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VOLUME 9 , ISSUE 1 ( January-June, 2018 ) > List of Articles

REVIEW ARTICLE

Etiology and Treatment of Bisphosphonate-related Osteonecrosis of the Jaw

Antonio crispino

Keywords : Bisphosphonates, Jaw, Osteonecrosis

Citation Information : crispino A. Etiology and Treatment of Bisphosphonate-related Osteonecrosis of the Jaw. J Health Sci Res 2018; 9 (1):11-14.

DOI: 10.5005/jp-journals-10042-1060

License: CC BY-ND 3.0

Published Online: 01-06-2018

Copyright Statement:  Copyright © 2018; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a severe adverse drug reaction, consisting of progressive bone destruction in the maxillofacial region of patients. Dental screening and adequate treatment are fundamental to reducing the risk of osteonecrosis in patients under antiresorptive or antiangiogenic therapy, or before initiating the administration. The treatment of BRONJ is generally difficult and the optimal therapy strategy is still to be established. This article elucidates the clinical indications and mechanism of action of bisphosphonates (BPs), reports some of the clinical diagnostic criteria for BRONJ, and describes the histopathological criteria for BRONJ diagnosis, the potential triggering pathways, and the available treatment strategies.


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  1. Auluck A. How do I manage a patient with biphosphonaterelated osteonecrosis of the jaw (BRONJ). J Can Dent Assoc 2016 May;82:g10.
  2. Khosla S, Burr D, Cauley J, Dempster DW, Ebeling PR, Felsenberg D, Gagel RF, Gilsanz V, Guise T, Koka S, et al. Bisphosphonate-associated osteonecrosis of the jaw: report of a task force of the American Society for Bone and Mineral Research. J Bone Miner Res 2007 Oct;22(10):1479-1491.
  3. Khan AA, Sándor GK, Dore E, Morrison AD, Alsahli M, Amin F, Peters E, Hanley DA, Chaudry SR, Dempster DW, et al. Canadian consensus practice guidelines for bisphosphonate associated osteonecrosis of the jaw. J Rheumatol 2008 Jul;35(7):1391-1397.
  4. Morrison A, Khan A, Tetradis S, Peters E. Osteonecrosis of the jaw: an update for dentists. J Can Dent Assoc 2015 Nov; 81:f19.
  5. Khan AA, Morrison A, Hanley DA, Felsenberg D, McCauley LK, O'Ryan F, Reid IR, Ruggiero S, Taguchi A, Tetradis S, et al. Diagnosis and management of osteonecrosis of the jaw: a systematic review and international consensus. J Bone Miner Res 2015 Jan;30(1):3-23.
  6. Ruggiero SL, Dodson TB, Assael LA, Landesberg R, Marx RE, Mehrotra B; American Association of Oral and Maxillofacial Surgeons. American Association of Oral and Maxillofacial Surgeons position paper on bisphosphonate-related osteonecrosis of the jaw—2009 update. J Oral Maxillofac Surg 2009 May;67(5 Suppl):2-12.
  7. Marx RE. Pamidronate (Aredia) and zoledronate (Zometa) induced avascular necrosis of the jaws: a growing epidemic. J Oral Maxillofac Surg 2003 Sep;61(9):1115-1117.
  8. Ruggiero SL, Mehrotra B, Rosenberg TJ, Engroff SL. Osteonecrosis of the jaws associated with the use of bisphosphonates: a review of 63 cases. J Oral Maxillofac Surg 2004 May;62(5):527-534.
  9. Aghaloo TL, Felsenfeld AL, Tetradis S. Osteonecrosis of the jaw in a patient on Denosumab. J Oral Maxillofac Surg 2010 May;68(5):959-963.
  10. Peters E, Lovas GL, Wysocki GP. Lingual mandibular sequestration and ulceration. Oral Surg Oral Med Oral Pathol 1993 Jun;75(6):739-743.
  11. Scully C. Oral ulceration: a new unusual complication. Br Dent J 2002 Feb;192(3):139-140.
  12. Sonnier KE, Horning GM. Spontaneous bony exposure: a report of 4 cases of idiopathic exposure and sequestration of alveolar bone. J Periodontol 1997 Aug;68(8):758-762.
  13. Kassolis JD, Scheper M, Jham, Reynolds MA. Histopathologic findings in bone from edentulous alveolar ridges: a role in osteonecrosis of the jaws? Bone 2010 Jul;47(1):127-130.
  14. Ruggiero SL, Fantasia J, Carlson E. Bisphosphonate-related osteonecrosis of the jaw: background and guidelines for diagnosis, staging and management. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006 Oct;102(4):433-441.
  15. Khan AA, Rios LP, Sandor GK, Khan N, Peters E, Rahman MO, Clokie CM, Dore E, Dubois S. Bisphosphonate-associated osteonecrosis of the jaw in Ontario: a survey of oral and maxillofacial surgeons. J Rheumatol 2011 Jul;38(7):1396-1402.
  16. Etminan M, Aminzadeh K, Matthew IR, Brophy JM. Use of oral bisphosphonates and the risk of aseptic osteonecrosis: a nested case-control study. J Rheumatol 2008 Apr;35(4):691-695.
  17. Tennis P, Rothman KJ, Bohn RL, Tan H, Zavras A, Laskarides C, Calingaert B, Anthony MS. Incidence of osteonecrosis of the jaw among users of bisphosphonates with selected cancers or osteoporosis. Pharmacoepidemiol Drug Saf 2012 Aug;21(8):810-817.
  18. Christodoulou C, Pervena A, Klouvas G, Galani E, Falagas ME, Tsakalos G, Visvikis A, Nikolakopoulou A, Acholos V, Karapanagiotidis G, et al. Combination of bisphosphonates and antiangiogenic factors induces osteonecrosis of the jaw more frequently than bisphosphonates alone. Oncology 2009 Feb;76(3):209-211.
  19. Allen MR. Animal models of osteonecrosis of the jaw. J Musculoskelet Neuronal Interact 2007 Oct-Dec;7(4): 358-360.
  20. Allen MR. Bisphosphonates and osteonecrosis of the jaw: moving from the bedside to the bench. Cells Tissues Organs 2009;189(1-4):289-294.
  21. Saad F, Brown JE, Van PC, Ibrahim T, Stemmer SM, Stopeck AT, Diel IJ, Takahashi S, Shore N, Henry DH, et al. Incidence, risk factors, and outcomes of osteonecrosis of the jaw: integrated analysis from three blinded active-controlled phase III trials in cancer patients with bone metastases. Ann Oncol 2012 May;23(5):1341-1347.
  22. Fournier P, Boissier S, Filleur S, Guglielmi J, Cabon F, Colombel M, Clezardin P. Bisphosphonates inhibit angiogenesis in vitro and testosterone-stimulated vascular regrowth in the ventral prostate in castrated rats. Cancer Res 2002 Nov;62(22):6538-6544.
  23. Santini D, Vincenzi B, Dicuonzo G, Avvisati G, Massacesi C, Battistoni F, Gavasci M, Rocci L, Tirindelli MC, Altomare V, et al. Zoledronic acid induces significant and long-lasting modifications of circulating angiogenic factors in cancer patients. Clin Cancer Res 2003 Aug;9(8):2893-2897.
  24. Kumar V, Sinha RK. Bisphosphonate related osteonecrosis of the jaw: an update. Maxillofac Oral Surg 2014 Dec;13(4): 386-393.
  25. Ficarra G, Beninati F. Bisphosphonates-related osteonecrosis of the jaws: an update on clinical, pathological and management aspects. Head Neck Pathol 2007 Dec;1(2):132-140.
  26. Aas JA, Reime L, Pedersen K, Eribe ERK, Abesha-Belay E, Store G, Olsen I. Osteoradionecrosis contains a wide variety of cultivable and non-cultivable bacteria. J Oral Microbiol 2010 Jul;2:5072.
  27. Stockmann P, Wehrhan F, Furlan SS, Stelzle F, Trabert S, Neukam FW, Nkenke E. Increased human defensine levels hint at an inflammatory etiology of Bisphosphonate-associated osteonecrosis of the jaws: an immunohistological study. J Transl Med 2011 Aug;9:135.
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