The outcomes of conservative and surgical treatment of stage 2 bisphosphonate-related osteonecrosis of the jaws: a case series

Jabbour, Zaher; El-Hakim, Michel; Mesbah-Ardakani, P.; Henderson, Janet E.; Albuquerque, Rubens Ferreira de

doi:10.1016/j.ijom.2012.05.012

Cited by 28 publications

(32 citation statements)

References 30 publications

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“…for the patients with implants,in 1 case Z & P4n.s.n.s.n.s.n.s.RS with 119 ONJ patients, 4 due to dental implantsDentureAuthor Year ReferenceStudy typePatientsPrimary Disease in BP-ONJBP/DenosumabBP-ONJ CasesComment Nibbe 2015 [15]RS424 patients with oral/IV BP or denosumab.128 patients with IV BP or denosumab - further investigation of this group68 patients with denturesn.s. in all casesOral/IV BPDenosumab16424 patients with oral or IV BP were analyzed, 21 BP-ONJ, only IV BP patients for further analysis34 removable dentures → 11 BP-ONJ34 fixed partial denture → 5 BP-ONJ60 patients without denture → 5 BP-ONJONJ only in patients with IV BP or denosumab Hasegawa 2012 [43]RSQuestionnaire was sent to 248 medical institutions regarding BP-ONJ250 patients99 with dentures151 without denturesn.s.Oral/IV BP99151 osteonecrosis patients without denture had a longer osteonecrosis free time.Most ONJ in the mandible with a focus on the premolar and molar region154 patients with IV BP, 102 with oral BP, 7 both Jabbour 2012 [35]RS14 patients with BP-ONJ4 due to denturesOsteoporosis 2kidney cancer 1breast cancer 1A P4RS analyzing the reason for osteonecroses Vahtsevanos 2009 [39]RS1,621 patients with IV BPn.s.n.s. for the denture patients2424 out of 80 BP-ONJ patients denture as triggering factor diseases and BP for the patients with dentures n.s.…”

Section: Resultsmentioning

confidence: 99%

Dental implants in patients treated with antiresorptive medication – a systematic literature review

et al. 2016

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ObjectiveBisphosphonate-associated osteonecrosis of the jaws (BP-ONJ) is triggered by inflammatory processes. Typical trigger factors are periodontal disease, denture pressure sores, and surgical interventions such as tooth extractions. Unfortunately there is only little data on how to proceed with implant therapy in patients with bisphosphonate treatment. This topic is not addressed in the German guidelines on medication-associated osteonecrosis. Therefore a systematic literature review was performed.MethodsThe PICO design was used: (Patients) For which subclientel of patients with antiresorptive therapy (intervention) do dental implants have a benefit (control) compared to forgoing dental implants (outcome) in regards to oral rehabilitation and quality of life without having a substantial risk of BP-ONJ development? A PubMed search was performed including all studies dealing with this topic. Case reports and studies with less than 5 cases were excluded.ResultsThere is only very little data available, mostly retrospective case series. 50 articles were analyzed in detail. BP-ONJ can be triggered by dental implants and by dentures in patients with benign and malignant primary diseases. In most studies, analyzing osteoporosis patients only, no cases of BP-ONJ were observed in patients with implant therapy in the time span observed. There are no studies about implant therapy in patients with malignant diseases. Many case series analyzing the trigger factors for BP-ONJ describe dentures as one of the main causes. Perioperative antimicrobial prophylaxis has a benefit in the prevention of BP-ONJ development.ConclusionSuccessful implant therapy is possible in patients receiving antiresorptive therapy. The possibility of osteonecrosis development needs to be explained to the patient. An individual risk assessment is essential, taking the primary disease with the medication and further wound-healing-compromising diseases and medications into account. If possible, bone augmentations should be avoided, and a perioperative antimicrobiological prophylaxis is strongly recommended in these patients.

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Section: Resultsmentioning

confidence: 99%

Dental implants in patients treated with antiresorptive medication – a systematic literature review

et al. 2016

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“…Treatment for lower stages should be conservative as possible. For advanced stages or cases refractory to nonsurgical approach, surgical resection of the necrotic bone [56] should be performed, possibly granting a proper suture of margins and, according to good reported results, inserting PRP in the residual postsurgical wound. In any case, a try of nonsurgical treatment in every patient seems mandatory.…”

Section: Discussionmentioning

confidence: 99%

Platelet Rich Plasma in the Treatment of Bisphosphonate-Related Osteonecrosis of the Jaw: Personal Experience and Review of the Literature

Longo

Guida

Aversa

et al. 2014

International Journal of Dentistry

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Bisphosphonates (BPs) are a class of synthetic drugs commonly used to treat bone metastasis and various bone diseases that cause osseous fragility (such as osteoporosis). Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a common complication in patients who received BPs, especially intravenously. Recently, osteonecrosis of the jaw (ONJ) caused by chemotherapeutic not belonging to BPs drug class has been reported. For this reason, it has been proposed recently to rename BRONJ in antiresorptive agents related osteonecrosis of the jaw (ARONJ), to include a wider spectrum of drugs that may cause osteonecrosis of the jaw. The most debated topic about ARONJ/BRONJ is therapy. The most adequate procedure is far from being standardized and prevention seems to play a pivotal role. In our study, we considered 72 patients with BRONJ with nonsurgical therapy, surgical therapy, and surgical therapy with platelet rich plasma (PRP) gel to evaluate its therapeutic effect in promoting ONJ wounds healing. Good results showed by PRP in improving wound healing give away to case-control randomized studies that could give definitive evidence of its effectiveness.

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“…17,27,44,49,68,69,72,73,76,78,89,90,94,[100][101][102][104][105][106][107]110,113,[116][117][118]123,[125][126][127][128][129][130][131][132][133][134][135][136]139,141,144,150,152,154 Major surgical intervention was reported in 22 publications, 17,44,68,92,100,103,106,115,…”

Section: Management Of Osteonecrosis Of the Jawmentioning

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

294

213

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The outcomes of conservative and surgical treatment of stage 2 bisphosphonate-related osteonecrosis of the jaws: a case series

Cited by 28 publications

References 30 publications

Dental implants in patients treated with antiresorptive medication – a systematic literature review

Dental implants in patients treated with antiresorptive medication – a systematic literature review

Platelet Rich Plasma in the Treatment of Bisphosphonate-Related Osteonecrosis of the Jaw: Personal Experience and Review of the Literature

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

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