Mücke

Krestan

Mitchell

et al. 2016

Semin Musculoskelet Radiol

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Association between biomarkers and medication-related osteonecrosis of the jaws: a systematic review

Moraschini

Almeida²,

Figueredo

et al. 2019

Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology

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Objectives: Our aim was to conduct a systematic review (SR) of the literature assessing the role of human biomarkers in the diagnosis or prognostication of medication-related osteonecrosis of the jaws (MRONJ). prospective or retrospective cohorts, case controls, and case series evaluating the association between biomarkers and MRONJ. The protocol of this SR was registered in PROSPERO under number CRD42018095886. Results:The search and selection process yielded 19 studies (2 case series, 6 case-control studies, 9 prospective cohort studies and 2 retrospective studies) published between 2008 and 2018. Twenty-four biomarkers collected from serum, saliva, and urine were investigated by these studies. Eleven biomarkers were possibly related to MRONJ; however, no consensus is observed in the literature in regard to the sensitivity and clinical effectiveness of these biomarkers. ACCEPTED MANUSCRIPT A C C E P T E D M A N U S C R I P T3 Conclusion: While many biomarkers have been associated with MRONJ, the present SR found scarce clinical evidence supporting the use of these biomarkers for the diagnosis and prognosis of MRONJ.

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Full blood counts are not predictive of the risk of medication-related osteonecrosis of the jaws: a case-control study

McGowan

Ware

Acton

et al. 2019

Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology

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Objectives. The role of immune function in susceptibility to medication-related osteonecrosis of the jaws (MRONJ) remains unclear. This study investigated whether full blood counts, as a measure of systemic health and immune function, predict the development of MRONJ. Study Design. A case-control study was conducted in Brisbane, Australia. A total of 57 cases diagnosed with MRONJ from January 2010 to March 2017 were identified from hospital records and individually matched with up to 4 controls using primary disease, sex, age, and antiresorptive therapy (total sample = 249). Demographic and clinical data were extracted and associations were investigated using conditional logistic regression. Results. A total of 67% of cases and 65% of controls reported at least 1 result outside of the laboratory reference range (odds ratio = 0.7; 95% confidence interval: 0.3, 1.5; P = .29). The most commonly reported abnormal results were low hemoglobin (53% of cases, 48% of controls) and low hematocrit (33% of cases, 25% of controls). There were no significant differences between groups in any of the reported parameters. Conclusions. Patients taking antiresorptive medications often return blood test results outside the standard laboratory reference range. Altered blood counts were not limited to patients who developed MRONJ and do not appear to be clinically useful in identifying patients at high risk for this condition. (Oral Surg Oral Med Oral Pathol Oral Radiol 2019;000:1À8) K. McGowan has received a speaker honorarium from Eli Lilly.

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Do measurements of inflammatory mediators in blood predict recurrence in patients with bisphosphonate-related osteonecrosis of the jaws?

Cited by 4 publications

References 23 publications

Bisphosphonate and Medication-Related Osteonecrosis of the Jaw: A Review

Bisphosphonate and Medication-Related Osteonecrosis of the Jaw: A Review

Association between biomarkers and medication-related osteonecrosis of the jaws: a systematic review

Full blood counts are not predictive of the risk of medication-related osteonecrosis of the jaws: a case-control study

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