Risk profile for antiangiogenic agent-related osteonecrosis of the jaws

Caminha, Raquel D’Aquino Garcia; Chicrala, Gabriela Moura; Júnior, Luiz Alberto Valente Soares; Santos, Paulo Sérgio da Silva

doi:10.31744/einstein_journal/2019rw4628

Cited by 7 publications

(12 citation statements)

References 25 publications

(191 reference statements)

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“…Additionally, the osteonecrosis of the jaw was reported in patients with angiogenesis inhibitors administration. 5 , 6 , 10 In this nation-wide questionnaire survey, the dental treatment-related complications was observed in 79 patients with angiogenesis inhibitors, although the precise prevalence of these complications remains unclear. Among 79 patients, 58 patients were received anti-VEGF monoclonal antibody, bevacizumab.…”

Section: Discussionmentioning

confidence: 97%

“…In a meta-analysis of the anti-angiogenic agent-related osteonecrosis of the jaws, since tooth extraction was seen in 50% of cases as triggering factors, invasive dental procedures such as tooth extraction was one of the major risk factors for onset of angiogenesis inhibitors-related osteonecrosis of the jaws. 6 In a previous report, the extraction of tooth with pre-existing local inflammation was reported a risk of medication-related osteonecrosis of the jaws after tooth extraction. 15 In this study, since the causes of dental treatments were mainly marginal periodontitis, apical periodontitis, and root fracture, pre-existing local inflammation might be also one of risk factors for anti-angiogenesis related osteonecrosis of the jaws after tooth extraction.…”

Section: Discussionmentioning

confidence: 97%

“… 1 However, in the review of the anti-angiogenic agent-related osteonecrosis of the jaws, bevacizumab was most commonly found in 58% in cases. 6 Bevacizumab prevents VEGF to bind onto endothelial cells, which results in antiangiogenetic effects. 6 On the other hands, VEGF has been reported to have important roles in wound healing processes with the regulation of angiogenesis, the improvements of re-epithelization, and collagen deposition.…”

Section: Discussionmentioning

confidence: 99%

“… 6 Bevacizumab prevents VEGF to bind onto endothelial cells, which results in antiangiogenetic effects. 6 On the other hands, VEGF has been reported to have important roles in wound healing processes with the regulation of angiogenesis, the improvements of re-epithelization, and collagen deposition. 11 , 12 Since the VEGF exists also in the saliva, it has the important roles in cell repairing and wound healing of oral mucosa.…”

Section: Discussionmentioning

confidence: 99%

“… 3 , 4 Regarding oral adverse events, various clinical symptoms were reported such as mucositis, gingival bleeding, osteonecrosis of the jaw, and dysgeusia, etc. 1 , 5 , 6 …”

Section: Introductionmentioning

confidence: 99%

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Questionnaire survey of angiogenesis inhibitor-related oral complications based on a nation-wide study in Japan

Yamada

Kitamura

Tanaka

et al. 2021

Journal of Dental Sciences

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Background/purpose The prevalence of oral adverse events and dental treatments related complications during the molecular targeted drugs therapy remains unclear. The purpose of this study was to investigate the contents of dental treatment-related complications in Japanese patients during molecular targeted therapy. Materials and methods The nation-wide survey of dental treatment related complications was performed by the Japanese Society of Dentistry for Medically Compromised Patient as retrospective cohort study. Results Among 212 dentists, 87.3% recognized the possibility of dental treatments related complications in patients with angiogenesis inhibitors. The oral adverse events including dental treatment-related complications associated with angiogenesis inhibitors were 79 cases. In patients with angiogenesis inhibitors, 73.4% of patients were administrated with bevacizumab. The average administration period of angiogenesis inhibitors was 14.0 ± 10.0 months. As the dental treatment related complications, delayed wound healing was most commonly seen in 45 patients (57.0%), followed by osteonecrosis of the jaw in 25 (31.6%). The triggered factor of complications was tooth extraction in 51 cases (96.2%). Conclusion The extraction of the tooth with pre-existing inflammation may be suggested as one of risk factors for angiogenesis inhibitor-related dental treatment complications.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“… 3 , 4 Regarding oral adverse events, various clinical symptoms were reported such as mucositis, gingival bleeding, osteonecrosis of the jaw, and dysgeusia, etc. 1 , 5 , 6 …”

Section: Introductionmentioning

confidence: 99%

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Questionnaire survey of angiogenesis inhibitor-related oral complications based on a nation-wide study in Japan

Yamada

Kitamura

Tanaka

et al. 2021

Journal of Dental Sciences

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Emerging antiresorptive medications and their potential implications for dental surgeries

Aminoshariae¹,

Donaldson²,

Horan³

et al. 2022

The Journal of the American Dental Association

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Bone Morphogenetic Protein 2 Plus Leukocyte and Platelet-Rich Fibrin for the Treatment of MRONJ

Moraes-da-Silva

Maluf

Rubira-Bullen

et al. 2022

Journal of Craniofacial Surgery

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dilated vascular channels with walls that are difficult to distinguish from the intervascular smooth muscle), with the solid type being the most common (67%). However, among angioleiomyomas limited to the head and neck region, the venous type is the most common. In the 2 cases described here, both patients were diagnosed with venous type angioleiomyoma. We presume that the tunica media of the STA had abnormally proliferated with thick muscular walls of varying size, because the tumor was directly linked to the STA. To the best of our knowledge, only 1 previous report has described a case of angioleiomyoma of the parotid gland, fed by the STA. 3 Clinically, angioleiomyoma usually presents as a painful, gradually growing mass. Tumors that present with pain are most frequently solid and occur in the extremities, whereas tumors in the head and neck region usually present without pain. 3,4,8 In the cases described here, both patients experienced no mass-related symptoms, including pain, but had insight regarding the growing mass. Parotid gland tumor accounts for ~3%-6% of all head and neck tumors, and is diagnosed according to clinical presentation, physical examination, radiological assessment, and FNA cytology. 1,2 However, preoperative diagnosis of head and neck angioleiomyoma is challenging because of its rarity and lack of definite radiological features. The radiological features detected by ultrasound, CT, and magnetic resonance imaging have several similarities with those of lipoma and vascular tumors. 3,10 Moreover, preoperative diagnostic FNA cytology does not provide sufficient clues, and can occasionally lead to a misdiagnosis of hemangioma or schwannoma. 3,10 Only total surgical excision followed by histological examination can fulfill the requirement for final diagnosis. Immunohistochemical stains for SMA, myosin, and desmin are useful for diagnosis, and CD34 and S100 protein are used to differentiate other types of spindle cell tumors. 3,10 In most cases, angioleiomyoma can be treated by simple total resection. It is usually possible to resect the mass without difficulty because the tumor is typically well encapsulated. In the 2 cases described here, the STA was completely ligated to prevent recurrence and to enable easy detachment of the tumor from the surrounding tissue. CONCLUSIONWe report 2 cases of very rare angioleiomyoma discovered in the parotid gland, with the STA as the feeding vessel. It is difficult to make a certain diagnosis of angioleiomyoma with conventional preoperative diagnostic tools. Once a parotid tumor is discovered, although rare, the possibility of angioleiomyoma should be considered, and we recommend prompt surgical excision for accurate diagnosis and treatment.

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Risk profile for antiangiogenic agent-related osteonecrosis of the jaws

Cited by 7 publications

References 25 publications

Questionnaire survey of angiogenesis inhibitor-related oral complications based on a nation-wide study in Japan

Questionnaire survey of angiogenesis inhibitor-related oral complications based on a nation-wide study in Japan

Emerging antiresorptive medications and their potential implications for dental surgeries

Bone Morphogenetic Protein 2 Plus Leukocyte and Platelet-Rich Fibrin for the Treatment of MRONJ

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