Preventive dental management of osteonecrosis of the jaws related to zoledronic acid treatment

Coello-Suanzes, J A; Rollon-Ugalde, V; Castaño-Séiquer, Antonio; Lledo-Villar, E; Herce-Lopez, Javier; Infante-Cossio, Pedro; Mayordomo, Ángel Rollón

doi:10.1111/odi.12842

Cited by 11 publications

(11 citation statements)

References 30 publications

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“…The results therefore suggest that nonrestorable teeth and those with poor prognosis should be extracted before the development of inflammation and should not be postponed in cancer patients receiving high‐dose BP and DS. The observations differ from the results reported by Coello‐Suanzes et al (2018), who could not describe connections between MRONJ and periodontal infection. However, in a Swedish prospective study with a 4‐year follow‐up, Hallmer et al (2018) indicated that pre‐existing inflammatory dental disease such as periodontal disease or periapical pathology is a well‐recognized risk factor, assessed as the initiating factor for the development of MRONJ in 18% and 4% of the cases, respectively.…”

Section: Discussioncontrasting

confidence: 99%

Incidence and risk factors for medication‐related osteonecrosis after tooth extraction in cancer patients—A systematic review

Schwech

Nilsson

Gabre

2022

Clinical & Exp Dental Res

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Objectives: Antiresorptive medication has been reported to be associated with medication-related osteonecrosis of the jaw (MRONJ). This systematic review aims at investigating the incidence of and risk factors for MRONJ after tooth extractions in cancer patients treated with high-dose bisphosphonate and denosumab (BP and DS).Material and Methods: The protocol followed the PRISMA statement list and was registered in PROSPERO. Searches were performed for literature published up to April 2021 in the electronic databases PubMed, Embase, Web of Science, and CINAHL and then supplemented by manual research. Results:The search process resulted in 771 identified articles, of which seven studies fitted the population, intervention, comparison, and outcome framework. All were observational studies and four had control groups. A total of 550 patients treated with BP and DS were identified of whom 271 had received tooth extractions after medication onset. Due to significant heterogenicity in the collected data, only a qualitative analysis was performed. The MRONJ incidence after tooth extractions varied between 11% and 50% at the patient level. MRONJ occurred up to 3 years after the tooth extraction. Teeth affected by inflammation before the extraction and additional osteotomy during the surgical procedure were identified as risk factors.Conclusions: Reliable methods of diagnosing MRONJ and adequate follow-up periods are important factors in obtaining the actual incidence of MRONJ after tooth extractions in patients treated with high-dose BP and DS.

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Section: Discussioncontrasting

confidence: 99%

Incidence and risk factors for medication‐related osteonecrosis after tooth extraction in cancer patients—A systematic review

Schwech

Nilsson

Gabre

2022

Clinical & Exp Dental Res

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“…Bifosfonatlar ise osteoporoz, malign tümörlerin osteolitik kemik metastazları, malign tümörlerin neden olduğu hiperkalsemi ve Paget's hastalığı varlığında kullanılırlar (4,5,6,7,8). Bu grup ilaçlar ise kemik osteoklastik aktivitesini ve kemik döngüsünü baskılayarak etki gösterirler (9). Her iki grup ilacın faydalarının yanında, çene kemiklerinde osteonekroza neden olmak gibi kötü bir yan etkileri de vardır.…”

Section: Bifosfonat Kullanımına Bağlı çEne Kemiklerinde Görülen Osteounclassified

Bi̇fosfonat Kullanimina Bağli Çene Kemi̇kleri̇nde Görülen Osteonekroz Vakalarinin Medi̇kal Ve Cerrahi̇ Tedavi̇leri̇ Sonrasi Uzun Dönem Taki̇pleri̇

ERDEM¹,

GÜMÜŞER²

2020

Atatürk Üniversitesi Diş Hekimliği Fakültesi Dergisi

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Bu çalışman amacı bifosfonata bağlı çene kemiğinin osteonekrozu (Bisphosphonate Related Osteonecrosis of the Jaws *BRONJ+) tanısı konmuş hastaların, yapılan medikal ve cerrahi tedavileri sonrasında tedavilerinin başarısını görmek ve uzun dönem takibin önemini vurgulamaktır. Gereç ve Yöntem: BRONJ tanısı konulmuş, altısı kadın ikisi erkek olmak üzere 8 hastanın ilaç ve cerrahi tedavileri ve uzun dönem klinik ve radyolojik takip sonuçları değerlendirilmiştir. Ruggiero ve arkadaşlarının oluşturduğu evrelendirmeye göre vakalar evrelendirilmiş ve tedavileri yapılmıştır. Hastaların üçü osteoporoz (biri intravenöz, ikisi oral yoldan), kalan beşi malignite (intravenöz yoldan) nedeneniyle bifosfonat kullanmaktadır. Bulgular: Hastalar 8 ila 43 ay arasında değişen, ortalama 23.8 aylık süreyle bifosfonat grubu ilaç almışlardır. Hastaların ortalama yaşları 61.2 ve tedavi sonrası ortalama takip süreleri ise 12.5 aydır. , 8 vakanın beşi evre 3, diğer üçü ise evre 2 olarak değerlendirilmiştir. Evre 3 hastaların hiçbirinde, medikal ve cerrahi tedavi sonrası belirtilen takip süresince klinik ve radyolojik olarak BRONJ rekürrensi görülmemiştir. Evre 2 vakalarda ise ilaç tedavisi sonrası hastalık semptomatik olarak kontrol altına alınmıştır. Sonuç : Sonuç olarak uygulanan bu tedavi protokolü ve bu çalışmaya dahil edilen vakalardan elde edilen veriler, cerrahi tedavinin gerektiğinde uygun zamanda yapılmasının önemini güçlendirmiştir. Ayrıca hiperbarik oksijen tedavisinin BRONJ vakalarında yardımcı tedavi yöntemlerinden biri olarak düşünülebileceği söylenebilir. Bifosfonat kullanım nedenleri hastaların cerrahi ya da medikal yolla tedavi edilmelerinde direkt olarak etkili olmamıştır. Anahtar kelimeler: bifosfonat, çene osteonekrozu, hiperbarik oksijen tedavisi Long term follow up of patients with bisphosphonate related osteonecrosis of the jaws after medical and surgical treatment.

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“…Studies in animal models have reported that ZA suppresses bone remodelling and increases peri‐implant bone loss, which results in dental implant failures and the development of BRONJ lesions (Davison et al., 2020; Kniha et al., 2020). Furthermore, in most clinical cases, BRONJ can be triggered by the oral wounds during the surgical procedures, such as tooth extractions, periodontal disease and pressure denture sores (Coello‐Suanzes et al., 2018; Walter et al., 2007). As BRONJ cases in relation to dental implant were frequently reported (Bedogni et al., 2010; Fliefel et al., 2015; Kasai et al., 2009; Starck & Epker, 1995), more and more researchers proposed that dental implant therapy could be an risk factor for BRONJ (Kuroshima et al., 2019; Kwon et al., 2014; Mendes et al., 2019; Schmitt et al., 2018).…”

Section: Introductionmentioning

confidence: 99%

Titanium implant alters the effect of zoledronic acid on the behaviour of endothelial cells

Liang

et al. 2021

Oral Diseases

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Objectives To evaluate the effect of zoledronic acid (ZA) on human umbilical vein endothelial cells (HUVECs) attached to different surfaces. Materials and Methods A total of three groups were evaluated in this study: sandblasting and acid etching (SLA) + HUVECs; mechanically polished (MP) + HUVECs; and plastic cell culture plates + HUVECs. Scanning electron microscopy, energy‐dispersive X‐ray spectroscopy, surface roughness and water contact angle were tested for titanium surface characterisation. ZA was added at different concentrations (0, 1, 10, 50 and 100 μM). Cell adhesion, proliferation, viability, apoptosis and gene expression were evaluated. Results Mechanically polished and SLA surfaces showed negative effects on cell adhesion and proliferation and promoted cell apoptosis with 100 μM ZA (p < .05). The highest expression of intercellular adhesion molecule‐1 (ICAM‐1) and angiopoietin‐1 was found on SLA surfaces (p < .01). The lowest expression of platelet‐endothelial cell adhesion molecule‐1 and ICAM‐1 was found on MP surfaces (p < .05). A significant decrease in von Willebrand factor was detected on MP and SLA surfaces (p < .001). Conclusions Zoledronic acid has an anti‐angiogenic effect on HUVECs attached to titanium implants, while the SLA surface might stimulate HUVECs to express angiogenic and adhesive factor genes despite ZA treatment.

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Preventive dental management of osteonecrosis of the jaws related to zoledronic acid treatment

Abstract: BRONJ occurred significantly in patients who underwent dental extractions after the initiation of ZA and did not accomplish a preventive dental program.

Cited by 11 publications

References 30 publications

Incidence and risk factors for medication‐related osteonecrosis after tooth extraction in cancer patients—A systematic review

Incidence and risk factors for medication‐related osteonecrosis after tooth extraction in cancer patients—A systematic review

Bi̇fosfonat Kullanimina Bağli Çene Kemi̇kleri̇nde Görülen Osteonekroz Vakalarinin Medi̇kal Ve Cerrahi̇ Tedavi̇leri̇ Sonrasi Uzun Dönem Taki̇pleri̇

Titanium implant alters the effect of zoledronic acid on the behaviour of endothelial cells

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