Tomographic study of Jaw bone changes in patients with bisphosphonate-related osteonecrosis

Simpione, Guilherme; Caldas, Rogério Jardim; Soares, Mariana Quirino Silveira; Rubira-Bullen, Izabel Regina Fischer; Santos, Paulo S.

doi:10.4317/jced.56265

Cited by 4 publications

(4 citation statements)

References 23 publications

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“…In a study by Kizub et al (2021), of the 57 analyzed MRONJ cases, 42 (73.7%) happened in the mandible. This prevalence was also found in the studies by Simpione et al (2020) and Shin and Kim (2018), with percentages of 52.4% and 65.4%, respectively.…”

Section: Risk Factors Associated With Mronjsupporting

confidence: 75%

“…By using a CBCT, the DDS can observe bone changes common in MRONJ lesions. According to Simpione et al (2020) and Kim et al (2020), the most frequent alterations are bony sequestrum, bone exposure, and osteosclerosis. In the study by Ogura et al (2021), in addition to CBCT images, histopathology was also used to identify the main microscopic features of MRONJ, including necrotic bone, granulation tissue surrounded by bone and inflammatory cells; osteoclasts are rarely found around the necrotic bone, but were seen on its surface, in contact with the granulation tissue.…”

Section: Discussionmentioning

confidence: 99%

“…The DDS can also use imaging exams to diagnose MRONJ. The use of CT scans allows a better analysis of the lesions and their characteristics, assists in the understanding of the disease, and in the process of choosing the appropriate treatment (Ruggiero et al, 2022;Simpione et al, 2020). In the study by Simpione et al (2020), the most present consequences of MRONJ lesions were bony sequestrum (52.4%), bone exposure (42.9%), and osteosclerosis (28.6%).…”

Section: Diagnosis Treatment and Preventionmentioning

confidence: 99%

“…The use of CT scans allows a better analysis of the lesions and their characteristics, assists in the understanding of the disease, and in the process of choosing the appropriate treatment (Ruggiero et al, 2022;Simpione et al, 2020). In the study by Simpione et al (2020), the most present consequences of MRONJ lesions were bony sequestrum (52.4%), bone exposure (42.9%), and osteosclerosis (28.6%). The authors also observed some changes in the bone in the regions where there were no lesions, such as widened periodontal ligament space (33.3%), alterations in the maxillary sinus (23.8%), and cortical bone thickness of the mandibular canal (19%), suggesting that the use of antiresorptive drugs may cause some changes resulting from alterations in osteoclastic activity.…”

Section: Diagnosis Treatment and Preventionmentioning

confidence: 99%

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Medication-related osteonecrosis of the jaw and the role of the doctor of dental surgery: a literature review

Cabral

Santiago

Silva

et al. 2023

RSD

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Introduction: Medication-related Osteonecrosis of the Jaw (MRONJ) is a condition that may affect patients undergoing oral surgery procedures that use antiresorptive drugs. It is essential that the Doctor of Dental Surgery (DDS) is familiar with the pathology and how to diagnose, prevent and approach it. Objectives: To perform a literature review on MRONJ and to guide the DDS on how to manage the affected patients. Methodology: a systematized search was conducted on the PubMed virtual database using the terms: "diphosphonates", "dentist's practice pattern", "dentists", "dentist's role" and "Bisphosphonate-Associated Osteonecrosis of the Jaw". 29 articles in English, published in the last 5 years, were included. Results and discussion: MRONJ is characterized by exposed and necrotic bone that persists for more than 8 weeks and happens in patients taking antiresorptive agents. It is multifactorial and its severity depends on the dosage, route of administration, and treatment duration. Its management must be multidisciplinary to improve the patient's quality of life. The DDS must focus on prevention. Every patient should have their oral health evaluated before starting antiresorptive therapy and be informed of its risks and benefits. Most DDSs do not feel confident to adequately manage these cases, even though information on MRONJ is more widespread among younger DDSs and recent graduates. Conclusion: MRONJ is a harmful condition for the patient and it is the DDS's responsibility to know how to treat and prevent it, by having adequate knowledge of this pathology and making decisions based on the latest scientific evidence.

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Section: Risk Factors Associated With Mronjsupporting

confidence: 75%